Diuretics

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Diuretics

 

agents that increase the excretion of urine and decrease the amount of fluid in the tissues and serous cavities. Natriuretics increase the excretion of sodium ions. Diuretics are used primarily to treat edema accompanying cardiovascular, liver, and kidney diseases. Depending on their effect, they are classified as renal diuretics, which act directly on the kidneys and have the most pronounced effect, and extrarenal diuretics, which act indirectly through other systems in the body.

Renal diuretics act by blocking the kidney enzymes responsible for the transport of electrolytes, as well as by inhibiting reabsorption in the terminal tubules, which intensifies the excretion of sodium, chlorine, and potassium ions. Among the renal diuretics are the mercury compounds Mercusal and Novurit and carbonic anhydrase inhibitors such as Diacarb and dichlorphenamide (Daranid)—sulfonamide derivatives that intensify the excretion of bicarbonate, causing a drop in the alkaline reserve in the blood and, in some cases, acidosis. Benzothiadizine and sulfamoylanthranilic and dichlorophenoxyacetic acid derivatives such as dichlothiazide (Hypothiazide), furosemide (Lasix), and ethacrynic acid (Uregit) are extremely potent diuretics that sharply increase the excretion of sodium and have a hypotensive effect. Pyrimidine and pteridine derivatives, such as Allacyl and triamterene (pterofen), inhibit tubular reabsorption of sodium and chlorine ions but do not affect the excretion of potassium. Aldosterone antagonists, including spironolactone (Aldactone and Verospiron), increase the excretion of sodium and decrease the excretion of potassium and urea.

Depending on how they act, extrarenal diuretics are classified as osmotic and other types of agents. Among the osmotic agents are potassium acetate, mannitol, and urea, which are excreted by the kidneys and absorb water. They cause the excretion of sodium and chlorine in proportion to the increase in volume of urine and are used to lower intracranial pressure and reduce cerebral edema. Acid-forming diuretics include ammonium chloride and potassium chloride, which act by the transformation of cations. The ammonium ion is transformed into urea in the liver, the calcium ion settles in the intestine in the form of phosphate or carbonate, and chlorine ions occur in excess in the blood plasma and are excreted by the kidneys with sodium.

Extracts and tinctures are sometimes prepared for use as diuretics from bearberry leaf (tincture or decoction), field horsetail (decoction or fluid extract), and Orthosiphon leaf (tincture).

References in periodicals archive ?
The ESC presentation revealed that the perindopril + amlodipine treatment combination significantly reduced the risk of death by any cause (by 11%), cardiovascular death (by 24%), stroke (by 23%), total coronary events (by 13%), and new-onset diabetes (by 30%), compared with the atenolol + bendroflumethiazide combination.
They were randomized to antihypertensive therapy with the alpha-1 receptor blocker doxazosin or bendroflumethiazide.
The bendroflumethiazide group had increases in total cholesterol, triglycerides, and serum glucose at both time points.
ASCOT evaluated an amplodipine plus or minus perindopril based treatment regimen compared to an atenolol plus or minus bendroflumethiazide based regimen.
4 /PRNewswire-FirstCall/ -- CV Therapeutics announced today that patients in ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) receiving a treatment regimen of the calcium channel blocker amlodipine plus or minus the angiotensin converting enzyme (ACE) inhibitor perindopril experienced a significant reduction in major cardiovascular endpoints and in all-cause mortality compared to patients receiving a regimen of the beta blocker atenolol plus or minus the diuretic bendroflumethiazide, according to data presented today at the European Society of Cardiology Congress 2005 in Stockholm, Sweden, and published concurrently in The Lancet.
Over 900,000 of these are on atenolol or bendroflumethiazide monotherapy, and an additional 639,000 patients take the combination of the two.
Preliminary results released today from the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) showed that patients receiving a regimen of the calcium channel blocker amlodipine and the angiotensin converting enzyme (ACE) inhibitor perindopril experienced a significant reduction in major cardiovascular endpoints and in all-cause mortality compared to patients receiving a regimen of the beta blocker atenolol and the diuretic bendroflumethiazide.
Patients were randomized to receive either a treatment regimen of the beta blocker atenolol and the diuretic bendroflumethiazide or a treatment regimen of the calcium channel blocker amlodipine and the ACE inhibitor perindopril.
Data from the Anglo- Scandinavian Cardiac Outcomes Trial (ASCOT), evaluating the effectiveness of a treatment regimen with the calcium channel blocker amlodipine and the angiotensin converting enzyme (ACE) inhibitor perindopril compared to a treatment regimen with the beta blocker atenolol and the diuretic bendroflumethiazide in the reduction of cardiovascular events, will be presented as a late breaking clinical trial at the American College of Cardiology (ACC) Scientific Sessions 2005 on Tuesday, March 8 in Orlando, FL.
Patients were randomized to receive a treatment regimen of the beta blocker atenolol and the diuretic bendroflumethiazide or a treatment regimen of the calcium channel blocker amlodipine and the ACE inhibitor perindopril.
15 /PRNewswire/ -- The Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT), evaluating the effectiveness of a treatment regimen with the calcium channel blocker amlodipine and the angiotensin converting enzyme (ACE) inhibitor perindopril compared to a treatment regimen with the beta blocker atenolol and the diuretic bendroflumethiazide, has been stopped early by the ASCOT steering committee due to significant benefits observed in the amlodipine plus perindopril arm of the study, according to those conducting the study.