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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 ?
Both JNC V (2) and the more current 1997 JNC VI (3) base their recommendations on good evidence from multiple prospective randomized trials that used diuretics or beta-blockers alone or in combination.
During controlled clinical trials, one investigation compared heart failure patients who were treated with both digoxin and diuretics to treatment with diuretics alone.
Meanwhile, however, studies in persons with isolated systolic hypertension (an increase in the upper of the two measurements used to define blood pressure) showed diuretics to be particularly effective in this condition seen more often in the elderly.
Patients receiving simple diuretic therapy excreted significant amounts of magnesium, but untreated patients, and those taking a potassium-sparing diuretic had minimal losses of magnesium.
In addition, diuretics drugs are also used in the treatment of these diseases (Carter, 2012).
During five years of follow-up, beta-blockers were prescribed to 915 patients, diuretics to 1 316, statins to 1 353 and calcium channel blockers to 1 171.
Doctors have long worried about patients' compliance with their loop diuretics because existing formulas-often inconveniently-encourage the body to pass more than a liter of fluid within four hours or less.
The most likely explanation for the short-term jump in risk of hip fracture may be related to the prominent urinary symptoms that often accompany a new prescription for loop diuretics.
You're right about thiazide diuretics being the first choice if you need to take a drug to bring high blood pressure under control.
The institute says that if lifestyle changes are not sufficient, diuretics then normally should be the drug of first choice.
Three of those tests involved diuretics and the others involved traces of other drugs.