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The following article is from The Great Soviet Encyclopedia (1979). It might be outdated or ideologically biased.



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).

The Great Soviet Encyclopedia, 3rd Edition (1970-1979). © 2010 The Gale Group, Inc. All rights reserved.
References in periodicals archive ?
Hydrochlorothiazide (a thiazide diuretic) was the 12th most prescribed drug in the United States in 2018, and furosemide the 15th most prescribed.
Though, Thiazide diuretic is not primarily used to treat osteoporosis, further researches should be conducted to weigh the risk and benefits of Thiazide diuretic use among hypertensive patients with osteoporosis, and to compare Thiazide with other bone mineralizing agents thus one medication can be used for patients with hypertension and osteoporosis which would also help in increasing the compliance rate.
Blood pressure lowering medication are available at the SUS, freely distributed, and a list of drugs include thiazide diuretic, beta-blocker, ACE inhibitor, and an angiotensin receptor blocker (ARB).
Loop diuretics ( HR , 1.05; 95% CI , 0.61–1.80; and adjusted HR , 1.11; 95% CI , 0.64–1.93), thiazide diuretics ( HR , 0.94; 95% CI , 0.63–1.38; and adjusted HR , 0.97; 95% CI , 0.65–1.44), beta-blockers ( HR , 0.70; 95% CI , 0.49–1.01; and adjusted HR , 0.77; 95% CI , 0.52–1.12), and ARBs ( HR , 0.89; 95% CI , 0.63–1.26; and adjusted HR , 0.89; 95% CI , 0.63–1.27) were not associated with the risk of NOF development from crude HR to adjusted HR [ P > 0.05, [Table 2].{Table 2}
All these guidelines recommend use of thiazide diuretics as the drug of first choice in patients of Stage 1 hypertension without any compelling indications.
Thiazide diuretics (e.g., hydrochlorothiazide [Microzide[R], Esidrix[R]], chlorothiazide [Diuril[R]], indapamide [Lozol[R]], chlorthalidone [Thalitone[R]]) lower blood volume by interfering with the absorption of sodium ions in the distal renal tubular segment of nephrons.
Starting therapy with a thiazide diuretic, angiotensin-converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), or calcium channel blocker (CCB)--all of which have high-quality evidence of improved outcomes (18-20)--is recommended for most patients, including those with diabetes.
More than two-thirds of older adults have high blood pressure in the United States and thiazide diuretics are often recommended as the initial medication for these hypertensive patients.
Long term evaluation of combined antihypertensive therapy with lisinopril and a thiazide diuretic in patients with essential hypertension.
Angiotensin-converting enzyme inhibitors (ACEI) are the most used drug class for arterial hypertension (63.5%), followed by thiazide diuretics (54.9%) and beta blockers (27.7%).
If a calcium channel blocker is not tolerated as second line, consider using thiazide diuretics. Afro-Caribbean patients who are already on calcium channel blockers, add in an ARB, rather than an ACE inhibitor (3).
In a new study, when older adults used thiazide diuretics during the first nine months, the incidence of hyponatremia (low sodium levels), hypokalemia (low potassium levels), or a decline in renal function increased.