# Chapter Fifteen: Clinical Use of Diuretics, part 1

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Text version: https://stenobird.com/podcast/channel-your-enthusiasm-1374325/chapter-fifteen-clinical-use-of-diuretics-part-1.md
Podcast: [Channel Your Enthusiasm](https://stenobird.com/podcast/channel-your-enthusiasm-1374325)
Published: 2024-05-13T23:18:12+00:00
Episode link: http://www.rosebook.club/episodes/2024/5/10/chapter-fifteen-part-1
Audio file: https://chrt.fm/track/47G747/static1.squarespace.com/static/548bc7f6e4b0a269c594ebc2/t/6643d81125a37504af54a6b4/1723815734958/Chapter+15+part+1+Diuretics+fixed.mp3
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Duration seconds: 7256

## Resource

Outline Chapter 15 — Clinical Use of Diuretics - Among most commonly used drugs - Block NaCl reabsorption at different sites along the nephron - The ability to induce negative balance has made them useful in multiple diseases - Edematous states - Hypertension - Mechanism of action - Three major classes - Loop - NaK2Cl - Up to 25% of filtered sodium excreted - Thiazide - NCC - Up to 3-5% of filtered sodium excreted - Potassium sparing - ENaC - Up to 1-2% of filtered sodium excreted - Each segment has a unique sodium channel to allow tubular sodium to flow down a concentration gradient into the cell - Table 15-1 is interesting - Most of the sodium 55-655 is reabsorbed in the proximal tubule - Proximal diuretics would be highly effective if it wasn’t for the loop and other distal sites of Na absorption - Loop Diuretics - Furosemide - Bumetanide - Torsemide - Ethacrynic acid - NaK2Cl activated when all four sites are occupied - Loop diuretic fits into the chloride slot - In addition to blocking Na reabsorption results in parallel decrease in calcium resorption - Increase in stones and nephro albinos is especially premature infants which can increase calcium excretion 10-fold - Thiazide - Even though they are less potent than loops they are great for hypertension - “Not a problem in uncomplicated hypertension where marked fluid loss is neither necessary nor desirable” - Some chlorothiazide and metolazone also inhibit carbonic anhydrase in the proximal tubule - Increase Calcium absorption. Mentions that potassium sparing diuretics do this also - Potassium sparing diuretics - Amiloride - Spironolactone - Triamterene - Act at principal cells in the cortical collecting tubule, - Block aldosterone sensitive Na channels. - Discusses the difference between amiloride and triamteren…

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