Diuretic - Mechanism of Action

Mechanism of Action

Classification of common diuretics and their mechanisms of action:

Examples Mechanism Location (numbered in distance along nephron)
ethanol, water inhibits vasopressin secretion 1.
Acidifying salts CaCl2, NH4Cl 1.
Arginine vasopressin
receptor 2 antagonists
amphotericin B, lithium citrate inhibit vasopressin's action 5. collecting duct
Aquaretics Goldenrod, Juniper Increases blood flow in kidneys 1.
Na-H exchanger antagonists dopamine promote Na+ excretion 2. proximal tubule
Carbonic anhydrase inhibitors acetazolamide, dorzolamide inhibit H+ secretion, resultant promotion of Na+ and K+ excretion 2: proximal tubule
Loop diuretics bumetanide, ethacrynic acid, furosemide, torsemide inhibit the Na-K-2Cl symporter 3. medullary thick ascending limb
Osmotic diuretics glucose (especially in uncontrolled diabetes), mannitol promote osmotic diuresis 2. proximal tubule, descending limb
Potassium-sparing diuretics amiloride, spironolactone, triamterene, potassium canrenoate. inhibition of Na+/K+ exchanger: Spironolactone inhibits aldosterone action, Amiloride inhibits epithelial sodium channels 5. cortical collecting ducts
Thiazides bendroflumethiazide, hydrochlorothiazide inhibit reabsorption by Na+/Cl- symporter 4. distal convoluted tubules
Xanthines caffeine, theophylline, theobromine inhibit reabsorption of Na+, increase glomerular filtration rate 1. tubules

Chemically, diuretics are a diverse group of compounds that either stimulate or inhibit various hormones that naturally occur in the body to regulate urine production by the kidneys. Herbal medications are not inherently diuretics. They are more correctly called aquaretics.

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