1.Objectives
The action sites of diuretics. The pharmacological effects,
clinical uses and untoward effects of furosemide, thiazides,
triamterene, mannitol, etc.
2.Teaching content
(1)The concept of diuretics. Review urinary physiological
process, glomerular filtration, reabsorption and secretion
of tubes and function of collective tubes. The importance
of diuretics in treatment of edema, hypertension and congestive
heart failure. The classification of diuretics depending
on the action sites.
(2)High efficacy diuretics (loop diuretics): furosemide
and bumetamide, pharmacological effects, characteristics:
high efficacy fast onset. Inhibition of Na+-K+-2Cl- cotransport
system in the thick ascending limb of loop of Henle in
medulla and cortex, inhibition of Cl- active reabsorption
and Na+ passive reabsorption. Inhibit concentrating and
diluting function of kidneys. Clinical uses: used to treat
severe edema, acute pulmonary edema and cerebral edema,
renal failure. and untoward effects.
(3)Moderate efficacy diuretics (thiazides or thiazide-like
diuretics): primary site of action is at the distal convoluted
tubule, inhibiting Na+-Cl- cotransport. Hydrochlorothiazide,
pharmacological effects, clinical uses and untoward effects.
Comparison of the same kind of drugs.
(4)Low efficacy diuretics (potassium-sparing diuretics):
triamterence, amiloride: pharmacological characteristic,
clinical uses and untoward effects.
(5)Osmotic diutetics: concepts, dehydration effects of
mannitol, sorbitol and hypertonic glucose. Clinical uses
and side effects.
(6)Chinese herbal medicine: diuresis of tuckahoe, agaric,
plantago.
Teaching hours: 3
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