Question

In some conditions (such as high blood pressure or heart failure), medical staff deliberately stimulate diuresis in order to reduce fluid in the body. There are several types of diuretic drugs which can be used clinically, all of which act in different ways to induce diuresis. Pick one type of diuretic drug and describe:
• Its mechanism of action
• Under what circumstances this particular type of diuretic might be used

Answer 1

According to the efficacy diuretics are divided into 3 parts- 1)High ceiling diuretics

2) Medium efficacy diuretics - thiazides

3) Weak or adjunctive diuretics

High ceiling diuretics - most important high ceiling diuretic is furosemide.

The major site of action for these is thick ascending limb of Henle loop. They inhibit the Na+ -K+ - 2Cl- channel. Furosemide like drugs are secreted in PCT by organic anion transporter and acts through luminal side to inhibit the transporter in loop of Henle. Due to this inhibition more of ions are excreted and along this water also goes out, this leads to diuretic effect.

Most common indication for the use of high ceiling diuretics is edema ~ it can be used in edema irrespective of the etiology of edema ( hepatic, cardiac or renal)