Type and Name

Where

Used for

Side effects

PCT and LOH

Trauma with risk of brain swelling, promote diuresis in drug intoxication, acute renal failure, edema, ascites

Hypo AND hyper-natremia, dehydration, headache, pulmonary edema in patients with poor CV reserve

PCT

Glaucoma, edema, acute mountain sickness, epilepsy

Metabolic acidosis, sulfonamide related allergies, bone marrow depression, skin toxicity

Na-K-2Cl symport inhibitor

Furosemide

Ethacrinic acid

(don’t give to infants, good for those with sulfa allergies)

Thick ascending limb of LOH

High ceiling diuretics

All possible edemas, including those associated with hepatic and kidney problems, hypertension

Acute pulmonary edema, edema

Hypo…Na, K, Ca, Mg

Increased LDL, decreased HDL

Ototoxicity

Hemoconcentration

Dehydration, dermatitis

Allergy (sulfa)

Nephritis

Gout (hyperurecimia)

!

Drug interactions:

Synergism with thiazides and spironolactone

Assume all other combinations are bad:

• Potentiates digitalis, anticoagulants, propranolol

• NSAIDs antagonize it

• Sulfonylureas promote hyperglycemia

DCT

Not a high-ceiling effect

CHF, hepatic cirrhosis, edema due to renal dysfunction causes, hypertension

Hypo…Na, K, Mg

Hypercalcemia

Hypotension, metabolic alcalosis, hyperuricemia, allergy as to sulfa drugs, hypotension, volume depletion, impotence

Drug interactions:

• Potentiate digitalis (and corticosteroids worsen hypokalemia)

• Decreased glucose tolerance

• Antagonize uricosurics

• NSAIDs antagonize it

K+ sparing diuretics, renal epithelial Na channels inhibitors

Triamterene

Amiloride

Late DCT and collecting duct

All possible edemas

CHF edema

Triamterene only: Anaphylaxis, photosensitivity, thrombocytopenia, megaloblastic anemia

Both: hyperkalemia, contraindicated are K supplements, headache, dizziness, leg cramps

Aldosterone antagonists

Spironolactone

Late DCT and collecting duct

Hyperaldosteronism, edema, hypertension, hypokalemia

Hyperkalemia, all the steroid side effects

Drug interactions: used synergistically with loop and thiazide diuretics