Renal Pharmacology—High-Yield For INI-CET
May 7, 2025
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Renal Diuretics
Classes of Diuretics
Some Other Miscellaneous Diuretics
Mechanism of Action
Drugs
Uses of Acetazolamide Like Drugs
Loop Diuretics
Drugs Under Loop Diuretics
Thiazides
K+ Sparing Diuretics
Summary Of Diuretics
Renal Adh
Vasopressin Agonists
Renal Diuretics
- Diuretics: Increase urine volume—measured as urinary flow rate
- Increase Na+ excretion in urine: Drugs—Natriuretics
- Increased water excretion through urine: Drugs—Aquaretics
Classes of Diuretics
Types Mechanism Action Carbonic anhydrase inhibitors
- Acetazolamide PCT of nephron and inhibit carbonic anhydrase enzyme Na+/HCO3- excretion in urine Osmotic diuretics
- MannitolActs on descending limb of Henle/loop of Henle Inhibit reabsorption of water Loop diuretics
- FurosemideNa+K2+Cl- transporter inhibitors Acts on the medullary portion of the thick ascending limb Thiazide diuretics
- ChlorothiazideInhibition of Na+Cl- symporter Cortical portion of thick ascending limb + early part of DCT K+ sparing diuretics
- Spironolactone Inhibit the action of aldosterone Late part of DCT and the cortical portion of the collecting duct Maximum sodium loss Loop diuretics > Thiazides > Osmotic diuretics > Carbonic anhydrase inhibitors> K+ sparing diuretics Maximum potassium loss Carbonic anhydrase inhibitors > Thiazides > Loop diuretics > Osmotic diuretics - Na+ absorption is inhibited in the proximal part of the nephron
Some Other Miscellaneous Diuretics
Theophylline and caffeine:
- Drug used in asthma – Theophylline
- Drug used in migraine – Caffeine
- Causes blockage of adenosine A1 receptor on nephron
Natriuretic peptides:
Includes
- Atrial Natriuretic peptides
- Brain Natriuretic peptides (Nesiritide – Used in heart failure)
- Act on enzyme linked receptors on nephron. Attach to guanylyl cyclase and increase CGMP leading to sodium loss in urine
SGLT-2 Inhibitors
- Recommended in diabetes mellitus
- Inhibit sodium glucose transporter in nephron
- Na+ loss + Glycosuria
- Drugs ends with the word - flozin
- Canagliflozin
- Empagliflozin
- Dapagliflozin
Mechanism of Action
- Act on the PCT of nephron
- Inhibits carbonic anhydrase enzyme
- Na+/HCO3 - excretion in urine
Drugs
- Acetazolamide
- Methazolamide
- Dichlorphenamide
- Derivatives of antibiotics—sulfonamide (causes severe allergic reactions)
- Acetazolamide like drugs are contraindicated in sulfa allergy
- These drugs are competitive and irreversible inhibitor
- Except acetazolamide—a noncompetitive and reversible inhibitor of carbonic anhydrase enzyme
- Topical eye drops—recommended in glaucoma
- Brinzolamide
- Dorzolamide
Also read: Microbiology Image Based Questions for NEET PG 2025
Uses of Acetazolamide Like Drugs
Mnemonic GAME Plan
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Action |
Uses |
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G- Glaucoma |
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Eye drops of Brinzolamide, Dorzolamide
IV drugs- Acetazolamide
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A- Alkalinization of urine |
Side effects
Treatment
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M- Metabolic acidosis in blood |
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E- Epilepsy |
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P- Periodic muscle paralysis |
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Loop Diuretics
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MOA-1 |
MOA-2 |
MOA-3 |
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Thick ascending limb ↓ Reabsorption of sodium ↓ Increase the osmolarity of medulla ↓ Reabsorption of water into the medulla |
Prostaglandin ↓ Dilated the blood vessels in nephrons of kidneys ↓ Increase in blood supply ↓ Increase in GFR ↓ Increased urine production |
Drugs Under Loop Diuretics
- Mercury Containing → MERSALYL
- Phenoxy-acetic Acid → Ethacrynic acid
- Sulfa Containing → Furosemide (Frusemide)
Bumetanide: Most potent
Toresamide: longest acting
Also read: Pharmacology Image Based Questions for NEET PG 2025
Adverse Effects of Loop Diuretics
Thiazides
Mechanism of action
- Acts on the cortical portion of the thick ascending limb and early part of DCT
- Other Name- Distal tubule
- Inhibit Na+Cl- symporter
K+ Sparing Diuretics
Mechanism of Action: Inhibits the action of aldosterone at the level of the collecting duct and late part of DCT
Summary Of Diuretics
Diuretics Blood Na+ K+ H+ Ca+ Mg+ Produce Carbonic anhydrase inhibitors ↓ ↓ ↑ ↓ ↓ Hypokalemic metabolic acidosis Loop diuretics ↓ ↓ ↓ ↓ ↓ Hypokalemic metabolic alkalosis Thiazides ↓ ↓ ↓ ↑ ↓ K+ sparing ↓ ↑ ↑ ↑ ↑ Hyperkalemic metabolic acidosis Osmotic ↓ ↓ ↓ ↓ ↓ Hypokalemic metabolic alkalosis
Also read: Pathology Image Based Questions for NEET PG 2025
Renal Adh
Vasopressin Agonists
End with the word “PRESSIN”
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Properties |
Uses |
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Terlipressin |
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Felypressin |
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Desmopressin |
Side effect:
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