Page 70 - pharma 1 theoretical updated MNU_Neat

Clinical pharmacy 2024/2025 Level 3 Pharm D Pharmacology 1 (PO 502)

 Loop diuretics (high ceiling diuretics)
ex: Bumetanide, Ethacrynic acid, Furosemide, acid and Torsemide

➢ Most effective (efficient) diuretics
Adv. /selection ➢ Act properly even if patients with poor renal function or not

respond to thiazides or other drugs.

+
+
-
❖ Inhibit cotransport of Na K / cl in luminal membrane in
MOA ascending loop of Henle ➔ ↓ reabsorption
++
✓ ↓renal vascular resistance & ↑ renal blood flow, ↑Ca content
of urine ➔ preferred in patient with renal calculi

➢ Diuretics not only used in ttt in hypertension

Effect • ↓ plasma volume ➔  COP ➔  B.P.
• Differ from thiazide in promoting Ca excretion. (differ from
++
thiazides) suitable for patients who are predisposed for stones

1- Hypokalemia ➔ Metabolic alkalosis.
2- Hypocalcemia & hypomagnesemia.
3-  blood glucose & uric acid levels (as thiazide).
4- Ototoxicity: hearing can be affected in loop diuretics particularly

when used conjugated with aminoglycosides antibiotic (affect

S/E Cochlea)
 Permanent damage may result with continuous treatment.
✓ Ethacrynic acid is the most likely ➔ cause deafness, vestibular
function is disturbed but may be affected with combined antibiotic.
(Vestibular center responsible for balance)

5- Hypersensitivity reactions (in sulfonamide loop diuretics).

| P a g e - 54 -