Question
Classify Diuretics. Briefly describe Frusemide. (4+4)
Q5 8 marks Short Essays ★ ✓
Answer
a) Classification of diuretics (by site of action)
Site Class Examples Proximal convoluted tubule Carbonic anhydrase inhibitors Acetazolamide Thick ascending limb High-ceiling (loop) diuretics Furosemide, Bumetanide Distal convoluted tubule Thiazides Hydrochlorothiazide, Chlorthalidone Collecting duct Potassium-sparing Spironolactone, Amiloride Throughout the nephron Osmotic diuretics Mannitol
b) Frusemide (Furosemide)
A high-efficacy loop diuretic. MOA : inhibits the Na⁺-K⁺-2Cl⁻ (NKCC2) cotransporter in the thick ascending limb of the loop of Henle, blocking reabsorption of Na⁺, K⁺, and Cl⁻, producing marked natriuresis and diuresis — abolishes the medullary concentration gradient, so both dilution and concentration of urine are impaired. Uses : acute pulmonary edema/heart failure, edema of cardiac/hepatic/renal origin, hypertensive emergencies (adjunct), hyperkalemia/hypercalcemia, acute renal failure to maintain urine output. Adverse effects : hypokalemia, hyponatremia, hypochloremic metabolic alkalosis, ototoxicity (especially with rapid IV administration), hyperuricemia, hypovolemia/hypotension.
1 Antihypertensives
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