Diuretic Drugs

In this article, we will discuss Diuretic Drugs (Part-I). So, let’s get started.

Diuretic Drugs

Acetazolamide It is carbonic anhydrase inhibitor. 5 mg/kg/day q 12 to 24 hr oral as diuretic and 20-100 mg/kg/day q 8 hr oral for hydrocephalus. Also useful in glaucoma and epilepsy (8–30 mg/kg/day).

Adult dose: 250-500 mg per day q 12-24 hr for edema or glaucoma; 8–30 mg/kg/day q 8 hr (maximum 1 g/day) in epilepsy.

Indication: Diuretic, closed angle glaucoma, antiepileptic, brain edema, high altitude sickness.

C/I: Sodium or potassium depletion, marked hepatic and renal dysfunction

Side Effects: Flushing, ataxia, confusion, allergic skin reaction, urticaria, fever, hypo- or hyperglycemia, hypokalemia, hyponatremia, metabolic acidosis, crystalluria, agranulocytosis, liver dysfunction.

(Diamox, zolamide, avva, acetamide tab 250 mg, avva SR, iopar SR cap 250 mg)

Amiloride As antihypertensive and heart failure (as adjunct): 0.4 to 0.625 mg/kg once daily.

Adults: 5–10 mg daily in 1-2 divided doses. Maximum up to 20 mg/day.

Side Effects: Hyperkalemia, dizziness, fatigue, headache, constipation/diarrhea, muscle cramps, cough.

C/I: Elevated serum potassium (>5.5 mEq/l), anuria, acute/chronic renal insufficiency, hepatic impairment.

(Available as combination – Tab biduret – L (hydrochlorthiazide 25 mg + amiloride 2.5 mg); tab biduret (hydrochlorthiazide 50 mg + amiloride 5 mg).

Bumetanide 0.01-0.02 mg/kg/dose oral, if needed may be repeated at intervals of 12 hr. Patients refractory to furosemide may respond to bumetanide. It is approximately 40 times more potent than furosemide.

Adult dose: 0.5-2.0 mg o.d. or every 12 hr up to maximum of 10 mg/d.

Side Effects: Muscle cramps, gynecomastia, leukopenia, thrombocytopenia.

C/I: Hepatic coma, anuria.

(Bumet, bumex, burinex tab 1 mg).

Chlorthalidone 1-2 mg/kg/day single dose oral for edema or hypertension.

Adult dose: 25 to 100 mg/day single dose daily or on alternate days.

C/I: Anuria.

(Thalizide 12.5 mg, hydrazide 25 mg; hythalton tab 100 mg).

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