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Drugs & Medication


Aldosterone antagonists | Loop diuretics | Osmotic diuretics - Sorbitol | Potassium-sparing diuretics | Thiazides

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A diuretic (colloquially called a water pill) is any drug or herb that elevates the rate of bodily urine excretion (diuresis). Diuretics also decrease the extracellular fluid (ECF) volume, and are primarily used to produce a negative extracellular fluid balance. Caffeine, cranberry juice and alcohol are all weak diuretics.


In medicine, diuretics are used to treat heart failure, liver cirrhosis, hypertension and certain kidney diseases. Diuretics alleviate the symptoms of these diseases by causing sodium and water loss through the urine. As urine is produced by the kidney, sodium and water which cause edema related to the disease move into the blood to replace the volume lost as urine, thereby reducing the pathological edema. Some diuretics, such as acetazolamide, help to make the urine more alkaline and are helpful in increasing excretion of substances such as aspirin in cases of overdose or poisoning.

The antihypertensive actions of some diuretics (thiazides and loop diuretics in particular) are independent of their diuretic effect. That is, the reduction in blood pressure is not due to decreased blood volume resulting from increased urine production, but occurs through other mechanisms and at lower doses than that required to produce diuresis. Indapamide was specifically designed with this is mind, and has a larger therapeutic window for hypertension (without pronounced diuresis) than most other diuretics.

Mechanism of action

Classification of common diuretics and their mechanisms of action
Agent Group Examples Mechanism
- Ethanol, Water inhibits vasopressin secretion
Acidifying salts CaCl2, NH4Cl  
Arginine vasopressin
receptor 2 antagonists
amphotericin B, lithium citrate inhibit vasopressin's action on nephron's collecting duct
Carbonic anhydrase inhibitors acetazolamide, dorzolamide inhibit H+ secretion, resultant promotion of Na+ and K+ excretion
Loop diuretics bumetanide, ethacrynic acid, furosemide, torsemide inhibit the cotransporter in the medullary thick ascending limb of the loop of Henle
Osmotic diuretics glucose, mannitol promote osmotic diuresis
Potassium-sparing diuretics amiloride, spironolactone, triamterene inhibition within collecting ducts of Na+-K+ exchange: Spironolactone inhibits aldosterone action, Amiloride inhibits epithelial sodium channels
Thiazides bendroflumethiazide, hydrochlorothiazide inhibit Na+/Cl- reabsorption from nephrons' distal convoluted tubules
Xanthines caffeine, theophylline inhibit tubular reabsorption of Na+, increase glomerular filtration rate

Chemically, diuretics are a diverse group of compounds that either stimulate or inhibit various hormones that naturally occur in the body to regulate urine production by the kidneys.

Alcohol produces diuresis through modulation of the vasopressin system.

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