Notes MOA Use ADE Contra-indication

Pharmaco-kinetic

Diureticsincreaseloss of H20 and Na + in urineenhance excretion of salt(mainly na) including k+,mg2+,ca2+

Dose 20-80mg daily ,3-6 hrs (LASIX)

Frusemide(F)- the inhibitors of Na+K+2Cl-symport bind to Na+K+2Cl- cotranspoerter in thick ascending limb and block fn,bringing salt transport virtual stand still.Also inhib ca+,mg+ reabs in ascend limb byabolishintransepithelialpotential difference

-To relieve odema-cardiac,hepatic and renal-Congestive heart failure- red work load-Hypertension-Kidney stones-Poisoning-like barbiturates& salicylates

Hypokalemia(-sd plasmalvlof k+)Fluid-electrolyte imbalNausea,vomitingAnorexiaFatigue, weaknessHyperuricemiaHearing impairment,deafness

musclecramp

(interaction)Anticoagulants - activity+sed-AG antibiotics –f +ces potential for ototoxicity- Cisplatin – same as AG

Rapidly abs orally but bio 60%,Extens bound to plasma protein(PP) & secreted rapidly by organic acid transpot sys of prox renal tubule,Onset action –oral,within 60mins iv- 5minT1/2- 2hr,Duration 6-8 hr oral

The term symport is used to denote an integral membrane protein that simultaneouly transports two substances across membrane in the same direction.

Spiranlolactone (S)- aldosterone antagonist

Cause diuresis byacting as competitive antag of aldosterone cause Na excretion & K+ retention

-Odema due to CHF, hepatic and renal-hypertension-hypokalemia-Rx of hirutismCirrhosis ofliver

Nausea,vomEpigastric diseaseSkin rashDrowsinessAtaxia

ConfusionHirsutism(is the excessive hairiness on women in those parts of the body)

After oral drug signific metabolised in first pass(liver)-extensively bound to PP. metabolite of Sactive

Anti diuretics (ADH)/Vasopressin - -se urine output

Dose: diab insipidus 5-20 units IM inj evry 4 hrVariceal bleeding 20 u over15min for intial control of oesophageal v. bleeding

D. insipidusPolyuriaPolydipsiaBedwetting in children & nocturia in adult-Heamophilia-Bleeding oesophageal varices

NauseaBelching Abd crampsHypersensitivityConstrictn of coronary arterySweatingDrowsiness

-Pregnancy,- breast feeding, -Elderly patients,- Vascular disease (coron artery disease)-Chronic nephritis

Urinary antisepticsUTI is common distresiing & lifethreatening condn.Infection may

Antimicrobial drugNitrofuranation-Synthetic , bacteriostatic but cidal in higher concen

-Acute cystitis- UTI-pyelitis(nflammation of the renal pelvis)-PyelonephritisPost –operatve

Nausea, vomitDiarrhoeaAnorexiaArthralgiaFeverAnaphylaxisDizziness

In neonates, anuriaOr impaired reanal fn.pregnancy

Oral admin rapidlyand completely abs from Git

extend part or through out UT. Clin feactures,diag,Rx,complications & longterm significance vary dep on site of infn.Dose:Trimethoprim 200mg twice daily for3-5 days in acutecystitis

Activity enhanced by lowr pH. Active largely against E coli, enterococciDose: 50-100mg 6 hrly with mealsMax 400mg

infn of UTi-

HeadacheInterstitial pulmonary fibrosis - in chronictreatment

Urinary Acidifiers- Methionine

Dosage:Control diaper rash-childrn- 75 mg in formula or othr liq 3-4 times fr 3-5 daysAdults: control of odor in incontinent adults: 200- 400mg3-4 times dayD Forms-Capsule500mg, tab 500 mg

-Rx of diaper rash & control of odor-Dermatitis-Ulceration caused by ammmoniacal urine

Urinary alkalanizers-Pottasiom citratePC metabolized to pott bicarbonate and act as systemic alkaliser

Citrate forms ionic complexes and reduces ionic ca conen.Prevent formn of urinary stones compof uric acid and cystine

Severe renalimpairment with oliguria(is the

low output of urine)-Addisons disease-Acute dehydration-Severe myocardial damage-Hyperkalemic by any cause and resp ormetabolic alkalosis