January 26, 2023

Use the PharmacoPhoto video ‘flash-card’ series to reinforce your knowledge of drug classes and specific medications.

Hi there and thanks for joining me as we try to paint a drug picture of the loop diuretics for rossum id and bumetanide are both loop diuretics the loop diuretics excrete more sodium and along with the sodium excretion the water is going to follow the loop diuretics are primarily used for decreasing and dimittis conditions for instance congestive heart failure liver

Failure and pulmonary edema they are effective in reducing blood pressure but only marginally in comparison to placebo according to the latest reviews the loop diuretics work at the level of the kidneys so let’s go down to the level of the kidneys and see if we can get a good picture of them we normally have two kidneys and each kidney has an average of 1.2 million

Functional units called the nephron in the nephron blood is filtered through the glomerulus and then the filtrate or pre urine goes through a number of different areas and these include the proximal convoluted tubules the descending loop of henle the a sending loop of henle the distal convoluted tubules and then the collecting ducts the filtrate that remains at

The end of the collecting ducts is then the urine it’s not able to be reabsorbed back into the blood or changed at all in any one of those areas of the nephron if the carrier proteins that are embedded in the cell surface of the nephron allow a substance to go from the lumen of the nephron to the other side which is the interstitial space it’s very possible that

That substance will get reabsorbed into the blood because we’ve got a lot of capillaries or sometimes called capillaries there in the interstitial space that are there specifically to do just that reabsorb substances back into the blood with the exception of the osmotic diuretic switch our pharmacologically inert all diuretics exert their effects either directly or

Indirectly on one or more of those carrier proteins and therefore they affect the reabsorption of some of the electrolytes the loop diuretics furosemide and bumetanide act on the broad part of the ascending limb of the loop of henle so right here and there they inhibit the sodium potassium chloride symporter by binding to the chloride site of the co-transporter the

End result and most important thing about that action is that there first of all going to decrease the amount of sodium in the blood because we’re actually excreting more sodium with the excretion of sodium there’s going to be water that follow so we’re excreting water is well we’re going to decrease the potassium because the potassium is going to be kept in the

Tubules in the filtrate instead of being reabsorbed we’re going to decrease the calcium and decrease the magnesium as well and finally there’s one other action it happens at a different portion of the nephron but that is going to result in a decreased excretion of uric acid but i’d like to add a few side effects and potential complications of the loop diuretics

First of all there is as they as we decrease the amount of fluid in the body we’re not decreasing all of the other things like glucose and uric acid proportionally so there is an actual relative increase in things like glucose and in uric acid so people with hyperglycemia or diabetes type 2 could actually have an exacerbation of the hyperglycemia people with

Gout could actually have an exacerbation of their hyperuricemia and then there’s another problem with odo toxicity so toxicity to the ear the loop diuretics are thought to be potentially ototoxic and finally with all diuretics the electrolytes are going to have to be monitored on a regular basis and probably the ecg or ekg analyses should be performed on a regular basis as well you

Transcribed from video
Loop diuretics: Furosemide and bumetanide By PharmacoPhoto