Diuretics are drugs used to remove excess salt and water from the body through urine. This drug has several types, namely: loop diuretic, potassium-sparing diuretics, and thiazides. diuretic or diuretic available in the form of oral or injectable drugs.
Diuretics work by preventing the absorption of salt, including sodium and chloride, in the kidneys. Salt levels also affect the amount of water absorbed or excreted by the kidneys. With this way of working, salt and water will be removed from the body through urine excretion.
There are several conditions and diseases that can be treated by diuretic drugs, namely:
- Hypertension
- Excess water retention, edema, or ascites
- Congestive heart failure or liver cirrhosis
- Glaucoma
- Increased intracranial pressure (pressure inside the head)
In addition, several types of diuretics can be used to prevent and treat diabetes altitude sickness, relieves edema in renal failure, helps treat certain types of diabetes insipidus, and helps diagnose hyperaldosteronism.
Types of Diuretic Drugs
Based on the mechanism of action, diuretic drugs can be divided into several types, namely:
1. Thiazide
Thiazides work by reducing the absorption of sodium or chloride in the distal renal tubules, thereby increasing urine production. In addition, thiazides can relax blood vessels, making it effective in lowering blood pressure.
2. Loop diuretics
Loop diuretics work by decreasing the absorption of potassium, chloride, and sodium in the loop of Henle in the kidney. This will increase the amount of water and salt excreted in the urine.
3. Potassium-sparing diuretic
Potassium-sparing diuretics work by increasing the volume of fluid and sodium in the urine while maintaining potassium levels in the body.
4. Carbonic anhydrase inhibitor
Carbonic anhydrase inhibitor diuretics work by increasing the excretion of bicarbonate of acid, sodium, potassium, and water in the renal tubules.
5. Osmotic diuretic
Osmotic diuretics increase the amount of body fluid that is filtered out by the kidneys, while inhibiting the reabsorption of fluids by the kidneys.
Precautions Before Using Diuretics:
- Do not use diuretics if you have a history of allergy to this medicine or to sulfonamides or sulfa drugs, such as cotrimoxazole.
- Tell your doctor about your medical history and past illnesses. This is because the use of diuretics needs to be done with caution or is not even recommended if you have a history of urinary disorders, dehydration, diabetes, lupus, liver disease, gout, kidney disease, or heart rhythm disorders.
- Tell your doctor if you have Addison's disease. This is because potassium-sparing diuretics should not be given to patients with this disease.
- Tell your doctor if you are taking any medications, supplements, or herbal remedies before taking diuretics. Especially when taking bismuth subsalicylate, aspirin, aminoglycosides, or chemotherapy drugs.
- Tell your doctor if you are pregnant, breastfeeding, or planning a pregnancy before taking diuretics. This drug is not an option for treating hypertension during pregnancy.
- Discuss with your doctor about the use of diuretic drugs in children and the elderly so that they can be given the right type of drug and dose.
- If you have an allergic reaction or overdose after using a diuretic, contact your doctor immediately.
Diuretic Side Effects
Side effects that can occur with the use of diuretics can vary. This depends on the type and condition of the patient. Some of the side effects that often arise due to the use of diuretic drugs are:
- Dizzy
- Headache
- dry mouth
- stomach cramps
- Muscle cramp
- Constipation or constipation
- Impotence
- Ringing in the ears (tinnitus)
- Decreased blood pressure (hypotension)
- Gynecomastia
- Excessive fatigue and weakness
- Increased levels of uric acid and gout
- Increased blood sugar levels
- Increased cholesterol levels in the blood
- Electrolyte changes and imbalances, including potassium, sodium, chloride, or magnesium
In addition, the use of diuretic drugs can also cause an allergic reaction to the drug which can be characterized by the appearance of an itchy red rash, swelling of the eyelids and lips, and difficulty breathing.
Type, Trademark, and Dosage of Diuretics
Diuretic drugs will be given by the doctor. The dose of diuretic given depends on the type and form of the drug, as well as the age and condition of the patient.
1. Thiazide
Diuretic drugs belonging to the thiazide class are indapamine, hydrochlorothiazide, and chlorthalidone. Here is the explanation:
IndapamideDosage form: tablet Adults: 2.5 mg, once daily. If needed, the dose may be increased to 5 mg per day after 1 week of treatment. Adults: 1.25–2.5 mg, once daily. Chlorthalidone Trademark: - Adults: initial dose of 25–50 mg daily. The dose can be increased to 100–200 mg per day. Maintenance dose 25–50 mg per day. Adult: initial dose of 12.5 or 25 mg daily. The dose may be increased to 50 mg per day if needed. Children: initial dose 0.5–1 mg/kg every 48 hours. Maximum dose: 1.7 mg/kg every 48 hours. Adult: initial dose 100 mg, 2 times daily. Maintenance dose: 50 mg per day Children: initial dose 0.5–1 mg/kg once every 48 hours. Maximum dose: 1.7 mg/kg every 48 hours. Hydrochlorothiazide To find out the dosage and more information about this drug, please visit the hydrochlorothiazide drug page. 2. Loop Diuretics Diuretic drugs that belong to the loop diuretic group are bumetanide and furosemide. Here is the explanation: bumetanide Dosage form: tablet and injection Trademark: - Adults: 1 mg single dose. If needed, an additional dose of 1 mg can be given after 6-8 hours. Elderly: 0.5 mg per day. Furosemide To find out the dosage and more information about this drug, please visit the furosemide drug page. Torasemide To find out the dosage and more information about this drug, please visit the torasemide drug page. 3. Potassium-sparing diuretic Diuretic drugs that belong to the class of potassium-sparing diuretics are amiloride, eplerenone, spironolactone, and triamterene. Here is the explanation: Amiloride Dosage form: tablet Trademark: Lorinide Mite Adults: initial dose 5–10 mg daily. If used concurrently with other diuretics or antihypertensive drugs, the dose given is 2.5 mg per day. Maximum dose: 20 mg per day. Triamterene Dosage form: tablet Trademark: - Adults: 150–250 mg, 2 times daily after breakfast and lunch. Maximum dose: 300 mg per day. Adults: initial dose of 50 mg daily if used concomitantly with other diuretics. Eplerenone To find out the dosage and more information about this drug, please visit the eplerenone drug page. Spironolactone To find out the dosage and more information about this drug, please visit the spironolactone drug page. 4. Carbonic anhydrase inhibitor A diuretic, which belongs to the type of carbonic anhydrase inhibitor, is acetazolamide. To find out the dosage and more information about this drug, please visit the acetazolamide drug page. 5. Osmotic diuretic Diuretics including types of osmotic diuretics are mannitol. To find out the dosage and more information about this drug, please visit the mannitol drug page.