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Loop diuretics are pharmacological agents that primarily inhibit the Na-K-Cl cotransporter located on the luminal membrane of cells along the thick ascending limb of the loop of Henle. [4] They are often used for the treatment of hypertension and edema secondary to congestive heart failure , liver cirrhosis , or chronic kidney disease .
The antihypertensive actions of some diuretics (thiazides and loop diuretics in particular) are independent of their diuretic effect. [ 1 ] [ 2 ] 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 ...
Thiazide diuretics inhibit this receptor, causing the body to release NaCl and water into the lumen, thereby increasing the amount of urine produced each day. [6] An example of a molecule that is chemically a thiazide but not used as a diuretic is methylchloroisothiazolinone, often found as an antimicrobial in cosmetics. [8]
A thiazide-like diuretic is a sulfonamide diuretic that has similar physiological properties to a thiazide diuretic, but does not have the chemical properties of a thiazide, lacking the benzothiadiazine molecular structure. Examples include metolazone, chlorthalidone, and indapamide. [1]
Metolazone is a thiazide-like diuretic marketed under the brand names Zytanix, Metoz, Zaroxolyn, and Mykrox. It is primarily used to treat congestive heart failure and high blood pressure . Metolazone indirectly decreases the amount of water reabsorbed into the bloodstream by the kidney , so that blood volume decreases and urine volume increases.
Thiazide diuretics are sometimes combined with amiloride to prevent hypokalemia caused by the thiazides. It seems paradoxical to treat an extreme diuresis with a diuretic, and the exact mechanism of action is unknown but the thiazide diuretics will decrease distal convoluted tubule reabsorption of sodium and water, thereby causing diuresis.
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