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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 .
Thiazide diuretics also increase calcium reabsorption at the distal tubule. By lowering the sodium concentration in the tubule epithelial cells, thiazides indirectly increase the activity of the basolateral Na + /Ca 2+ antiporter to maintain intracellular Na + level, facilitating Ca 2+ to leave the epithelial cells into the renal interstitium.
Metolazone and a loop diuretic will synergistically enhance diuresis over the use of either agent alone. Using this combination, diuretic effects will occur at two different segments of the nephron; namely, the loop diuretic will act at the loop of Henle, and metolazone will act at the distal convoluted tubule. Metolazone is frequently ...
Hydrochlorothiazide, sold under the brand name Hydrodiuril among others, is a diuretic medication used to treat hypertension and swelling due to fluid build-up. [4] Other uses include treating diabetes insipidus and renal tubular acidosis and to decrease the risk of kidney stones in those with a high calcium level in the urine. [4]
Trichlormethiazide appears to block the active reabsorption of chloride and possibly sodium in the ascending loop of Henle. This results in excretion of sodium, chloride and water, and thus acts as a diuretic. [1] Although trichlormethiazide is used to treat hypertension, its hypotensive effects may not necessarily be due to its role as a ...
Chlortalidone is considered a first-line medication for treatment of high blood pressure. [2] Some recommend chlortalidone over hydrochlorothiazide. [1] [15] A meta-analysis of randomized controlled trials found that chlortalidone is more effective than hydrochlorothiazide for lowering blood pressure, while the two drugs have similar toxicity.
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The thiazide-like diuretics (indapamide and chlorthalidone) reduce risk of major cardiovascular events and heart failure in hypertensive patients compared with hydrochlorothiazide with a comparable incidence of adverse events. [5] Both thiazide diuretics and thiazide-like diuretics are effective in reducing risk of stroke.