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First, they effectively reduce blood pressure. Loop and thiazide diuretics are secreted from the proximal tubule via the organic anion transporter-1 and exert their diuretic action by binding to the Na(+)-K(+)-2Cl(-) co-transporter type 2 in the thick ascending limb and the Na(+)-Cl(-) co-transporter in the distal convoluted tubule, respectively.
Hydrochlorothiazide is a thiazide medication which inhibits reabsorption of sodium and chloride ions from the distal convoluted tubules of the kidneys, causing a natriuresis. [4] [5] This initially increases urine volume and lowers blood volume. [6] It is believed to reduce peripheral vascular resistance. [6]
Urinary retention is an inability to completely empty the bladder. [1] Onset can be sudden or gradual. [1] When of sudden onset, symptoms include an inability to urinate and lower abdominal pain. [1]
The arterial cells of the kidneys sense the increase in blood pressure and signal the kidneys to excrete superfluous fluid in an attempt to stabilize the pressure. The kidneys increase urine production and fill the bladder; when the bladder fills, the individual may then feel the urge to urinate.
Enalapril, sold under the brand name Vasotec among others, is an ACE inhibitor medication used to treat high blood pressure, diabetic kidney disease, and heart failure. [5] For heart failure, it is generally used with a diuretic, such as furosemide. [6] It is given by mouth or by injection into a vein. [5]
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.
Hypertension - A systematic review by the Cochrane Hypertension group assessing the anti-hypertensive effects of loop diuretics found only a modest reduction in blood pressure when compared to placebo. [14] According to Joint National Committee (JNC-8) guidelines, the first line treatment of hypertension is thiazide diuretics. The use of loop ...
For example, they can be used to reduce intracranial [4] and intra-ocular pressure. Osmotic diuretics increase plasma volume, but because they do not cross the blood-brain barrier, this does not affect the nervous system. In effect, this is the cause of their action reducing locally the plasma volume in the nervous system.
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