Let’s play:  NAME THAT DIURETIC!

I was just going to have you come up with the name of the diuretic on your own but frequently there are many related drugs that fit each description.  I’ll list the descriptions & if you still can’t name a diuretic I’ll have a list at the bottom to pick from.

1. Carbonic Anhydrase Inhibitor
   (Recall that bicarb is quite osmotically active.  Carbonic anhydrase converts bicarb to CO2 which can diffuse away.  No enzyme, no C02, lots of osmotically active bicarb left in the tubular fluid.  Of course, as bicarb is depleted, this drug won’t work any more.  It wastes K+ & can lead to metabolic acidosis from the bicarb loss.  Urine will be alkalinized.
    
2. Inhibits reabsorption of sodium in the distal tubule.  Also wastes K+ and inhibits calcium excretion.  It is a sulfonamide derivative.
    
3. Inhibits sodium reabsorption in the thick ascending loop of Henle.  Another sulfonamide derivative.  Very powerful diuretic.  Wastes K+.
    
4. Aldosterone antagonist via competitive inhibition at the collecting duct receptors.  K+ sparing!  Takes several days to reach a therapeutic blood level.
   
    

Need a hint?  Here are some choices:  fuosemide, thiazides, dichlorphenamide, spironolactone, acetozolamide.
 

THE ANSWERS

1. dichlorphenamide or acetozolamide (or numerous others)
   
   
   
   
    
2. thiazides
   
   
   
   
    
3. furosemide
   
   
   
   
    
4. spironolactone