Chlorothiazide
Cesium Isotopes
Ethacrynic Acid
Kidney Tubules, Distal
Chlorpropamide
Benzene Derivatives
Carbonic Anhydrase Inhibitors
Uricosuric Agents
Inulin
Suspensions
Furosemide
Acetazolamide
Localization of diuretic effects along the loop of Henle: an in vivo microperfusion study in rats. (1/56)
In order to clarify the effects on sodium reabsorption in the loop of Henle of methazolamide (a carbonic anhydrase inhibitor), chlorothiazide and the loop diuretics frusemide and bumetanide, superficial loops were perfused in vivo in anaesthetized rats and the individual diuretics were included in the perfusate. Differentiation between effects in the pars recta and in the thick ascending limb of Henle (TALH) was achieved by comparing responses to the diuretics when using a standard perfusate, designed to mimic native late proximal tubular fluid, and a low-sodium perfusate, designed to block net sodium reabsorption in the pars recta. With the standard perfusate, methazolamide caused decreases in sodium reabsorption (J(Na)) and water reabsorption (J(V)); with the low-sodium perfusate, a modest effect on J(Na) persisted, suggesting that carbonic anhydrase inhibition reduces sodium reabsorption in both the pars recta and the TALH. The effects of chlorothiazide were very similar to those of methazolamide with both the standard and low-sodium perfusates, suggesting that chlorothiazide also inhibits sodium reabsorption in the pars recta and TALH, perhaps through inhibition of carbonic anhydrase. With the standard perfusate, both frusemide and bumetanide produced the expected large decreases in J(Na), but J(V) was also lowered. With the low-sodium perfusate, the inhibitory effects of the loop diuretics, particularly those of frusemide, were substantially reduced, while net potassium secretion was found. These observations indicate that a significant component of the effect of frusemide (and possibly of bumetanide) on overall sodium reabsorption is located in the pars recta, and that loop diuretics induce potassium secretion in the TALH. (+info)The acute effect of chlorothiazide on serum-ionized calcium. Evidence for a parathyroid hormone-dependent mechanism. (2/56)
The acute effects of chlorothiazide (CTZ) on total (TSCA) and ionized (SCA-plus 2) serum calcium concentrations were studied in three groups of people: (a) eight subjects with normal parathyroid function; (b) six patients with hypoparathyroidism; and (c) two patients with hyperparathyroidism. Most subjects were studied on four occasions; at least 3 days intervened between studies on an individual subject. During each experiment the subject received an i.v. influsion of 5% dextrose in water at 1 ml/min from 8 a.m. to 4 p.m. Additions to the infusions were (a) none; (b) CTZ to deliver 3.33 mg/kg/h; (c) parathyroid extract to deliver 1 U/kg/h; or (d) both CTZ and parathyroid extract at the rates previously indicated. CTZ, when used, was added to the infusion at 10 a.m., parathyroid extract at 8 a.m. When CTZ was infused, the diuretic-induced losses of Na and water were replaced by i.v. infusion. In normal subjects 2 h after the start of CTZ infusion, there was a transient increase in SCA-plus 2 which coincided in time of day with a transient decrease in SCA-plus 2 in control experiments. At that time of day SCA-plus 2 was 4.18 plus or minus 0.12 mg/100 ml in control experiments and 4.56 plus or minus 0.08 in experiments with CTZ, P smaller than 0.025. The corresponding values for (TSCA) were 9.32 plus or minus 0.15 and 9.80 plus or minus 0.30, P smaller than 0.01. Such differences were not observed in the group with hypoparathyroidism. In the two patients with hyperparathyroidism, CTZ produced sustained increases in TSCA and SCA-plus 2. In normal subjects and those with hypoparathyroidism, CTZ plus parathyroid extract infusion resulted in sustained increases in both SCA-plus 2 and TSCA throughout the periods of observation when compared to experiments in which only parathyroid extract was infused, P smaller than 0.01 in all instances. The results suggest that the acute hypercalcemic action of CTZ requires the presence of circulating parathyroid hormone. (+info)Clarification of the site of action of chlorothiazide in the rat nephron. (3/56)
The saluretic effect of the thiazide diuretics has been attributed to inhibition of sodium reabsorption in the distal nephron of the kidney. Recent micropuncture studies have shown, however, that chlorothiazide administration can also inhibit sodium reabsorption in the proximal convolution. To clarify the site of the saluretic effect of chlorothiazide, these micropuncture studies examined the effect of chlorothiazide on chloride transport in the nephron. The effect of chlorothiazide on chloride transport was studied because chlorothiazide's effectiveness as a saluretic is largely due to its ability to enhance sodium chloride excretion; if only changes in sodium transport are examined, it would be then difficult to determine if sodium as bicarbonate or as chloride is affected, since chlorothiazide can inhibit carbonic anhydrase. One group of rats was studied before and after 15 mg/kg per h chlorothiazide. For comparison, another group of rats was studied before and after 2 mg/kg per h benzolamide, a carbonic anhydrase inhibitor. Fractional chloride delivery from the proximal tubule was similarly increased in both groups from 59.4 to 71.0% by chlorothiazide administration, Pless than 0.0001, and from 54.3 to 68.2% by benzolamide administration, P less than 0.001. The increased delivery very of chloride from the proximal tubule was largely reabsorbed before the early distal tubule as fractional chloride delivery to this site increased only from 5.08 to 7.40% after chlorothiazide administration, P less than 0.001, and from 4.50 to 6.29% after benzolamide administration, P less than 0.01. Benzolamide had no effect on chloride reabsorption in the distal convoluted tubule. However, chlorothiazide administration resulted in a marked decrease in distal tubular chloride reabsorption, the fraction of filtered chloride present at the late distal tubule incresing from 1.24 to 6.25%, P less than 0.001. Fractional chloride excretion in the urine increased from 0.29 to 3.44%, P less than 0.001, after chlorothiazide, but did not change after benzolamide. The influence of chlorothiazide on proximal chloride transport presumably is related to its ability to inhibit renal carbonic anhydrase. However, it is not the effect of chlorothiazide in the proximal convolution but rather its effect in the distal convoluted tubule which is primarily responsible for its ability to be an effective saliuretic. (+info)Mechanism of calcium transport stimulated by chlorothiazide in mouse distal convoluted tubule cells. (4/56)
Thiazide diuretics inhibit Na+ and stimulate Ca2+ absorption in renal distal convoluted tubules. Experiments were performed on immortalized mouse distal convoluted tubule (MDCT) cells to determine the mechanism underlying the dissociation of sodium from calcium transport and the stimulation of calcium absorption induced by thiazide diuretics. Control rates of 22Na+ uptake averaged 272 +/- 35 nmol min-1 mg protein-1 and were inhibited 40% by chlorothiazide (CTZ, 10(-4) M). Control rates of 36Cl- uptake averaged 340 +/- 50 nmol min-1 mg protein-1 and were inhibited 50% by CTZ. CTZ stimulated 45Ca2+ uptake by 45% from resting levels of 2.86 +/- 0.26 nmol min-1 mg protein-1. Bumetanide (10(-4) M) had no effect on 22Na+, 36Cl-, or 45Ca2+ uptake. Control levels of intracellular calcium activity ([Ca2+]i) averaged 91 +/- 12 nM. CTZ elicited concentration-dependent increases of [Ca2+]i to a maximum of 654 +/- 31 nM at 10(-4) M. CTZ reduced intracellular chloride activity ([Cl-]i), as determined with the chloride-sensitive fluorescent dye 6-methoxy-N-(3-sulfopropyl)quinolinium. The chloride channel blocker 5-nitro-2-(3-phenylpropylamino)benzoic acid (NPPB, 10(-5) M) abolished the effect of CTZ on [Cl-]i. NPPB also blocked CTZ-induced increases of 45Ca2+. Resting membrane voltage, measured in cells loaded with the potential-sensitive dye 3,3'-dihexyloxacarbocyanine iodide [DiOC6(3)], averaged -72 +/- 2 mV. CTZ hyperpolarized cells in a concentration-dependent and reversible manner. At 10(-4) M, CTZ hyperpolarized MDCT cells by 20.4 +/- 7.2 mV. Reduction of extracellular Cl- or addition of NPPB abolished CTZ-induced hyperpolarization. Direct membrane hyperpolarization increased 45Ca2+ uptake whereas depolarization inhibited 45Ca2+ uptake. CTZ-stimulated 45Ca2+ uptake was inhibited by the Ca2+ channel blocker nifedipine (10(-5) M). We conclude that thiazide diuretics block cellular chloride entry mediated by apical membrane NaCl cotransport. Intracellular chloride, which under control conditions is above its equilibrium value, exits the cell through NPPB-sensitive chloride channels. This decrease of intracellular chloride hyperpolarizes MDCT cells and stimulates Ca2+ entry by apical membrane, dihydropyridine-sensitive Ca2+ channels. (+info)Fluid transport in a cultured cell model of kidney epithelial cyst enlargement. (5/56)
Madin-Darby canine kidney (MDCK) cells, when seeded into collagen gel, from polarized, spherical, epithelial cysts, which grow by a process involving fluid secretion and cell proliferation. These cysts are a useful model for understanding the dynamics of cyst enlargement in renal cystic disease. The hypothesis that MDCK cyst fluid secretion depends upon chloride secretion was tested, and a cell model for this process is presented here. Lumen and epithelial cell volumes were measured by video microscopy in acute experiments. Fluid absorption (-0.073 +/- 0.007 microliters.h-1.cm-2; N = 8) was observed when cysts were superfused with unsupplemented Dublecco's modified Eagle's medium at 36 to 37 degrees C. Fluid secretion (0.221 +/- 0.0016 microliters.h-1.cm-2; N = 25) was seen when 1 mM dibutyryl cAMP plus 0.1 mM 3-isobutyl-1-methylxanthine were added to the superfusate. cAMP-induced fluid secretion was significantly inhibited by basolateral 1 mM ouabain, 0.1 mM furosemide, or 1 mM amiloride. It was not significantly affected by 1 mM chlorothiazide, 0.01 mM bumetanide, or 0.1 mM acetazolamide in the presence of normal bicarbonate/CO2. In the nominal absence of bicarbonate/CO2 fluid secretion was 18% of control. Vasopressin-induced fluid secretion was significantly inhibited by pretreatment of cysts with 0.1 mM 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid (DIDS). Cyst cell shrinkage in isosmotic chloride-free Ringer's solution (chloride replaced by gluconate) was inhibited by 0.1 mM basolateral DIDS. The results suggest that chloride-bicarbonate exchange in the basolateral membrane of MDCK cyst epithelial cells plays a critical role in cyst fluid secretion. (+info)Action of chlorothiazide on the distribution excretion and hypotensive effect of pempidine in man. (6/56)
When chlorothiazide is given to hypertensive patients who are receiving pempidine a rise in plasma pempidine concentration occurs and this is proportionately greater than the additional fall in blood pressure. After pempidine has been added to human whole blood in vitro or in vivo the ratio of the pempidine concentration in the red cells to that in the plasma falls in the course of 1 hr from an initial value greater than 2 to about 1.2. If chlorothiazide is present also, however, the ratio remains constant at 0.7. Changes in the plasma pempidine concentration in vivo probably result from the binding of pempidine to plasma protein in the presence of chlorothiazide. This has been observed in vitro by a dialysis technique. (+info)A comparison of the use of Aldactone and Aldactone A in the treatment of hepatic ascites. (7/56)
In eight patients with cirrhosis and stable ascites controlled on chlorothiazide and spironolactone, a small particle preparation of spironolactone (Aldactone A) was as effective, at one quarter the dosage, as conventional spironolactone (Aldactone). Plasma spironolactone metabolite levels and urinary excretion of spironolactone metabolite were equivalent with both preparations. The variable dosage requirement of spironolactone in patients with cirrhosis and ascites is discussed in relation to these observations. (+info)Dangers in the use of some potent drugs. (8/56)
The chief dangers reported with some common drugs are reviewed. Hazards of antibiotic therapy include: the increasing incidence of sensitization to penicillin with occasional anaphylactic reactions; aplastic anemia with chloramphenicol, and the poor tolerance of infants for chloramphenicol; staphylococcal enterocolitis; unnecessary "prophylactic" use of antibiotics. Thiazide diuretics may precipitate potassium depletion, skin reactions, pancreatitis, blood dyscrasias, gout, diabetes mellitus and hepatic coma. Reserpine can increase gastric acidity, induce mental depression, and when used with digitalis lead to ventricular premature beats. Hydralazine may aggravate angina pectoris, cause tachycardia, and bring about a syndrome resembling disseminated lupus erythematosus. Guanethidine may result in loose stools, impotence, and postural hypotension. Hazards of phenothiazines include jaundice, parkinsonian states and tremors, convulsions, hypotension, and blood dyscrasias. The butanediols have numerous side effects including gastrointestinal, cutaneous and hypotensive reactions. Prolonged corticosteroid therapy introduces a new danger in surgical treatment. The progesterone-like drugs may induce masculinization of the female fetus. (+info)Chlorothiazide is a medication that belongs to a class of diuretics known as thiazide diuretics. It works by increasing the excretion of salt and water from the body through urine, which helps to reduce blood pressure and decrease edema (swelling). Chlorothiazide is used to treat hypertension (high blood pressure), heart failure, and edema caused by various medical conditions.
The medical definition of Chlorothiazide is:
A thiazide diuretic drug used in the treatment of hypertension, heart failure, and edema. It acts by inhibiting the reabsorption of sodium and chloride ions in the distal convoluted tubule of the nephron, leading to increased excretion of salt and water in the urine. Chlorothiazide has a rapid onset of action and a short duration of effect, making it useful for acute situations requiring prompt diuresis. It is available in oral and injectable forms.
Cesium is a chemical element with the atomic number 55 and the symbol Cs. There are several isotopes of cesium, which are variants of the element that have different numbers of neutrons in their nuclei. The most stable and naturally occurring cesium isotope is cesium-133, which has 78 neutrons and a half-life of more than 3 x 10^20 years (effectively stable).
However, there are also radioactive isotopes of cesium, including cesium-134 and cesium-137. Cesium-134 has a half-life of about 2 years, while cesium-137 has a half-life of about 30 years. These isotopes are produced naturally in trace amounts by the decay of uranium and thorium in the Earth's crust, but they can also be produced artificially in nuclear reactors and nuclear weapons tests.
Cesium isotopes are commonly used in medical research and industrial applications. For example, cesium-137 is used as a radiation source in cancer therapy and industrial radiography. However, exposure to high levels of radioactive cesium can be harmful to human health, causing symptoms such as nausea, vomiting, diarrhea, and potentially more serious effects such as damage to the central nervous system and an increased risk of cancer.
Ethacrynic acid is a loop diuretic drug that is primarily used to treat edema (swelling) associated with heart failure, liver cirrhosis, and kidney disease. It works by increasing the excretion of water and sodium in the urine, which helps reduce fluid buildup in the body. Ethacrynic acid is also known as a "high-ceiling" diuretic because it has a strong effect on urine production.
The drug is available in oral form and is typically taken once or twice a day, depending on the severity of the edema and the patient's response to treatment. Ethacrynic acid can have side effects, including hearing loss, kidney damage, and electrolyte imbalances, so it is important for patients to be monitored closely by their healthcare provider while taking this medication.
It is worth noting that ethacrynic acid is not as commonly used as other loop diuretics, such as furosemide or torsemide, due to its higher risk of side effects and the availability of safer alternatives.
Distal kidney tubules are the final segment of the renal tubule in the nephron of the kidney. The nephron is the basic unit of the kidney that filters blood and produces urine. After the filtrate leaves the glomerulus, it enters the proximal tubule where most of the reabsorption of water, electrolytes, and nutrients occurs.
The filtrate then moves into the loop of Henle, which is divided into a thin and thick descending limb and a thin and thick ascending limb. The loop of Henle helps to establish a concentration gradient in the medullary interstitium, allowing for the reabsorption of water in the collecting ducts.
The distal tubule is the last segment of the renal tubule before the filtrate enters the collecting duct. It is a relatively short structure that receives filtrate from the thick ascending limb of the loop of Henle. The distal tubule plays an important role in regulating electrolyte and water balance by actively transporting ions such as sodium, potassium, and chloride.
The distal tubule also contains specialized cells called principal cells and intercalated cells that are responsible for secreting or reabsorbing hydrogen and potassium ions to maintain acid-base balance. Additionally, the distal tubule is a site of action for several hormones, including aldosterone, which stimulates sodium reabsorption and potassium excretion, and vasopressin (antidiuretic hormone), which promotes water reabsorption in the collecting ducts.
Chlorpropamide is a type of oral anti-diabetic drug known as a sulfonylurea, which is used to lower blood glucose levels in people with type 2 diabetes. It works by stimulating the release of insulin from the pancreas and increasing the sensitivity of peripheral tissues to insulin.
Here's the medical definition:
Chlorpropamide: A first-generation sulfonylurea medication used in the management of type 2 diabetes mellitus. It acts by stimulating the release of insulin from the pancreatic beta cells and increasing peripheral tissue sensitivity to insulin. Chlorpropamide has a longer duration of action than other sulfonylureas, with a peak effect at around 6-12 hours after administration. Common side effects include hypoglycemia, weight gain, and gastrointestinal symptoms such as nausea and diarrhea. It is important to monitor blood glucose levels regularly while taking chlorpropamide to avoid hypoglycemia.
Benzene derivatives are chemical compounds that are derived from benzene, which is a simple aromatic hydrocarbon with the molecular formula C6H6. Benzene has a planar, hexagonal ring structure, and its derivatives are formed by replacing one or more of the hydrogen atoms in the benzene molecule with other functional groups.
Benzene derivatives have a wide range of applications in various industries, including pharmaceuticals, dyes, plastics, and explosives. Some common examples of benzene derivatives include toluene, xylene, phenol, aniline, and nitrobenzene. These compounds can have different physical and chemical properties depending on the nature and position of the substituents attached to the benzene ring.
It is important to note that some benzene derivatives are known to be toxic or carcinogenic, and their production, use, and disposal must be carefully regulated to ensure safety and protect public health.
Diuretics are a type of medication that increase the production of urine and help the body eliminate excess fluid and salt. They work by interfering with the reabsorption of sodium in the kidney tubules, which in turn causes more water to be excreted from the body. Diuretics are commonly used to treat conditions such as high blood pressure, heart failure, liver cirrhosis, and kidney disease. There are several types of diuretics, including loop diuretics, thiazide diuretics, potassium-sparing diuretics, and osmotic diuretics, each with its own mechanism of action and potential side effects. It is important to use diuretics under the guidance of a healthcare professional, as they can interact with other medications and have an impact on electrolyte balance in the body.
Carbonic anhydrase inhibitors are a class of medications that work by blocking the action of carbonic anhydrase, an enzyme that is responsible for converting carbon dioxide and water into carbonic acid. This enzyme is found in various tissues throughout the body, including the eyes, kidneys, and nervous system.
By inhibiting the activity of carbonic anhydrase, these medications can reduce the production of bicarbonate ions in the body, which helps to lower the rate of fluid buildup in certain tissues. As a result, carbonic anhydrase inhibitors are often used to treat conditions such as glaucoma, epilepsy, and altitude sickness.
In glaucoma, for example, these medications can help to reduce pressure within the eye by promoting the drainage of fluid from the eye. In epilepsy, carbonic anhydrase inhibitors can help to reduce the frequency and severity of seizures by reducing the acidity of the blood and brain. And in altitude sickness, these medications can help to alleviate symptoms such as headache, nausea, and shortness of breath by reducing the buildup of fluid in the lungs.
Some common examples of carbonic anhydrase inhibitors include acetazolamide, methazolamide, and dorzolamide. These medications are available in various forms, including tablets, capsules, and eye drops, and are typically prescribed by a healthcare professional.
Uricosuric agents are a class of medications that work by increasing the excretion of uric acid through the kidneys, thereby reducing the levels of uric acid in the blood. This helps to prevent the formation of uric acid crystals, which can cause joint inflammation and damage leading to conditions such as gout.
Uricosuric agents achieve this effect by inhibiting the reabsorption of uric acid in the kidney tubules or by increasing its secretion into the urine. Examples of uricosuric agents include probenecid, sulfinpyrazone, and benzbromarone. These medications are typically used to manage chronic gout and hyperuricemia (elevated levels of uric acid in the blood). It is important to note that uricosuric agents may increase the risk of kidney stones due to increased excretion of uric acid in the urine, so it is essential to maintain adequate hydration while taking these medications.
Inulin is a soluble fiber that is not digestible by human enzymes. It is a fructan, a type of carbohydrate made up of chains of fructose molecules, and is found in various plants such as chicory root, Jerusalem artichokes, and onions.
Inulin has a number of potential health benefits, including promoting the growth of beneficial bacteria in the gut (prebiotic effect), slowing down the absorption of sugar to help regulate blood glucose levels, and increasing feelings of fullness to aid in weight management. It is often used as a functional food ingredient or dietary supplement for these purposes.
Inulin can also be used as a diagnostic tool in medical testing to measure kidney function, as it is excreted unchanged in the urine.
In the context of medical definitions, "suspensions" typically refers to a preparation in which solid particles are suspended in a liquid medium. This is commonly used for medications that are administered orally, where the solid particles disperse upon shaking and settle back down when left undisturbed. The solid particles can be made up of various substances such as drugs, nutrients, or other active ingredients, while the liquid medium is often water, oil, or alcohol-based.
It's important to note that "suspensions" in a medical context should not be confused with the term as it relates to pharmacology or physiology, where it may refer to the temporary stopping of a bodily function or the removal of something from a solution through settling or filtration.
Furosemide is a loop diuretic medication that is primarily used to treat edema (fluid retention) associated with various medical conditions such as heart failure, liver cirrhosis, and kidney disease. It works by inhibiting the sodium-potassium-chloride cotransporter in the ascending loop of Henle in the kidneys, thereby promoting the excretion of water, sodium, and chloride ions. This increased urine output helps reduce fluid accumulation in the body and lower blood pressure.
Furosemide is also known by its brand names Lasix and Frusid. It can be administered orally or intravenously, depending on the patient's condition and the desired rate of diuresis. Common side effects include dehydration, electrolyte imbalances, hearing loss (in high doses), and increased blood sugar levels.
It is essential to monitor kidney function, electrolyte levels, and fluid balance while using furosemide to minimize potential adverse effects and ensure appropriate treatment.
A nephron is the basic structural and functional unit of the kidney. It is responsible for filtering blood, reabsorbing necessary substances, and excreting waste products into the urine. Each human kidney contains approximately one million nephrons.
The structure of a nephron includes a glomerulus, which is a tuft of capillaries surrounded by Bowman's capsule. The glomerulus filters blood, allowing small molecules like water and solutes to pass through while keeping larger molecules like proteins and blood cells within the capillaries.
The filtrate then passes through the tubular portion of the nephron, which includes the proximal convoluted tubule, loop of Henle, distal convoluted tubule, and collecting duct. The tubular portion reabsorbs necessary substances like water, glucose, amino acids, and electrolytes back into the bloodstream while excreting waste products like urea and creatinine into the urine.
Overall, nephrons play a critical role in maintaining fluid and electrolyte balance, regulating blood pressure, and removing waste products from the body.
Acetazolamide is a medication that belongs to a class of drugs called carbonic anhydrase inhibitors. It works by decreasing the production of bicarbonate in the body, which helps to reduce the amount of fluid in the eye and brain, making it useful for treating conditions such as glaucoma and epilepsy.
In medical terms, acetazolamide can be defined as: "A carbonic anhydrase inhibitor that is used to treat glaucoma, epilepsy, altitude sickness, and other conditions. It works by decreasing the production of bicarbonate in the body, which helps to reduce the amount of fluid in the eye and brain."
Acetazolamide may also be used for other purposes not listed here, so it is important to consult with a healthcare provider for specific medical advice.
Urine is a physiological excretory product that is primarily composed of water, urea, and various ions (such as sodium, potassium, chloride, and others) that are the byproducts of protein metabolism. It also contains small amounts of other substances like uric acid, creatinine, ammonia, and various organic compounds. Urine is produced by the kidneys through a process called urination or micturition, where it is filtered from the blood and then stored in the bladder until it is excreted from the body through the urethra. The color, volume, and composition of urine can provide important diagnostic information about various medical conditions.