Diuretics, or simply diuretics, aresubstances that contribute to the removal of urine and reduce the amount of fluid contained in the serous cavities and tissues of the body. Most often, diuretics are used as an adjunct in the treatment of diseases of the heart, kidneys, and liver, which are accompanied by edema. Diuretics are designed only to reduce or eliminate stagnation, and the main treatment should eliminate the pathological process that provokes the accumulation of excess fluid in the body.
The very first diuretic drugs highEfficiency appeared about a hundred years ago, when the diuretic effect of mercury, or rather its compounds used in the treatment of syphilis, was completely accidentally revealed. Currently, due to its high toxicity, mercury diuretics are no longer used, but the study of these funds has played a large role in shaping the modern understanding of the extrarenal and diuretic mechanisms of action of diuretics.
In addition to the previously obsoletemercury diuretics, which are xanthine derivatives, are currently synthesized and many other more effective drugs are used: dichlothiazide, furosemide cyclomethiazide (benzothiadiazine derivatives), diacarb (carbonic anhydride inhibitor), pterophene - triamterene, allacil (derivatives of pteridine, and pyllidine, and pyllidine, and pylline and aryl hydrazide)
In addition to drugs to combatThe accumulation of excess fluid in the body is widely used natural diuretics (vegetable), such as leaves of lingonberry and bearberry, various kidney teas, birch buds, diuretic fees number 1 and number 2, grass horsetail.
Основным эффектом мочегонных средств является increased renal excretion of sodium ions and water. Due to its ability to influence the water and electrolyte balance, vascular tone and blood volume, diuretics are very often used as antihypertensive agents. Diuretics that have a strong diuretic effect, due to the acceleration of renal excretion, are used in the treatment of poisoning with various water-soluble substances.
Single, taking into account all aspects of actiondiuretics, classification today does not exist. All diuretics, having a different chemical structure, differ from each other in their localization, mechanism, strength of action, speed of onset of effect, its duration and side effects. For a long time, the classification of diuretics was based on their chemical structure, there were also attempts to classify them by the nature of their effects on the kidneys, but for many diuretics, there are also extrarenal effects. Therefore, all diuretics are more rational to classify according to the mechanism of their action.
Based on the pharmacodynamics of drugs, all modern diuretic drugs are divided into three groups:
- potassium-saving diuretics, which increase sodium excretion and slightly affect potassium excretion. These include amiloride, triamteren, spironolactone and eplerenone.
- saluretics - thiazide derivatives, thiazide-like, loop diuretic, carbonic anhydrase inhibitors.
- osmotic diuretics that increase pressure in the tubules and prevent water reabsorption - mannitol, urea.
In addition to the pharmacodynamic classification, diuretics are classified according to the speed of onset and the duration of this effect.
The strength of the action are distinguished:weak, medium and strong diuretic. According to the speed of the onset of the diuretic effect, there are 30–40 minutes of emergency (fast) action, 2–4 hours of medium action, 2–4 days of slow action. For the duration of the diuretic effect: a short action - 5-8 hours, an average duration - 8-15 hours, a long action - several days.
The main area of use of diuretics is cardiovascular pathology, especially circulatory failure with the syndrome of swelling and arterial hypertension.
