Renal pharmacology, Diuretics but focus more on loop and thiazide and

Renal pharmacology, Diuretics but focus more on loop and thiazide and use katzung and all othrr books

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loop diuretics mechanism of action thick ascending limb NKCC2

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thiazide diuretic mechanism distal convoluted tubule NCC cotransporter

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This covers renal pharmacology / diuretics comprehensively, synthesized across all available textbooks. Here's a quick orientation to the content above:

What's covered:

Overview table — All diuretic classes, nephron site, transporter, and potency hierarchy
Loop Diuretics — full pharmacology:
- Chemistry of all 4 agents (furosemide, bumetanide, torsemide, ethacrynic acid)
- NKCC2 mechanism with Harrison's diagram showing TAL transport
- Why they're the most potent diuretics (25–30% of filtered NaCl handled by TAL)
- Sigmoidal dose-response curve with threshold and ceiling (Lippincott)
- Pharmacokinetics table including furosemide's variable bioavailability vs. torsemide/bumetanide >80%
- Adverse effects: hypokalemia, ototoxicity (NKCC1 in inner ear), hypercalciuria, hypomagnesemia, hyperuricemia, metabolic alkalosis
Thiazide Diuretics — full pharmacology:
- NCC mechanism with Harrison's DCT diagram
- The critical Ca²⁺ reabsorption paradox (opposite of loops) explained mechanistically
- Chlorthalidone vs HCTZ comparison
- Loss of efficacy at GFR <30 (vs loops)
- Adverse effects: hyponatremia (> loops), hyperglycemia (dose-dependent), hyperlipidemia, skin cancer risk, gout
Side-by-side comparison table
Diuretic resistance — mechanisms + "sequential nephron blockade" strategy
Drug interactions — NSAIDs, digoxin, lithium, aminoglycosides
Special scenarios — nephrogenic DI, acute pulmonary edema, cirrhosis, osteoporosis

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