Diuretic and Uricosuric Agents

Abstract

Herein is presented the development and therapeutic use of diuretic agents, a topic that constitutes one of the most significant advances in medicine made during the twentieth century. Diuretics are among the most frequently prescribed therapeutic agents for the treatment of edema, hypertension, and congestive heart failure and they act primarily by inhibiting the reabsorption of sodium ions from the renal tubules in the kidney. Recent advances in renal and ion‐transport research have led to a more precise understanding of the cellular mechanisms of actions of the various classes of diuretic agents. This understanding has aided the design of newer and more effective agents. Today diuretics are grouped as loop, potassium‐sparing, thiazide, or osmotic diuretics and include compounds that have combined diuretic and uricosuric properties. Uricosuric agents increase the excretion of uric acid, a principal product of purine metabolism; and because hyperuricemia is an adverse effect sometimes observed with diuretic treatment, arising from decreased extracellular volume and increased urate reabsorption, this combined property is advantageous. However, given that diuretics themselv are convenient, inexpensive, and generally are well tolerated, they will probably continue to play a role in the treatment of hypertension.

Evaluation of Diuretic Activity of Siddha Poly Herbal Formulation <i>Vithu Vagai Chooranam</i> in Rodents

“…However, it was noted that potassium excretion in the interventional group was relatively less when compared to standard which may decrease the risk of hypokalaemia. So, it may suggest that the VVC has potassium-sparing properties 10,11 .…”

Adventures in Drug Discovery: Potent Agents Based on Ligands for Cell-Surface Receptors

“…28 Since circulating AVP levels may be high under pathological conditions, resulting in water retention and hyponatremia, 29 drugs for selective water excretion ("aquaresis") could be useful for treating edema, such as in liver disease and congestive heart failure. 30 To initiate drug discovery research in 1998, we established binding assays based on recombinant human V 1a and V 2 receptors 31 and cellular functional assays to determine agonist/antagonist action. 32 Suitable compounds would proceed to in vivo pharmacology.…”

“…Our interest was directed to V 1a and V 2 receptors 27 in that AVP maintains plasma volume and osmolarity through renal epithelial V 2 receptors and enhances vascular tone through V 1a receptors . Since circulating AVP levels may be high under pathological conditions, resulting in water retention and hyponatremia, drugs for selective water excretion (“aquaresis”) could be useful for treating edema, such as in liver disease and congestive heart failure …”

Medizinische Chemie der Diuretika: Entwicklung einer erfolgreichen Wirkstoffgruppe

“…1917 beobachteten Wiener Ärzte, die Merbaphen (1) (Abb. 1) zur Behandlung der Syphilis einsetzten [2], dessen massive harntreibende Wirkung [3]. Eine weitere Organoquecksilberverbindung, die breite Verwendung als Diuretikum fand, stellte das seit 1904 als Chemotherapeutikum eingesetzte Mersalyl (2)…”