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Diuretics: Thiazides, thiazides like diuretics (pharmacokinetics (T1/2…

- - - - thiazides : contain thiazide ring
        
        chlorothiazide (no longer used) / hydrochlorothiazide
    - - clopamide
      - indapamide
- - - - Na+ and Cl- excretion
    - - K+ and H- excretion (K+ and H- losing diuretics)
        
        delivery of Na+ to the collecting duct↑ -> increased Na+ reabsorption↑ -> lumen negative transepithelial potential difference↑ -> K+ and H- excretion↑
- - - - good (60-70%)
    - - near complete -> due to high lipophilicity (methylindole ring)
    - - moderate (60-80%)
  - - - renal excretion
    - - Biotransformation
- - - - by lowering Na+ in DCT cells, Ca2+ reabsorption is increased by Na+-Ca2+ exchanger
      - this effect can be beneficial in the treatment of patients with
        
        Ca2+ nephrolithiasis : to prevent the growth of Ca2+ containing calculus
        
        osteoporosis
    - - unknown mechanism
- - - - Na+ concentration↓ in vascular smooth muscle -> Na+ import and Ca2+ export↑ by Na+-Ca2+ exchanger
        -> Ca2+ concentration↓ in vascular smooth muscle -> smooth muscle relaxation -> peripheral vascular resistance↓