As per US FDA guidelines as per USPDA 1997

It is the intention to bring out the salient features. Hence relevent details as prescribed by US FDA guidelines as per USPDA 1997  are brought out clearly in the following chapters. 

Descriptons are detailed only to the Group Head and the indiviual items can be seen by visiting the Web Site

ANTIDIURETIC

Include- Carbamazepine,Chlorpropamide, Clofibrate, Desmopresin, Lypressin, Vasopressin,Bendoflumethizide, Benzthiazide, Chlorothizide, Chlorthalidone, Cyclothiazide, Hydrochlorthiazide,Hydroflumethizide, Metolazone, Polythiazide, Quinethazone, Trichlormethizide 

GROUPS OF - DIURETICS & ANTIDIURETICS

AMILORIDE AND TRIAMTERENE-

Action-

Act on distil tubule by blocking sodium, potassium, and hydrogen ecxhange. Thus they spare potassium . Unlike spironolactone theit action is not dependent on scretion of aldosterone. Their diuretic actionaction is comparitively weak.

CARBONIC ANHYDRASE INHIBITORS-

Include Acetozolamide-

Action- Inhibition of renal tubular carbonic anhydrase increases cation exchange mainly as sodium and potassium together with bicarbonate. The urine becomes alkalineand diuresis becomes self limitingas metabolic acidosis develops

LOOP DIURETICS-

Include- Bunetatanide, ethyctynic acid , frusemide and torsemide 

Action- Potent diuretic which act primarily by blocking sodium and chloride reabsorptionin the acending limb of the loop Henle .May also exert additional effects on the proximal and distal tubules

SPROLACTONE-

Action- Conpetitively inhibits the d istal tubular re-absorption of sodium and excretion of potassium that normally occurs under the influence of the adrenocortical hormone, aldosterone. Thus the diuresis occurs with excretion of sodium and retention of potassium. Its action depends on the adequate production of aldosterone and in normal person its diuretic effect is relatively weak. In a patient hyper-aldosteronism however, it may cause a large diuresis.

THIAZIDE AND SIMIILAR COMPOUNDS-

Include-  Bendrofluazide, Chlorthiazide, Chclopenthiazide, Hydrochlorothiazide and methyl clothizide.

Although not a thiazide Chlorthalidone, Clopamide, Clorexolone, Mefrusside, Metolazone, and quinethiazone all exert similar actions 

Actions- Induces a diuresis by inhibiting the renal absorption of sodium and chloride, chiefly in the early distil tubule (cortical diluting segment) . Some also exhibit weak carbonic angydraseinhibiting activity. All increase the renal excretion of sodium and chloride in approximately equal amounts 

Carbonic anhydrase diuretics include

Acetozolamide, Dichlorophenamide, Methazolamide

Refer- Acetozolamide

1. It GI upset occurs, take with food.

2. Avoid prolonged exposure to sunlight or sunlamps, may cause photosensitivity

3. May cause drowsiness, observe caution while driving or performing other tasks requiring alertness, coordination or physical dexterity

4. Notify physician if sore throat, fever, unusual bleeding or bruising, tingling ortremors in the hands or feet, flank or loin pain or skin rashes occurs

5. Allergies- tell your doctor if you have ever had any allergic reaction to carbonic anhydrase inhibitors, sulfonamide, or thiazidediuretics . also tell your doctor if you are allergic to any other substances such as foods, preservatives or dyes.

6. Pregancy- not studied in pregnant woman. Before taking this medicine make sure that your doctor knows that you are pregnant orif you may become pregnant.

7. Breast feeding- may pass into breast milk- It may be necessary for you to either use other medicine or to stop breast feeding during treatment.

8. Children- these medicines are not expected to cause different side effects or problems in children than they do in adults.

9. Elderly- these medicines are not expected to cause different side effects or problems in elderly than in younger adults.

10. Other medicines- Tell your doctor if you are using any other medicines e.g. - Amphetamines or Mecamylamine or Quinidine - use of carbonic anhydrase inhibitors may increase the chance of side efects. Methenamine - use of carbonic anhydrase inhibitors may decrease the effectiveness of methenamine

11. Other medical problems- tell your doctor if you have any other medical problems- Diabetes mellitus - use may increase the patients blood and urine sugar concentrations Emphysema or other chronic ling disease- use may increase the risk of acidosis

 12. Missed dose- if you miss a dose of this medcine take it as soon as possible. However, if it is time for the next dose,skip the missed dose and go back to the normal dose schedule Do not double doses.