1. Diuretic mechanism: Inhibit Na-K -2C1 - symporter - in the thick ascending branch of the spinal cord, inhibit NaC1 reabsorption, and excrete a large amount of isotonic urine, which can cause hypokalemia, hypomagnesemia, and hypochloremia. Alkalosis, hyponatremia, hypovolemia, hypocalcemia. .2. Dilate blood vessels:

1. Severe edema 2. acute pulmonary edema and cerebral edema 3. hypercalcemia 4． early stage of acute renal failure 5. Accelerate the excretion of poisons

1. Water and electrolyte disorders: manifested as six lows (hypovolemia, hypokalemia, hyponatremia, hyponatremia, Chloralkalosis, hypomagnesemia, hypocalcemia); 2. Ototoxicity: tinnitus, hearing loss 3. Hyperuricemia: induces gout 4． high blood sugar

1. Diuretic effect; (1) Inhibit Na-Cl-symporter; (2) Inhibit carbonic anhydrase, resulting in hypokalemia, hypomagnesemia, and hypercalcemia 2. Anti-diabetes insipidus effect: reduce urine output and thirst symptoms in patients with diabetes insipidus; 3. Reduce blood volume and reduce blood pressure in the early stage of blood pressure reduction; long-term expansion of peripheral blood vessels will cause hypotension. Pressure

1 Electrolyte disorders: hypokalemia, hyponatremia, hypochloremia, and hypercalcemia; 2 Hyperuricemia 3. Hyperglycemia: Insulin resistance 4 Others: allergic reaction

1 Edema: the first choice for mild and moderate source edema 2. Hypertension: combined with other drugs 3Diabetes insipidus

Pharmacological effects

Clinical application

Adverse reactions

Triamterene

1. Acts on the epithelial cells in the anterior segment of the proximal convoluted tubule, inhibits intracellular carbonic anhydrase, reduces intracellular H+ production, and reduces secretion into the lumen. Through the H-Na+ exchange mechanism, Na and water reabsorption are reduced. 2. It inhibits the function of carbonic anhydrase, but the effect is weak. It also inhibits carbonic anhydrase in the eye. It reduces the production of aqueous humor, lowers intraocular pressure, and treats glaucoma.

① It is difficult to enter the tissue through capillaries after intravenous injection ②Easily filtered through renal tubules; ③Not easily reabsorbed by renal tubules.

Pharmacological effects

Clinical application (20% hypertonic solution intravenous injection)

Adverse reactions

It is an isomer of mannitol. The effect is similar to mannitol, but weaker. The grid is often chosen because it is cheap.

It can partially diffuse from blood vessels into tissues and be easily metabolized and utilized. Therefore, the effect is weak and not long-lasting. It is used in combination with mannitol for cerebral edema.