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Osmotic diuretics work by expanding extracellular fluid and plasma volume, therefore increasing blood flow to the kidney. This washes out the cortical medullary gradient in the kidney. This stops the loop of Henle from concentrating urine, which usually uses the high osmotic and solute gradient to transport solutes and water.
Osmotic diuresis is the increase of urination rate caused by the presence of certain substances in the proximal tubule (PCT) of the kidneys. [2] The excretion occurs when substances such as glucose enter the kidney tubules and cannot be reabsorbed (due to a pathological state or the normal nature of the substance).
Osmotic agents work by primarily affecting the blood brain barrier. [1] It's very important that the osmotic agents cannot cross the blood brain barrier because the main idea is to use osmotic agents to increase plasma osmolarity and cause an osmotic gradient to cause water from brain cells to flow into the plasma.
Osmotic diuretics (e. g., mannitol) are substances that increase osmolarity, but have limited tubular epithelial cell permeability. They work primarily by expanding extracellular fluid and plasma volume, therefore increasing blood flow to the kidney , particularly the peritubular capillaries.
The macula densa cells do not have enough Na/K ATPases on their basolateral surface to excrete this added sodium. This results in an increase of the cell's osmolarity . Water flows into the cell along the osmotic gradient, causing the cell to swell.
Chlorothiazide, sold under the brand name Diuril among others, is an organic compound used as a diuretic and as an antihypertensive. [1] [2] It is used both within the hospital setting or for personal use to manage excess fluid associated with congestive heart failure. Most often taken in pill form, it is usually taken orally once or twice a day.
Mannitol is a type of sugar alcohol used as a sweetener and medication. [5] [6] It is used as a low calorie sweetener as it is poorly absorbed by the intestines. [5]As a medication, it is used to decrease pressure in the eyes, as in glaucoma, and to lower increased intracranial pressure.
Bumetanide is a loop diuretic and works by decreasing the reabsorption of sodium by the kidneys. The main difference between bumetanide and furosemide is in their bioavailability and potency. About 60% of furosemide is absorbed in the intestine, and there are substantial inter- and intraindividual differences in bioavailability (range 10-90%).