DIURETIC

any drug that increases the flow of urine. Diuretics promote the removal from the body of excess water, salts, poisons, and accumulated metabolic products, such as urea. They serve to rid the body of excess fluid (edema) that accumulates in the tissues owing to various disease states. There are many types of diuretics, but most act by decreasing the amount of fluid that is reabsorbed by the tubules of the kidneys, whence the fluid passes back into the blood. The most widely used diuretics, the benzothiadiazides (e.g., chlorothiazide), interfere with the reabsorption of salt and water by the kidney tubules. Instead of being reabsorbed, the salt and water are ultimately excreted, thus increasing the flow of urine. After they were synthesized in the late 1950s, the benzothiadiazides replaced most other existing diuretics. They are more convenient than some other diuretics in that they can be taken orally in the form of pills. These drugs are also used to reduce high blood pressure (hypertension). Mercurial diuretics (e.g., calomel) work as do benzothiadiazides but are less easy to use. Another class of diuretics are substances that cannot be reabsorbed by the kidney tubules and thus limit the reabsorption of water by the tubules. These include mannitol, sucrose, and urea. Other diuretics (e.g., acetazolamide) work by blocking the reabsorption of sodium bicarbonate by the tubules, thus increasing urine formation. These and still other types are used infrequently in conjunction with the mercurial diuretics.