CA inhibitors block HCO3^- reabsorption in PCT and cause diuresis; hyperchloremic metabolic acidosis reduces body pH; ↓ intraocular pressure

Metabolic acidosis, renal stones, ↑ K⁺ secretion, hyperammonemia in cirrhotics

Altered taste

Glaucoma, urinary alkalinization (enhance secretion of weak acids), mountain sickness, edema with alkalosis

Inhibit Na⁺/K⁺/2Cl^- transporter in the TAL reducing reabsorption of NaCl; diminishes lumen positive potential created by K⁺ back diffusion which drives Mg⁺² and Ca⁺² reabsorption

Ototoxicity, hypokalemia, hypocalcemia, hypovolemia, hyperuricemia (precipitate gout), hypomagnesemia, allergic reactions to sulfonamides

Pulmonary edema, peripheral edema, hypertension, acute hypercalcemia or hyperkalemia, acute renal failure, anion overdose

Not a sulfonamide but has typical loop activity and some uricosuric action

Ototoxicity, hypokalemia, hypocalcemia

Anatagonist of aldosterone, weak antagonism of androgen receptors;

Hyperkalemia, gynecomastia (spironolactone, not eplerenone)

Aldosteronism from any cause, hypokalemia due to other diuretics, post MI

Direct inhibitor of epithelial Na⁺ channels in CCT in collecting tubules; since K⁺ secretion is coupled with Na⁺ entry in CCT these agents are also K⁺ sparing

Hyperkalemia metabolic acidosis

Hypokalemia from other diuretics, reduces lithium-induced polyuria

Like spironolactone, more selective for aldosterone (mineralocorticoid) receptors

Less active on androgen and progesterone receptors = ↓ adverse effects than spironolactone

Like amiloride, Direct inhibitor of epithelial Na+ channels in CCT, but metabolized in liver = less potent, more toxic

hyperkalemia

Filtered by glomerulus but not reabsorbed; ↓ brain volume, ↓intraocular pressure

Nausea, vomiting, headache

Renal failure due to increased solute load (eg. rhabdomyolysis), glaucoma, increased intracranial pressure

Antagonist at V_1a and V₂ ADH receptors, reduces water reabsorption, ↑ plasma Na⁺

Hypernatremia and nephrogenic diabetes insipidus

Syndrome of Inappropriate ADH Secretion (SADH), hyponatremia due to ADH excess