osmotic diuretics


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os·mot·ic di·u·ret·ics

drugs (for example, mannitol) that by their osmotic effects retain water during urine formation and thus dilute electrolytes in the urine, making resorption less efficient; they promote elimination of water and electrolytes in the urine.

os·mot·ic di·u·ret·ics

(oz-mot'ik dī'yūr-et'iks)
Drugs (e.g., mannitol) that by their osmotic effects, promote the elimination of water and electrolytes in the urine.

diuretics

powerful drugs, often termed 'water tablets', that control hypertension and peripheral oedema; action of some local anaesthetics is antagonized by concomitant use of some diuretics (see Table 1), e.g. aldosterone antagonists (e.g. spironolactone); carbonic anhydrase inhibitors, e.g. acetazolamide; loop diuretics, e.g. furosemide; osmotic diuretics, e.g. mannitol; potassium-sparing diuretics, e.g. amiloride, or in combination with other diuretics; thiazide diuretics, e.g. bendroflumethiazide
Table 1: Principal drug interactions of local anaesthetic agents and other medications
Local anaesthetic agent Proprietary name Principal drug interactionsEffect of interaction
Lidocaine
Xylocaine
Antiarrhythmic agents
Antibacterial agents
Antipsychotics
Antivirals
Beta-blockers
Diuretics
Dolasetron
Ulcer-healing drugs
Increased myocardial depression
Increased risk of ventricular arrhythmias if lidocaine is given with quinpristin/dalfopristin
Increased risk of ventricular arrhythmias if lidocaine is given with any drug that prolongs the QT interval of the cardiac cycle
Plasma concentration of lidocaine increased by amprenavir, atazanavir and lopinavir
Increased myocardial depression
Increased risk of lidocaine toxicity when given with propranolol
The action of lidocaine is antagonized by the hypokalaemia caused by acetazolamide, loop diuretics or thiazide and related diuretics (i.e. a greater dose of lidocaine would be required to achieve anaesthesia)
Increased risk of ventricular arrhythmia if lidocaine is given with dolasetron
Plasma concentration of lidocaine increased when given with cimetidine; risk of lidocaine toxicity increased with cimetidine
Bupivacaine
Marcain
Levo-bupivacaine
Chirocaine
Beta-blockersIncreased risk of bupivacaine toxicity when given with propranolol
Increased risk of myocardial depression if given with other antiarrhythmic agents
Prilocaine
Citanest
Antiarrhythmic agents
Antibacterial agents
Increased risk of myocardial depression if given with antiarrhythmic agents
Increased risk of methaemoglobinaemia if given with sulphonamide antibacterial agents
Ropivacaine
Naropin
AntidepressantsMetabolism of ropivacaine is inhibited by fluvoxamine, thereby enhancing the risk of ropivacaine toxicity
Mepivacaine
Scandonest
Drug not listed in the British National Formulary