Diuretics - Overview
Overview
Diuretics are a class of drugs that increase urine output. That means that users not only urinate more often, they urinate in greater amounts than usual. The main medical uses for diuretics are the treatment of high blood pressure and congestive heart failure.
Because diuretics cause an overall water weight loss, they are often abused by individuals with eating disorders such as anorexia (pronounced ah-nuh-REK-see-uh) and bulimia (pronounced bull-EEM-eeh-yuh). Anorexia is a severe disorder characterized by an intense fear of gaining weight, a refusal to eat, a distorted sense of self-image, and excessive weight loss. Bulimia is a disorder that involves long periods of bingeing on food, followed by self-induced vomiting and abuse of laxatives. The words anorexia and bulimia are both taken from the Greek language. Anorexia means "no appetite" and bulimia means "great hunger."
Diuretics are also abused by athletes who are trying to "make weight" for certain classes of competition. Oftentimes, the use of diuretics can help athletes, such as weightlifters, lose just enough—perhaps an extra pound or so—to remain in their chosen weight class. This practice is illegal in sporting competition, however. Diuretics are considered banned substances according to the International Olympic Committee (IOC), the United States Anti-Doping Agency (USADA), the World Anti-Doping Agency (WADA), the National Collegiate Athletic Association (NCAA), and a number of other national and international sporting authorities.
William Withering's Work on Diuretics
The name diuretic comes from a Greek term meaning "to urinate." This type of drug first gained acceptance in the medical community when eighteenth-century British physician William Withering (1741–1799) created digitalis (dij-ih-TAL-us) from the dried leaves of the foxglove plant (Digitalis purpurea). Digitalis gives the heart muscle a boost, making its contractions stronger and faster.
Digitalis also acts as a diuretic. In With-ering's time, it became a popular treatment for dropsy (DROP-see), an old-fashioned term for edemaPronounced ih-DEEM-uh; water buildup in the body's tissues that causes swelling.. People with edema often have swollen feet, ankles, and lower legs due to water buildup in their tissues. Fluid retention in the tissues of the body can be very dangerous. It is frequently related to congestive heart failure, which can be deadly. As of 2005, digitalis-type drugs were still being used in the treatment of heart failure. By strengthening the contractions of the heart muscle, digitalis helps pump excess fluids throughout the body. When the heart works more efficiently, fluids are less likely to pool, or accumulate, in the feet and legs.
Breakthroughs in Diuretic Research
In 1957, researchers John Baer, Karl Beyer, James Sprague, and Frederick Novello formulated the drug chlorothiazide (KLOR-oh-THY-uh-zide), the first of the thiazide diuretics. It was a pioneering achievement in medicine. Chlorothiazide was the first safe and effective long-term treatment for patients with high blood pressure and heart failure. All four scientists received the Albert and Mary Lasker Foundation Special Public Health Award for 1975 for their work on diuretic drug compounds. According to the Lasker Foundation Web site, "Such compounds are now universally accepted as a primary treatment for these conditions."
The next class of diuretic drugs to be developed were the so-called "loop diuretics." They take their name from the fact that they work on a specific part of the kidneyThe body's urine-producing organ. known as the loop of HenleThe U-shaped part of the nephron (tiny filtering unit of the kidney) where reabsorption processes take place.. Loop diuretics are the most powerful of all diuretics. The first one to appear on the market was furosemide (Lasix) in 1965. Loop diuretics were hailed as a major advance in the treatment of congestive heart failure.
It was around this time that over-the-counter diuretics first became available. Pamabrom (Pamprin), a medication that relieves the fluid retention and bloating associated with a woman's menstrual cycleCommonly referred to as a woman's period; the monthly discharge of blood and other secretions from the uterus of nonpregnant females., is still available without a prescription. There are also certain dietary supplements that may have diuretic action as a side effect, but have a different primary purpose. For example, the supplement creatine promotes fluid loss with regular use. (A separate entry on creatine is available in this encyclopedia.)
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