Do I look bloated to you?

Hello. This past week has been an interesting one. I have not really done any homework since I got back from Spring Break. The laziness has been nice, but it has certainly increased my stress level.

This week I would like to make a departure once more. This past Tuesday I attended a funeral for my wife's grandfather. He died of natural causes after a long fight with heart failure. This forum is not appropriate to discuss the nature of my beliefs about the soul of man, but I do not believe that he is gone forever. When I too die I will no doubt be reunited with those who have preceded me to the next stage of existence. That is all I have to say about that.

Due to this experience I have chosen to focus on a medication that is often administered for the person who is enduring the complication of heart failure. This is especially relevant as I did a survey for this medication just yesterday as I spoke with a co-worker.
This weeks 'DotW' feature will be: Lasix, or Furosemide.
Here is a molecule of Lasix, also known as Furosemide. Using my limited understanding of chemistry, even though that is going to be my minor, I can see several sites where a possible reaction could occur. This molecule looks rather reactive.

Lasix is a form of Diruetic. Basically what this means is that it causes your body to loose fluid.
According to www.rateadrug.com:

Furosemide

Furosemide (INN) or frusemide (former BAN) is a loop diuretic used in the treatment of congestive heart failure and edema. It is most commonly marketed by Sanofi-Aventis under the brand name Lasix. It has also been used to prevent thoroughbred race horses from bleeding through the nose during races.Along with some other diuretics, furosemide is also included on the World Anti-Doping Agency's banned drug list due to its alleged use as a masking agent for other drugs.

That is a rather succinct summation of what Lasix is. Now, however, we must look at what a loop diuretic is.
This a graphic that explains the mechanism of absorption and action through which Lasix acts.

As you look through the mechanism you can see that Furosemide is labeled in the fifth group of actions going from left to right. There are a lot of ways that your body can have a diruetic agent act upon it.
Each type of medication works in a different part of the Nephron. The Nephron is the functional structure and basic unit of the Kydney (http://en.wikipedia.org/wiki/Nephron). The above picture is a simplified version of a Nephron.

Each class of diuretics has a distinct site of action in the nephron...Furosemide (Lasix), bumetanide (Bumex), ethacrynic acid (Edecrine) and torsemide (Demadex) work in the loop of Henle. (http://www.cmellc.com/geriatrictimes/g010327.html)

With the help of www.drugs.com we learn that a loop diruetic is essentially a 'water pill' that does not allow your body to absorb salt and instead passes that salt through your urine.

Diuretics are actually compounds that increase the urinary salt excretion, and water just happens to come along...Chemically, diuretics are organic anionic compounds.
-Christian W. Mende M.D. (http://www.cmellc.com/geriatrictimes/g010327.html)

Like most medications there are a number of cases in which it may be prescribed. I have chosen to discuss Lasix as they are used in the treatment of the heart failure patient, but the list of possible doses is, but is not limited to: congestive heart failure, kydney disorder, hypertension and liver disease (http://www.drugs.com/lasix.html). Additionally there are cases in which a medication such as Lasix is used to treat the symptoms of a different drug therapy. No specific instances come to mind, but a chain of drugs meant to relieve the symptoms of a first medication is not at all uncommon.

Now we have reached the end of our discussion on Lasix. Thank you for coming. As I ponder on the current status of medicine and pharmacology I find myself thinking that we have come a long way. The fact that my wife's grandfather was able to live as long as he did after he had his first surgery was nothing short of miraculous. That is due to prayers on his behalf and due to the advances in modern medicine that we all take for granted.
There is much more work to be done though.
I wish the best of luck to those who are working even now to improve the absorption pathways and better understand the human anatomy.