Category:Loop diuretics

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Loop diuretics inhibit renal tubular reabsorption of sodium from the ascending limp of the loop of Henle and are powerful diuretics. They act on the act on the Na+/K+/Cl- cotransporter. The most commonly used are furosemide and bumetanide. Ethacrynic acid is rarely used.

Contents

Therapeutic Uses

Heart Failure

They have a major role in the symptomatic treatment of heart failure.

Hypercalcaemia

With adequate salt and fluid load their action can be used to promote renal excretion of calcium

Hypertension

They have weak anti hypertensive actions but will enhance the hypotensive effects of say ACE inhibitors.

Nocturia

Some studies have shown that in elderly patients, a small dose of loop diuretic eg Bumetanide 1 mg given 6 hrs prior to bedtime reduced Nocturia

Side effects

Use of loop and thiazide diuretics is associated with gout, as they induce hyperuricaemia by increasing urate reabsorption. However this is not necessarily a direct action of the diuretics. Rather hyperuricaemia occurs when diuretics produce sufficient salt and water loss as to result in volume contraction and it is the volume contraction that causes urate reabsorption at the proximal tubule[1]. Accordingly it is the patients base line urate status before introduction of any diuretic that appears to be important[2] with to date the exception of bumetanide. There is good evidence that this drug is actually uricosuric[3]. Accordingly there is a predictable dose response behaviour both with dose of an individual diuretic and the worsening of hyperuricaemia when combination therapy is used.

References

Pages in category "Loop diuretics"

The following 5 pages are in this category, out of 5 total.

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