| Diuretic treatment for the sodium retention of congestive heart failure. | |
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MedLine Citation:
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PMID: 8074594 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The use of diuretics for the treatment of sodium retention in congestive heart failure was evaluated. Particular focus was given to the altered renal response to diuretics in patients with heart failure and adverse responses to diuretic therapy. Highlighted information included historical aspects of the development of diuretics, mechanisms of sodium retention, the physiologic and clinical response to diuretics, and the altered pharmacokinetics and pharmacodynamics of diuretics in congestive heart failure. Despite more than 60 years of empiric diuretic use in heart failure, the actual database regarding the long-term efficacy, adverse effects, and altered mortality outcome in heart failure is relatively small. Existent pharmacokinetic and pharmacodynamic data are typically not collected within the context of heart failure efficacy trials. In addition to altered electrolyte transport and total-body electrolyte depletion, diuretics may be associated with adverse neurohormonal activation. Thus, guidelines for acute and long-term therapy with diuretics in heart failure remain somewhat empiric. Diuretics will remain a mainstay for the treatment of edema in congestive heart failure but must be accompanied by moderate sodium restriction. However, large clinical trials of diuretics would be necessary to demonstrate that improved clinical efficacy with edema reduction is not offset by adverse effects, which include electrolyte depletion, ventricular arrhythmias, and subsequent increased mortality. |
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Authors:
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R J Cody; S H Kubo; K K Pickworth |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Archives of internal medicine Volume: 154 ISSN: 0003-9926 ISO Abbreviation: Arch. Intern. Med. Publication Date: 1994 Sep |
Date Detail:
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Created Date: 1994-09-27 Completed Date: 1994-09-27 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0372440 Medline TA: Arch Intern Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1905-14 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiology, Ohio State University Medical Center, Columbus. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Benzothiadiazines Diet, Sodium-Restricted* Diuretics / adverse effects, pharmacokinetics, pharmacology, therapeutic use* Drug Resistance Edema / metabolism, physiopathology Glomerular Filtration Rate Heart Failure / drug therapy*, metabolism, physiopathology Hemodynamics / drug effects Humans Injections, Intravenous Renal Circulation Sodium / metabolism* Sodium Chloride Symporter Inhibitors / pharmacokinetics, pharmacology, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Benzothiadiazines; 0/Diuretics; 0/Sodium Chloride Symporter Inhibitors; 7440-23-5/Sodium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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