Document Detail

Rational use of diuretics in acute decompensated heart failure.
MedLine Citation:
PMID:  18752765     Owner:  NLM     Status:  MEDLINE    
Chronic heart failure poses an enormous health care burden to the United States and other developed countries. Acute decompensated heart failure (ADHF) accounts for nearly half of the morbidity and expense of treating this disease. Most patients presenting with ADHF have symptomatic vascular congestion. Diuretics, especially loop diuretics, are the primary pharmacologic intervention used in this population. Despite their widespread use, scant data from randomized clinical trials are available to guide therapeutic choices. In addition, data from several large registries examining weight loss during hospitalization for ADHF suggest that efficacy with diuretic treatment is far from universal. Aggressive diuresis carries a significant risk of electrolyte and volume depletion, with subsequent arrhythmias, hypotension, and worsening renal function. These complications often translate into worse prognosis. Diuretic regimens used to treat ADHF must be individualized based on general knowledge of potency and pharmacokinetic and pharmacodynamic considerations. This article summarizes older and more recent literature to provide a framework for making rational treatment choices in this difficult patient population.
Jason A Goebel; Adrian B Van Bakel
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current heart failure reports     Volume:  5     ISSN:  1546-9549     ISO Abbreviation:  Curr Heart Fail Rep     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-28     Completed Date:  2008-10-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101196487     Medline TA:  Curr Heart Fail Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  153-62     Citation Subset:  IM    
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MeSH Terms
Acute Disease
Aldosterone Antagonists / therapeutic use
Diuretics / administration & dosage,  pharmacology,  therapeutic use*
Drug Resistance
Drug Therapy, Combination
Furosemide / administration & dosage
Heart Failure / drug therapy*
Natriuresis / drug effects
Natriuretic Agents / therapeutic use
Natriuretic Peptide, Brain / therapeutic use
Nitrates / therapeutic use
Receptors, Purinergic P1 / antagonists & inhibitors
Receptors, Vasopressin / antagonists & inhibitors
Sodium Chloride Symporter Inhibitors / therapeutic use
Vasoconstriction / drug effects
Reg. No./Substance:
0/Aldosterone Antagonists; 0/Diuretics; 0/Natriuretic Agents; 0/Nitrates; 0/Receptors, Purinergic P1; 0/Receptors, Vasopressin; 0/Sodium Chloride Symporter Inhibitors; 114471-18-0/Natriuretic Peptide, Brain; 54-31-9/Furosemide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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