| Rational use of diuretics in acute decompensated heart failure. | |
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MedLine Citation:
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PMID: 18752765 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Jason A Goebel; Adrian B Van Bakel |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current heart failure reports Volume: 5 ISSN: 1546-9549 ISO Abbreviation: Curr Heart Fail Rep Publication Date: 2008 Sep |
Date Detail:
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Created Date: 2008-08-28 Completed Date: 2008-10-31 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101196487 Medline TA: Curr Heart Fail Rep Country: United States |
Other Details:
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Languages: eng Pagination: 153-62 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Aldosterone Antagonists / therapeutic use Diuretics / administration & dosage, pharmacology, therapeutic use* Drug Resistance Drug Therapy, Combination Furosemide / administration & dosage Heart Failure / drug therapy* Humans 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 Syndrome Ultrafiltration Vasoconstriction / drug effects |
| Chemical | |
Reg. No./Substance:
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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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