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Harrington J T - - 1975
The use of diuretics to treat edema is reviewed. Normal salt and water metabolism is reviewed briefly. The drugs covered are the thiazide diuretics, loop diuretics(ethacrynic acid and furosemide) and distal blocking agents (spironolactone and triamterene). The sites and modes of action, indications, doses, complications and relative costs of these ...
Relevancy Score: Relevancy Score: 1000
Greger R - - 1987
Loop diuretics such as furosemide, piretanide, and bumetanide bind reversibly to the Na+2Cl-K+ carrier. This transporter is responsible for the uptake of Cl- into the thick ascending limb segment. As a consequence, these compounds reduce or abolish NaCl reabsorption in this nephron segment and lead to a decreased interstitial hypertonicity ...
Relevancy Score: Relevancy Score: 973
Orita Y - - 1996
Diuretics have been empirically developed. Inorganic mercury was used as diuretics from 16C. Guy's Hospital Pills (containing the equal part of Hg2Cl2, digitalis, and squill) was well known in the 19 C. Discovery of the diuresis of merbaphen has led to develop many organomercurial diuretics and to give suggestion of ...
Relevancy Score: Relevancy Score: 955
Nakanishi Keita - - 2006
Diuretics interfere with the sodium retention of heart failure by inhibiting the reabsorption of sodium in the renal tubes, increase urine output and decrease physical signs of fluid retention in patients with heart failure (HF). Diuretics are the only drugs used for the treatment of HF that can adequately control ...
Relevancy Score: Relevancy Score: 924
Schwartz J - - 1986
Microaspiration techniques and clearance studies have shown that reabsorption of filtered sodium approximates 65% in the proximal tubule, 25 to 30% in the ascending limb of the loop of Henle and 5 to 10% in the dilution segment. Reabsorption in the Henle loop is of special significance as it governs ...
Relevancy Score: Relevancy Score: 875
Taurand S - - 1997
Relevancy Score: Relevancy Score: 872
Martínez-Rodríguez R - - 2007
Loop diuretics are quite often used in medical practice. In spite of a wide security, there are several adverse events that should be known, in order to be early recognised as soon as they appear. Ototoxicity associated to furosemide is infrequent and reversible. However, permanent deafness associated with furosemide administration ...
Relevancy Score: Relevancy Score: 864
Morimoto S - - 1992
Relevancy Score: Relevancy Score: 863
Hashimoto S - - 2000
Relevancy Score: Relevancy Score: 863
Felker G Michael - - 2011
Congestion is a major component of the clinical syndrome of heart failure, and diuretic therapy remains the cornerstone of congestion management. Despite being widely used, there is very limited evidence from prospective randomized studies to guide the prescription and titration of diuretics. A thorough understanding of the pharmacology of loop ...
Relevancy Score: Relevancy Score: 859
Gobin Niels - - 2010
Loop diuretics belong to the most common medications used in ambulatory and hospitalized patients, especially in situation of hypervolemia and chronic renal failure. Prolonged used of these agents in particular medical conditions can lead to attenuation of their diuretic effect, commonly known as "resistance" to diuretics. This article intends to ...
Relevancy Score: Relevancy Score: 847
Dormans T P - - 1996
Although it is generally believed that the beneficial effect of loop diuretics is the result of a rapid increase in diuresis, substantial evidence, from a large number of in vitro and in vivo experiments, has accumulated showing that administration of furosemide causes direct vascular effects, which probably contribute to its ...
Relevancy Score: Relevancy Score: 844
Romankiewicz J A - - 1982
Relevancy Score: Relevancy Score: 835
Beermann B - - 1986
Thiazides and compounds with similar models of action exert their most important renal effects on the cortical-diluting segment of the nephron, most likely from the peritubular side. In contrast, the most important site of action of loop-diuretics is the luminal side of the ascending part of the diluting segment. The ...
Relevancy Score: Relevancy Score: 830
Wittner M - - 1991
In the thick ascending limb of the loop of Henle, NaCl reabsorption is mediated by a Na+/2Cl-/K+ cotransport system, present in the luminal membrane of this nephron segment. Loop diuretics such as furosemide (frusemide), piretanide, bumetanide and torasemide bind reversibly to this carrier protein, thus reducing or abolishing NaCl reabsorption. ...
Relevancy Score: Relevancy Score: 826
Asare Kwame - - 2009
PURPOSE: The management of loop diuretic resistance in the intensive care unit (ICU) is reviewed. SUMMARY: Volume overload, a common complication of fluid resuscitation, is frequently encountered in the ICU and is associated with numerous adverse effects, including pulmonary and peripheral edema, acute lung injury, and pleural effusions. Loop diuretics ...
Relevancy Score: Relevancy Score: 813
Ikeda K - - 1997
Recent advances in molecular biology have been applied to inner ear research. Loop diuretic ototoxicity has been suggested, but not proven, to share a common mechanism with diuretic effects on renal tubules. The discovery of the molecular nature of the Na-K-2Cl cotransporter in the cochlea provided a better understanding of ...
Relevancy Score: Relevancy Score: 813
Reyes A J - - 1993
In healthy subjects, 24-h natriuresis, kaliuresis, calciuresis, and magnesiuresis increase in response to the first oral dose of a standard (diuretic) formulation of a loop diuretic, such as furosemide 40 mg. However, low-dose formulations of loop diuretics, such as torasemide 2.5 mg, do not elevate 24-h natriuresis after the first ...
Relevancy Score: Relevancy Score: 804
Rybak L P - - 1993
The loop diuretics are drugs that increase the excretion of water and electrolytes in the urine by their action on the cells in the loop of Henle. Clinical reports of ototoxicity of these agents are reviewed, and the results of a number of studies in experimental animals are discussed. These ...
Relevancy Score: Relevancy Score: 797
Bülow H H - - 1993
The pharmacodynamics and -kinetics as well as rational pharmacotherapy of furosemide and bumetanide is reviewed. In renal insufficiency, a reduced response to diuretics is due to altered pharmacokinetics. The optimum dose can be determined within three to four hours by titration and the effect is measured by the amount of ...
Relevancy Score: Relevancy Score: 784
Sica Domenic A - - 2011
J Clin Hypertens (Greenwich). 2011;13:639-643. ©2011 Wiley Periodicals, Inc. KEY POINTS AND PRACTICAL RECOMMENDATIONS: •  Although chlorthalidone and hydrochlorothiazide are structurally similar, they are very different pharmacokinetically, with chlorthalidone having both an extremely long half-life (approximately 40 to 60 hours) and a large volume of distribution, with gradual elimination from the ...
Relevancy Score: Relevancy Score: 773
Fowler S F - - 1995
The pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and dosage and administration of torsemide are reviewed. Torsemide belongs to the pyridine-sulfonylurea class of loop diuretics. Its primary site of activity is the thick ascending limb of the loop of Henle, where it blocks active reabsorption of sodium and chloride, resulting in ...
Relevancy Score: Relevancy Score: 769
Yelton S L - - 1995
OBJECTIVE: To evaluate the role of continuous infusion loop diuretics in selected patient populations, discuss the advantages and disadvantages associated with continuous infusion, and recommend monitoring parameters for the use of continuous infusion therapy. Current dosing guidelines for continuous infusion loop diuretics have not been established, but a summary of ...
Relevancy Score: Relevancy Score: 758
Michel D - - 1992
Azosemide, a novel loop diuretic that has been available for the past few years, acts qualitatively like thiazide, viz by prolonging the diuretic effect with, however, only a slight delay in the onset of diuresis, in combination with the quantitative effect of previous loop diuretics, i.e. large excretion volumes. On ...
Relevancy Score: Relevancy Score: 756
Cox Zachary L ZL Assistant Professor; Department of Pharmacy Practice; Lipscomb University College of Pharmacy; Nashville, TN; Department of Pharmacy; Vanderbilt University Medical Center; Nashville, TN. Electronic address: - - 2014
Loop diuretics are a cornerstone of symptom management to nearly all patients with heart failure. Diuretic resistance is a clinical problem with similar presentation despite diverse and multiple etiologies. While the exact incidence is not known, diuretic resistance occurs frequently and can increase the length of hospitalization. Despite the prevalence ...
Relevancy Score: Relevancy Score: 748
Raphael V - - 1988
Relevancy Score: Relevancy Score: 743
Leonard Charles E CE Center for Clinical Epidemiology & Biostatistics, Department of Biostatistics & Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States of America; Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States of - - 2014
The effectiveness of the clinical strategy of empiric potassium supplementation in reducing the frequency of adverse clinical outcomes in patients receiving loop diuretics is unknown. We sought to examine the association between empiric potassium supplementation and 1) all-cause death and 2) outpatient-originating sudden cardiac death (SD) and ventricular arrhythmia (VA) ...
Relevancy Score: Relevancy Score: 742
Risler T - - 1994
Loop diuretics increase the fractional excretion of volume, sodium, potassium, chloride and calcium in all stages of renal failure, and their potency is directly correlated with these excretory activities. Tubular secretion of loop diuretics in renal failure is impaired both by reduced renal blood flow and by reduced activity of ...
Relevancy Score: Relevancy Score: 741
Leary W P - - 1984
Long term administration of common loop or distal tubular diuretics may cause somatic magnesium depletion. The resultant deficiency of Mg++ destabilises the myocardium electrically and is a principal cause of cardiac arrhythmias ascribed to diuretics. The adverse effects of diuretics caused by Mg++ depletion can be avoided by selecting diuretics ...
Relevancy Score: Relevancy Score: 739
Lief P D - - 1978
Relevancy Score: Relevancy Score: 737
Priebe H J - - 1984
Relevancy Score: Relevancy Score: 734
Havard C W - - 1974
Relevancy Score: Relevancy Score: 734
Panet R - - 1985
Mouse 3T3 fibroblasts have a loop diuretic sensitive Na+ transport system, responsible for more than 50% of the total Na+ influx. This transport system is dependent on the simultaneous presence of all three ions; Na+, K+, (Rb+) and Cl- in the extracellular medium. The same requirement for these three ions ...
Relevancy Score: Relevancy Score: 730
Eades S K - - 1998
The loop diuretics furosemide and bumetanide are frequently employed in the pediatric population for the management of fluid overload in both acute and chronic disease states. They act mainly by inhibiting sodium reabsorption in the nephron at the thick ascending limb of Henle's loop. Important pharmacokinetic differences between adults and ...
Relevancy Score: Relevancy Score: 727
Rossignol Patrick - - 2013
Introduction: Despite widespread use of loop diuretics in congestive heart failure (HF) to achieve decongestion and relief of symptoms, as recommended by the current guidelines, there is uncertainty as to their long-term therapeutic efficacy and safety. Their efficacy and safety compared to venous ultrafiltration are currently under investigation in acute ...
Relevancy Score: Relevancy Score: 723
Rice T L - - 1989
Relevancy Score: Relevancy Score: 721
Rybak L P - - 1991
A microelectrode was used to measure endocochlear potentials (EP) in adult chinchillas and to study the effects of a series of loop diuretics. EP was measured before, during and for several hours after the intravenous injection of the following loop diuretics: furosemide, piretanide, bumetanide, ethacrynic acid, indacrinone stereoisomers and ozolinone. ...
Relevancy Score: Relevancy Score: 720
Jentzer Jacob C - - 2010
Volume overload is an important clinical target in heart failure management, typically addressed using loop diuretics. An important and challenging subset of heart failure patients exhibit fluid overload despite significant doses of loop diuretics. One approach to overcome loop diuretic resistance is the addition of a thiazide-type diuretic to produce ...
Relevancy Score: Relevancy Score: 719
Greenberg A - - 2000
BACKGROUND: Diuretics are widely used and generally safe, but like any therapeutic agents, they may cause side effects. METHODS: A review of recent literature pertaining to diuretic usage was performed, with emphasis on specific reports of side effects. Reports of large-scale hypertension trials employing diuretics were also examined for descriptions ...
Relevancy Score: Relevancy Score: 716
Bard Robert L - - 2004
Food significantly affects the pharmacokinetics of oral loop diuretics in healthy individuals, but studies have not been performed in patients with edema. Because of this omission, food's effect on pharmacokinetics has been overlooked and may decrease the pharmacodynamic response in patients who rely on diuretics. Despite this potential interaction, reference ...
Relevancy Score: Relevancy Score: 715
Rahn K H - - 1983
Diuretics belong to the drugs most frequently used. Thiazide diuretics, loop diuretics and potassium sparing diuretics are the agents with practical significance. Many data concerning the pharmacokinetics of these drugs have been reported. Nevertheless, the metabolism of some diuretics is not yet fully elucidated. There are numerous pharmacodynamic drug interactions ...
Relevancy Score: Relevancy Score: 713
Williamson H E - - 1987
Relevancy Score: Relevancy Score: 710
Berg K J - - 1992
Loop-diuretics inhibit the Na+/K+/2Cl(-) -cotransport system in the thick ascending loop of Henle, and are the most potent of the diuretic agents. They also increase production of prostaglandins and, when given intravenously, reduce pulmonary capillary pressure. The clinical effects, and side effects, of loop diuretics are reviewed. In Norway, use ...
Relevancy Score: Relevancy Score: 709
Suki W N - - 1999
Resistance to diuretic action is frequently encountered in the clinical setting. This is best managed by systematically optimizing the pharmacodynamic-pharmacokinetic factors that may be involved. Important pharmacodynamic measures include improving the underlying disease state, restriction of salt intake, limiting the use of vasodilators which may cause hypotension, lowering protein excretion, ...
Relevancy Score: Relevancy Score: 707
Giebisch G - - 1993
This article provides a survey of transport mechanisms in the loop of Henle and of secondary effects on electrolyte excretion of loop diuretics. Results are presented of experiments that define ion transport in the thick ascending limb. New data on ion channels and transport regulation in this tubule segment are ...
Relevancy Score: Relevancy Score: 706
Brater D C - - 1991
The clinical pharmacology of torasemide, bumetanide, piretanide and furosemide (frusemide) is discussed. These drugs share a similar mechanism of action in inhibiting Na(+)-K(+)-2Cl- reabsorption at the thick ascending limb of the loop of Henle. They differ in their routes of metabolism, pharmacokinetics, and potency. Whether such differences are clinically important ...
Relevancy Score: Relevancy Score: 703
Chiong Jun R - - 2010
BACKGROUND: Heart failure (HF) is a common condition associated with substantial cost, morbidity, and mortality. Because results of clinical trials in the acute decompensated heart failure (ADHF) setting have been mostly neutral, loop diuretics remain the mainstay of treatment. HYPOTHESIS: Loop diuretic use may be associated with unfavorable outcomes. METHODS: ...
Relevancy Score: Relevancy Score: 702
Ritz E - - 2000
The main indications for diuretic treatment of renal patients are edema and hypertension. Pharmacokinetics and pharmacodynamics of diuretics are altered in patients with proteinuria and/or impaired renal function. These patients exhibit avid sodium retention. Diuretics are partially inactivated by binding to proteins in tubular fluid. The natriuretic response to diuretics ...
Relevancy Score: Relevancy Score: 701
Meschi Michele - - 2012
Refractory edema is a clinical condition which recognises different etiologies and is characterized by decreased or absent diuretic response before the therapeutic goal is reached. Several pharmacokinetic and pharmacodynamic strategies are used in this setting, and further research is needed in order to optimize drug effectiveness.
Relevancy Score: Relevancy Score: 698
Kedzierska K - - 2001
We describe a case of 40-year old patient with chronic, resistant to treatment hypokalaemia. Differential diagnosis of renal potassium loss among Gitelman's syndrome, Bartter's syndrome and loop diuretic abuse was made.
Relevancy Score: Relevancy Score: 696
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