Loop diuretics often are used alone or in combination. In patients with New York Heart Association class III and IV congestive heart failure, spironolactone has been found to reduce morbidity and mortality rates. In patients with cirrhosis, ascites is treated with paracentesis and spironolactone.
How effective are diuretics in the treatment of cirrhosis of the liver?
Due to effective diuresis and natriuresis, ascites formation was stopped in all patients without the need for diuretics. The liver function was improved in 81% of cases, and recurrent encephalopathy was found in 6% of patients. CONCLUSION
What are the different types of diuretics?
- thiazides, loop diuretics, potassium-sparing diuretics and osmotic diuretics. Thiazides are the most commonly prescribed but can cause potassium depletion. Because of this people on this type of diuretic often take potassium supplements. Loop diuretics are fast acing and increase the amount of urine produced in a few hours. They are often
Should diuretics be used to treat heart failure and nephrotic syndrome?
Background Choosing the suitable use of diuretics in patients with heart failure, nephrotic syndrome and cirrhosis requires an understanding of the pathophysiology of these edematous conditions. These diseases lead to sodium and water retention in patients, causing detrimental effects in their morbidity and mortality.
How are cirrhosis and nephrotic syndrome treated?
Treatment of ascites in liver cirrhosis with spironolactone as the primary agent is highlighted with further therapeutic options. Lastly, management choices for nephrotic syndrome are discussed and recommended beginning from basic sodium restriction to combined diuretic therapies.
What diuretic is used for cirrhosis?
Spironolactone is the first-line diuretic recommended for a patient with cirrhosis and edema, initiating with a dose of 50 mg.
Why are diuretics used in cirrhosis?
The cirrhotic patient with ascites has an increased tubular reabsorption of sodium. Diuretic therapy allows an urinary loss of sodium.
Why is spironolactone a choice of cirrhosis?
Spironolactone lowers portal hypertension by improvement of liver fibrosis and inhibition of intrahepatic vasoconstriction via down-regulating ROCK-2 activity and activating NO/PKG pathway. Thus, early spironolactone therapy might be the optional therapy in cirrhosis and portal hypertension.
Why is furosemide used in cirrhosis?
Furosemide, a loop diuretic, is used for inhibiting chloride and sodium reabsorption in the thick ascending limb of the loop of Henle. It can rapidly absorb from gut and its action can reach peak effect quickly within 1 to 2 hours, and then diuretic effects end in 3 to 4 hours after consumption.
What is a thiazide diuretic drug?
Thiazide diuretics are an FDA-approved class of drugs that inhibit the reabsorption of 3% to 5% of luminal sodium in the distal convoluted tubule of the nephron. By doing so, thiazide diuretics promote natriuresis and diuresis.
What are the 5 types of diuretics?
Let's take a closer look at the classes of diuretics and how they work, and what nurses need to know.Loop Diuretics. ... Thiazides and Thiazide-Like Diuretics. ... Carbonic Anhydrase Inhibitors. ... Potassium-Sparing Diuretics. ... Osmotic Diuretics. ... Nursing Considerations.
What class of drug is spironolactone?
Spironolactone is in a class of medications called aldosterone receptor antagonists. It causes the kidneys to eliminate unneeded water and sodium from the body into the urine but reduces the loss of potassium from the body.
What kind of diuretic is spironolactone?
Spironolactone is a potassium-sparing diuretic (water pill). It prevents your body from absorbing too much salt and keeps your potassium levels from getting too low. This medicine is also used to treat or prevent hypokalemia (low potassium levels in the blood).
How does spironolactone differ from furosemide?
Lasix (Furosemide) is a very effective water pill and it'll certainly make you go to the bathroom more often. Removes extra water from your body. Aldactone (spironolactone) should be used with other medicines to get rid of excess fluid in your body, especially if you have heart failure.
What class of drug is furosemide?
Furosemide belongs to a group of medicines called loop diuretics (also known as water pills). Furosemide is given to help treat fluid retention (edema) and swelling that is caused by congestive heart failure, liver disease, kidney disease, or other medical conditions.
Is Lasix contraindicated in cirrhosis?
Loop diuretics (applies to Lasix) cirrhosis Loop diuretic therapy should be initiated in the hospital under strict observation in patients with liver cirrhosis and ascites.
What diuretics are used to treat ascites?
LJ Ascites is most commonly treated with a diuretic, which removes the fluid from the abdomen. The most common such agent is spironolactone (Aldactone, Pfizer), with furosemide (Lasix, Hoechst) frequently used as an adjuvant. These medications lead directly to decreased fluid in the abdomen.
Which class of diuretics may interact with ACE inhibitors, angiotensin receptor blockers, sal
The classification of diuretics whose interactions may occur with ACE inhibitors, angiotensin receptor blockers (ARBs), salicylates, and NSAIDs to cause hyperkalemia is: potassium-sparing diuretics. Extreme caution is indicated when this diuretic class is used in patients with heart failure or active intracranial bleeding is:
What should be included in patient education for treatment with a non-uricosuric agent?
Patient education for treatment with a non-uricosuric agent, such as allopurinol (Zyloprim), should include: "Avoid alcohol.". Patient education for treatment with antispasmodics, such as Ditropan (oxybutynin), should include: "Use caution when driving or operating machinery.".
What is the best treatment for prostatic hypertrophy?
Alpha-blockers, such as tamsulosin (Flomax), treat benign prostatic hypertrophy. causing relaxation of the bladder neck and prostrate. Patient education for treatment with thiazide diuretics, such as hydrochlorothiazide (HydroDIURIL), should include: "Take with food.".
What is the treatment for ascites in cirrhosis?
The medical treatment of ascites in cirrhosis is based on sodium restriction and the administration of diuretics. Because the natriuretic potency of spironolactone is greater than that of loop diuretics (i.e., furosemide) in patients with marked sodium retention, spironolactone is the basic drug for the treatment of ascites.
Does spironolactone affect potassium?
The simultaneous administration of spironolactone and furosemide increases the natriuretic effect of each drug and diminishes their effects on potassium metabolism. Recent studies indicate that large-volume paracentesis associated with intravenous albumin infusion is more effective than diuretic therapy in eliminating the ascitic fluid;
Why do diuretics cause a decrease in potassium?
Diuretics are commonly prescribed in the treatment of. hypertension and to treat heart failure. Along with the loss of fluid, diuretics can also cause a fall in potassium levels.
What is the purpose of osmotic diuretics?
to help prevent excess potassium loss. Osmotic diuretics are. not used as often as the others. They are most commonly used to decrease. intracranial pressure (reduce swelling of the brain) and intraocular pressure (pressure in the eye). Gout is a disorder that occurs when.
What is the condition that can cause difficulty for males regarding the urinary system?
A common condition that can cause difficulty for males regarding the urinary system is. benign prostatic hypertrophy otherwise known as enlarged prostate. Two groups of medications that are used to. improve enlarged prostate.
What is gouty arthritis?
Gout (often also called gouty arthritis) results in the accumulation of uric acid crystals in the joints leading to great pain and swelling. Two of the most common drugs used in gout .
Does allopurinol reduce uric acid?
Allopurinol reduces. the level of uric acid in the blood by interfering with the enzyme involved with the production of uric acid in the body. Antispasmodic medications are prescribed to. reduce the strength and frequency of bladder contractions.
Does cholinergy help with bladder incontinence?
They can help increase the bladder capacity in patients with a neurogenic bladder that results in incontinence. Cholinergic medication. stimulate the parasympathetic nerves that influence the bladder bringing about. contraction of the bladder.