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.
What is the first-line diuretic for cirrhosis?
Spironolactone is the first-line diuretic recommended for a patient with cirrhosis and edema, initiating with a dose of 50 mg. With its long half-life, doses are altered after 3 to 4 days.
Can diuretics be used in cirrhosis with ascites?
Use of Diuretics in Cirrhosis with Ascites. The body weight loss recorded was dependent upon the amount of human serum albumin administered instead of the dose of diuretics [ 56 ]. A reduction in plasma renin concentration was observed in patients treated with human serum albumin combined with diuretic therapy [ 57 ].
What type of diuretics are used in heart failure?
Jentzer J. C., Dewald T. A., Hernandez A. F. Combination of loop diuretics with thiazide-type diuretics in heart failure. Journal of the American College of Cardiology. 2010;56(19):1527–1534. doi: 10.1016/j.jacc.2010.06.034.
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
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.
What is the most widely prescribed class of diuretics?
Thiazide diuretics Thiazides are the most commonly prescribed diuretics. They're most often used to treat high blood pressure. These drugs not only decrease fluids, they also cause your blood vessels to relax.
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.
Which class of diuretics should be prescribed?
Thiazide diuretics are recommended as one of the first drug treatments for high blood pressure. If diuretics aren't enough to lower your blood pressure, your doctor might add other blood pressure medications to your treatment plan.
What is the most effective diuretic?
Loop diuretics are the most potent diuretics as they increase the elimination of sodium and chloride by primarily preventing reabsorption of sodium and chloride. The high efficacy of loop diuretics is due to the unique site of action involving the loop of Henle (a portion of the renal tubule) in the kidneys.
Which is better Lasix or hydrochlorothiazide?
Lasix (Furosemide) is a very effective water pill and it'll certainly make you go to the bathroom more often. Removes water from the body, which lowers blood pressure. Microzide (hydrochlorothiazide (HCTZ)) is a well-tolerated water pill that's often the first-choice treatment for mild high blood pressure.
Which thiazide diuretic is best?
Chlorthalidone is the preferable diuretic for initial and subsequent therapy of hypertension, starting with 12.5 mg/d and increasing to ≤25.0 mg/d with or without other antihypertensive drugs.
Why is thiazide a diuretic?
Thiazide diuretics work by blocking sodium and chloride (Na/Cl) channels in the distal convoluted tubule of the nephron and inhibit the reabsorption of sodium and water.
What type of diuretic 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.
What is a common diuretic?
Examples of diuretics include: Aldactone (spironolactone) Bumex (bumetanide) Demadex (torsemide) Esidrix (hydrochlorothiazide)
What two classes of diuretics are commonly used for CHF and why?
Although there are three main classes of diuretics (loop diuretics, thiazide diuretics with metolazone and potassium-sparing diuretics), loop diuretics are most commonly used, because they have the most potent natriuretic action.
What are diuretics and its classification?
Diuretics may be classified according to their chemical structure, their mechanism and site of action within the nephron, and their diuretic potency. Those agents with primary action in the proximal nephron include the carbonic anhydrase inhibitors, e.g. acetazolamide, a sulfonamide derivative.
What is SBP in cirrhotic patients?
SBP is a frequent and serious complication of cirrhotic patients with ascites.
What is the cause of increased reabsorption of sodium in the distal tubule?
Cirrhosis is associated with enhanced reabsorption of sodium both at the proximal tubule and at the distal tubule.20Increased reabsorption of sodium in the distal tubule is due to increased circulating concentrations of aldosterone.
Why is ascites important?
Adequate management of ascites is important, not only because it improves quality of life in patients with cirrhosis, but also prevents serious complication such as SBP. However, treatment of ascites does not significantly improve survival.
When should ascitic amylase be measured?
Ascitic amylase should be measured when there is clinical suspicion of pancreatic disease. (Level of evidence: 4; recommendation: C.) Ascitic fluid should be inoculated into blood culture bottles at the bedside and examined by microscopy for a neutrophil count. (Level of evidence: 2a; recommendation: B.)