Also powerful inhibitor of cl reabsorption from

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Unformatted text preview: vity reactions) Loop Diuretics Loop • Example: – Furosemide (Lasix®) • A very powerful thiazide that retains its effect on blood vessels (vasodilation). • Also, powerful inhibitor of Cl- reabsorption from ascending limb of loop of Henle. • Lasix® is 8-10 times more powerful than other thiazides. • It can cause up to 4 liters of urine to be formed within the first few hours of administration. Furosemide: Therapeutic Uses Furosemide: • Emergency drug: rapid & effective diuretic. – Congestive heart failure – Acute pulmonary edema • works because of vasodilator effect – Hypertension - acute only (vasodilator effect) – Chronic renal failure • more powerful drug than other thiazides • is usually necessary when kidney 80% impaired – Note: Short duration of action (effects persist only about 4 hours) Furosemide: Special Cautions Furosemide: • Serious electrolyte imbalance common – especially potassium depletion and alkalosis • Dehydration and hypotension possible • Temporary or permanent deafness Other Loop Diuretics: Other • Examples: – ethacrynic Acid (Edecrin®) – bumetanide (Bumex®) – torsemide (Demadex®) • Mechanism – Inhibit Na+ reabsorption from pct – Inhibit Cl- reabsorption from ascending limb of loop of Henle Therapeutic Uses Therapeutic Other Loop Diuretics: • Edema of various causes • Alternatives to Furosemide: – as effective for diuresis – but not special vascular effect – not specifically for treating hypertension Cautions Cautions Other Loop Diuretics: • • • • • Toxicity, worsens with chronic use Dehydration and hypotension Hypokalemia and alkalosis Deafness (temporary or permanent) Rapid onset (maximum effect 2 hours – diuresis persists for 6-8 hours – not usually administered more than once per day • Rare cases of myalgia reported. Carbonic Anhydrase Inhibitors Carbonic ® acetazolamide (Diamox®) • no longer used as diuretics • we studied with glaucoma • May be used as adjunct: – in seizures – to prevent altitude sickness Potassium Sparing Diuretics Potassium • none are pot...
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