Loop diuretics mechanism of action and adverse effects. Diuretics help the body to lose excess amount of water. Journal of gerontological nursing there is increasing concern about possible or potential side effects of diuretics, particularly in the elderly. Furosemide is a potent diuretic which, if given in excessive amounts, can lead to a profound diuresis with water and electrolyte depletion. Although this helps the heart to function better as it has lesser volume of blood to pump, there are certain side effects that an. Diuretics are a group of drugs that induce increased production of urine. In contrast, potassiumsparing diuretics also remove salt and water from your body, but leave the potassium. Diuretics have been used in the treatment of hypertension for many years. This is achieved by inhibiting the nak2cl carrier in the luminal. Potassiumsparing diuretics information, uses and side effects. Among the thiazidetype diuretics, indapamide has been touted by some as distinctive in not causing significant metabolic. Different classes of diuretics have different side effect profiles. But potassiumsparing diuretics can cause low levels of calcium, which could hurt bone development. Although this helps the heart to function better as it has lesser volume of blood to pump, there are certain side effects that an individual taking them may experience.
Faqs information on diuretic drugs and the diseases and conditions they are prescribed for. Side effects are uncommon, as the dose needed to lower blood pressure is low. Whether these side effects occur and are clinically significant in nonhypertensive patients with recurrent kidney stones treated with thiazides is unclear. However, they also increase the amount of potassium passed out of the body through the kidneys. Thiaziderelated side effects are somewhat more common with longeracting compounds, such as chlorthalidone and metolazone. With the advent of chlorthiazide in 1958, thiazide diuretics quickly became a key component in the management of hypertension. Oct 04, 2018 loop diuretics and thiazide diuretics are stronger than potassiumsparing diuretics with regard to making the kidneys pass out more fluid. So, it is important to read that leaflet if you are prescribed a thiazide diuretic. It will also discuss examples of loop diuretics and side effects of these medications. Diuretics 3 side effects loop diuretics act on the loop of henle in the kidney and prevent reabsorption of water and salt. Sideeffects are uncommon, as the dose needed to lower blood pressure is low.
Depending on the class, diuretics act on different renal structures and lead to varying changes in the volume and composition of urine as well as electrolyte balance. Potassiumsparing diuretics information, uses and side. Diureticrelated side effects are more common and of a greater intensity with loop diuretics. The international encyclopedia of adverse drug reactions and interactions. This sometimes requires treatment with potassium supplements or with a potassiumsparing diuretic. Thiazide diuretics have many therapeutic uses that are summarized below. Lasix is a potent diuretic water pill used to eliminate water and salt from the body. Tl diuretics such as chlorthalidone have a longer elimination halflife compared with tt diuretics resulting in better 24hour bp reduction, especially during the night.
These diuretics have the potential to lower your potassium levels. Diuretics are used to treat high blood pressure, edema excess fluid in the tissues, heart failure, liver cirrhosis, hypertension, water poisoning, and certain kidney diseases. Thiaziderelated side effects are somewhat more common with longeracting compounds, such as chlortha. Xerostomia is one of the commonly mentioned side effects of diuretic medications. They are often used to treat hypertension, or high blood pressure. If he or she prescribes a special diet, such as a lowsodium diet with plenty of potassiumrich fruits and vegetables or, in some cases, a potassium pill. With the exception of potassiumsparing versions, all diuretics may cause a loss of potassium, which, if left untreated, increases the risk for heart rhythm. Morphological effects of diuretics, of bartter syndrome, and of ncc knockout on kidney tissue. This is achieved by inhibiting the nak2cl carrier in the luminal membrane in this segment, thereby minimizing the entry of luminal sodium and chloride into the cell figure 1 1. Diuretics arent recommended for women who are pregnant or breastfeeding. Low levels of potassium and magnesium in the blood can result in abnormal heart rhythms. Potassiumsparing diuretics, which include amiloride midamor, spironolactone aldactone, and eplerenone inspra, avoid the potential problem of potassium loss.
The leaflet which comes in the tablet packet provides a full list of possible side. Diuretics knowledge for medical students and physicians. The most important and frequent problem with thiazide and loop diuretics is hypokalemia. They work by reducing the ability of the kidneys to reabsorb salt and water from the urine and into the body thereby increasing the production and output of urine diuresis. Thiazide diuretics water pills are medications that are used to treat high blood pressure hypertension and reduce fluid accumulation in the body. If you take a thiazide diuretic, your potassium level can drop too low hypokalemia, which can cause lifethreatening problems with your heartbeat. If you take a thiazide diuretic, your potassium level. Side effects vary depending on the type of diuretic taken. Combination of different diuretics may be necessary and can be of use to reduce the side effects of one drug or to increase the effect, especially in patients with severe symptoms and respiratory compromise or in those with suspected or confirmed loop diuretic resistance 7.
Aug 19, 2019 loop diuretics reduce sodium chloride nacl reabsorption in the thick ascending limb of the loop of henle. Unfortunately, potassiumsparing diuretics are more likely to cause negative side effects. Common side effects of the thiazide and thiazidelike diuretics include nausea, dizziness, headache, polyuria, dehydration, hyponatremia, hypokalemia and hypomagnesia. Potassiumsparing diuretics are often combined with either a loop diuretic or a thiazide diuretic. While renal side effects are common in idiopathic systemic lupus erythematosus, immune complex glomerulonephritis is rare in druginduced lupus. Including uses, types, side effect, and drug interaction. Sep 05, 2019 these diuretics have the potential to lower your potassium levels.
In the years since diuretics have been used to treat hypertension, it has been recognized that lower doses than originally used can be effective at providing good blood pressure control, with consequently fewer side effects. Dm is a 62 year old africanamerican man who has had poorly controlled hypertension for the past 10 years, and now presents with signs of ankle edema, a low gfr and a serum creatinine of 2. Xerostomia is one of the commonly mentioned sideeffects of diuretic. A potential side effect of this activity is that they may cause electrolyte imbalances.
Therefore, careful medical supervision is required and dose and dosage interval must be adjusted to the individual patients needs. Loop diuretics reduce sodium chloride nacl reabsorption in the thick ascending limb of the loop of henle. Diuretics also called water pills are drugs that increase urine production in the kidneys, promoting the removal of salt and fluid from the body. Thiazide diuretics are the cornerstone of treatment of hypertension in most patients. Other side effects include gout, which results from raised uric acid levels hyperuricaemia table 2, fig. Diuretics are used to treat high blood pressure, edema excess fluid in the tissues, heart failure, liver cirrhosis, hypertension, water.
Diuretics act by enhancing urinary output thereby reducing the volume of circulatory fluid and reduce the work load of heart and kidney. Structure of the loop diuretics furosemide, azosemide, bumetanide, piretanide, torasemide, ethacrynic acid and etozolin by neurotiker. However, there is scant information about how they affect the risk of skin cancers. The most common side effect of diuretics is increased urination. Adverse reactions to diuretics oxford academic journals. Side effects of diuretics the most common side effect associated with diuretics is an increased elimination of potassium, resulting in a dangerously low level of potassium in the body. Some of these effects can be used to treat disorders like hypercalcemia, hypocalcemia or hyperaldosteronism. Along with its needed effects, a medicine may cause some unwanted effects. Common side effects of diuretics most frequently used in adhf are summarized in. High blood pressure can be a contributing factor in the development of various forms of heart disease.
Diureticrelated side effects can be separated into several categories, including those with well workedout mechanisms such as electrolyte defects andor. Although not all of these side effects may occur, if they do occur they may need medical attention. They possess a wide side effect profile, ranging from subjective effects and idiosyncratic. This lesson will provide a brief overview of the mechanism of action of loop diuretics. Side effects include increased urination and sodium loss. 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.
Depending on the class, diuretics act on different renal structures and lead to varying changes in the volume and. Your potassium, glucose, and cholesterol levels may fluctuate depending on the type of diuretic youre taking. Thiazides are historically one of the most commonly used antihypertensive drugs. Thiazide diuretics can lower potassium and magnesium blood levels since they are both eliminated in urine. Diuretics, also known as water pills, belong to a class of medications that remove excess salt and water from the body. May 05, 2019 renal side effects including new or worsened renal insufficiency may occur due to hctzinduced intravascular volume depletion.
Loop diuretics and thiazide diuretics are stronger than potassiumsparing diuretics with regard to making the kidneys pass out more fluid. A diuretic, a type of drug also known as water pills, helps rid the body of extra water and lower blood pressure. The effects of thiazides on kidney structure reported by reungjui et al 3 are similar to effects of thiazide treatment on dct segments described previously by loffing et al. Tips for taking diuretic medications harvard health. Tell your doctor if you are taking water pills diuretics, high blood pressure medicines, heart medicines, or medicines to treat a fungus. Older people tend to have more side effects such as fainting and dizziness from dehydration. The leaflet which comes in the tablet packet provides a full list of possible side effects. Where indicated, the mechanistic basis and treatment of such side effects is further discussed. Some diuretics are sulfa drugs, so they could cause a reaction if youre allergic. Effect of diuretics on salivary flow, composition and oral. If potassium levels become too high, it can cause dangerous heart rhythm problems and even cardiac arrest. The types of side effects caused by a diuretic depends on the drugs mechanism of action. Effects of thiazidetype and thiazidelike diuretics on.
A potentially serious side effect of potassiumsparing diuretics is hyperkalemia. In the years since diuretics have been used to treat hypertension, it has been recognized that lower doses than originally used can be effective at providing good blood pressure control, with. Rare cases of interstitial nephritis have been associated with hctz. Loop diuretics are the most potent diuretics as they increase the elimination of sodium and chloride by primarily preventing reabsorption of sodium and chloride. Thiazide diuretics uses, list, thiazide mechanism of. Common side effects of diuretics used in acute decompensated heart failure. When taken as prescribed, diuretics are generally well tolerated. Changes in electrolyte levels such as potassium, sodium, calcium or magnesium levels, depending on the type of diuretic. You can minimize side effects of furosemide lasix, a powerful diuretic that reduces fluid retention edema in people with heart failure, by following your doctors instructions carefully. Thiazide diuretics, particularly chlorthalidone, are considered firstline therapy for stage 1 hypertension. May 15, 2018 side effects vary depending on the type of diuretic taken. Other side effects and drug interactions are list below. Side effects of thiazides that are different from lasix include lightheadedness, blurred vision, loss of appetite, itching, stomach upset, headache, weakness, increased urination, and sexual dysfunction. It is used in patients hypersensitive to sulpha drugs.