Difference between revisions of "DIURETICS-LOOP DIURETICS"
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==Reference(s)== | ==Reference(s)== | ||
Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. | Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. [https://amzn.to/3YHrI6K Get it on Amazon.] | ||
<br/>Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. [https://amzn.to/3k7WSW0 Get it on Amazon.] | |||
<br/>Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy. | <br/>Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy. | ||
<br/>Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021]. | <br/>Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021]. | ||
Latest revision as of 20:03, 13 March 2023
SUMMARY
1. They remain effective when GFR is low (CrCl < 20 cc/min), but you have to increase the dose and/or give IV. Quite powerful: excretion of 20 to 25% of filtered sodium.
2. Inhibit the Na+/2CI-/K+ co-transporter & prevent reabsorption of Na+ in the thick ascending segment of Loop of Henle.
3. Hence, prevents development of the interstitial osmotic gradient, relied upon by the thin descending segment for water reabsorption.
4. The net effect is loss of both Na+ & water.
5. K+ is co-transported by the pump that is inhibited by loop diuretics, leading to hypokalemia.
6. Loop diuretics also increase Ca+ loss in the urine. Potential concern of nephrocalcinosis.
Reference(s)
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].
