Diuretics - Therapeutic uses
All diuretics increase the urinary elimination of sodium.
Diuretics of Henle loop and of the initial part of the distal tubule are hypokalemic. Those of the second part of the distal tubule, antialdosterones, amiloride and triamterene, are hyperkalemic.
All diuretics can be used for the treatment of arterial hypertension. However, each group has preferential therapeutic uses.
- Diuretics of the loop with intense effect of short duration are particularly indicated in the treatment of acute congestive heart failure, such as acute pulmonary edema. In sustained-release formulation they can be used to treat arterial hypertension.
- Thiazide diuretics are particularly adapted for the treatment of arterial hypertension.
- Potassium-sparing diuretics are indicated for treatment of congestive heart failure because they do not cause hypokalemia neither hypomagnesemia which increase the risk of heart rate disorders. They are also prescribed for the treatment of cirrhotic edema.
The use of diuretics in pregnant women is contra-indicated, more for the risk of hypovolemia and reduction of the volume of the amniotic fluid than for a teratogenic risk.
|
