Help the development of the site, sharing the article with friends!

Diuretics, or diuretics or natriuretics, affect the amount of urine produced and the work of the kidneys. They are used primarily in the treatment of hypertension, but not only. Check what types of diuretics are there and indications for their use. What are the contraindications to the use of diuretics and what drugs may interact in a dangerous way.

Diuretics( diuretics ,diuretics ,natriuretics)are preparations increasing diuresis. Diuresis, on the other hand, is the volume of urine excreted by a direct action on the kidneys.

Diuretics stimulate the excretion of sodium, and thus - accelerate the excretion of water.

Diuretics are very valuable agents that have an impact on arterial hypertension. These types of preparations are called antihypertensive drugs.

In addition to treating hypertension, they are used as an adjunct in diseases such as:

  • heart failure
  • kidney failure
  • puffiness of various origins
  • inflammation of the urinary tract

They are usually used in combination with other medications.

Diuretics: types

Diuretics are divided into:

1. Mild diuretics- this group includes: osmotically active diuretics, potassium-sparing diuretics and carbonic anhydrase inhibitors

  • Carbonic anhydrase inhibitors(low-efficiency diuretics) - this group includes acetazolamide - mainly used in the treatment of glaucoma. The diuretic properties of acetazolamide last up to 3 days - after this time it ceases to have a diuretic effect.
  • Osmotically active diuretics- used before diagnostic procedures of the large intestine, used to treat poisoning and constipation, as well as to reduce intracranial and intraocular pressure.
  • Representative of this group is mannitol, which works by increasing the osmotic pressure in the extracellular fluid and moving water from inside the cells to the interstitial fluid and plasma. Increases the excretion of sodium and chloride. It is quickly excreted from the body.
  • Potassium-sparing diuretics- mainly used in the treatment of hypertensionhowever, they are not very effective. Their action is to inhibit the process of sodium-potassium ion exchange in the distal tubule of the nephron. Thus, these drugs increase urine output, but do not decrease potassium levels. They are most often used as a supplement to diuretic therapy with other diuretics.

2. Moderate diuretics: thiazides and thiazide-like drugs

The oldest group of diuretics are thiazides, used in arterial hypertension, treatment of heart failure, arterial hypertension, cirrhosis, nephrolithiasis, and chronic kidney diseases.
In 1957, preliminary results were published by Freis showing the antihypertensive efficacy of chlorthiazide. Soon, the hydrochlorothiazide preparation appeared on the market, which has been playing a significant role in the treatment of hypertension for several decades.
Examples of thiazide diuretics are indapamide or the aforementioned hydrochlorothiazide. They inhibit the reabsorption of the chloride ion.

Their effect is therefore the excretion of water and sodium, but unfortunately they also cause a significant loss of potassium and magnesium and inhibit the excretion of calcium. In addition, according to research, they relax the smooth muscles of blood vessels.

3. Highly effective diuretics - loop

Loop diuretics are used to treat:

  • hypertension
  • cirrhosis of the liver
  • edema
  • heart failure
  • acute and chronic renal failure
  • ascites

Loop diuretics are the strongest diuretics. They work in the Henle loop (part of the kidney), inhibiting the transport of sodium and chloride ions. This increases the excretion of water and sodium.

This includes sulfonamide derivatives, e.g. furosemide, as well as phenoxyacetic acid derivatives, i.e. ethacrynic acid.

Loop diuretics are drugs of first choice in emergency situations, when it is almost necessary to immediately reduce the volume of circulating fluids in the body. Therefore, most often their use is short-term.

Diuretics: side effects

The most common side effects include:

  • abnormal heart rhythm
  • gastrointestinal disorders
  • too much potassium loss (hypokalemia) - it manifests itself in faster fatigue and muscle weakness
  • excessive reduction in blood pressure
  • magnesium deficiency (hypomagnesaemia) - causes body weakness, painful muscle spasms
  • increase in uric acid levels(hyperuricemia)
  • impaired glucose tolerance, making it difficult to control its level in the blood, which is especially important in diabetics
  • frequent urination (this state may last several hours after drug administration)
  • dizziness
  • male potency disorders
  • dry mouth

Diuretics and pregnancy

It should be remembered that diuretics are contraindicated in pregnant women, especially in its early stages. They can cause a reduction in the amount of amniotic fluid, which may endanger the developing baby.

These drugs should only be used during pregnancy if the expected benefit to the mother outweighs the potential risk to the fetus.

They are used only for a short time and under special medical supervision.

Diuretics: use in children

These drugs can be used both in children and the elderly. However, they require an individual dose and systematic control of the level of electrolytes in the body.

It should be remembered that regardless of whether the treatment covers a child or an adult - the dosage is determined by the doctor and any changes in the amount of the substance taken must be preceded by a prior consultation.

Diuretics: contraindications

  • severe kidney failure
  • gout
  • significant electrolyte disturbance
  • diabetes, carbohydrate intolerance
  • metabolic syndrome (also called syndrome X)
  • severe liver failure
  • pregnancy and breastfeeding

Diuretics: interactions

Diuretics may interact with other medications taken by the patient, therefore the doctor should be informed about all medications taken, including those available without a prescription, for example :

Thiazide diuretics interact:

  • with non-steroidal anti-inflammatory drugs (e.g. with ibuprofen) - the diuretic effect of the diuretic is weakened
  • with digitalis glycosides - diuretics increase the toxicity of glycosides
  • with antidiabetic drugs - the effect of these drugs is weakened, and thus it is difficult to control the level of glucose in the blood
  • with certain anti-arrhythmic drugs (amiodarone, sotalol) - in patients with low potassium levels there is an increased risk of dangerous cardiac arrhythmias
  • with sedatives and alcohol - possible hypotension (hypotension)

Potassium-sparing diuretics interact:

  • with diureticspotassium-sparing drugs, drugs and supplements containing this element, convertase inhibitors - the risk of hyperkalemia increases
  • with other antihypertensive drugs - intensification of the effects of these drugs, which can lead to a significant drop in blood pressure, even life-threatening
  • with lithium s alts - the risk of lithium toxicity increases
  • with non-steroidal anti-inflammatory drugs (e.g. ibuprofen) - the likelihood of acute renal failure increases

Loop diuretics interact:

  • with amninoglycoside antibiotics - intensification of the nephro- and ototoxic effects of antibiotics
  • with cephalosporins - increased nephrotoxicity of antibiotics
  • with lithium s alts - with high doses, the toxicity of this element is increased
  • with digitalis glycosides - increased toxicity of glycosides
  • with glucocorticoids and laxatives - increasing the risk of hypokalemia
  • with antidiabetic drugs - diuretics weaken the effect of these drugs

Diuretics and diet

People who take loop diuretics, such as hydrochlorothiazide or furosemide, may be deficient in potassium in their body. Loop diuretics increase the excretion of potassium ions by the kidneys.

Disturbing the functioning of muscle pains or cramps may be the result of a deficiency of this element, so in the event of any disturbing symptoms, immediately inform your doctor, who may recommend a diet rich in potassium and magnesium or supplementation of these elements.

Foods rich in potassium and magnesium are mainly green vegetables, pulses, bananas, tomatoes, tomato juice, oranges, nuts, pumpkin, raisins, beets.

And patients taking potassium-sparing diuretics may increase the concentration of potassium ions in the blood, which is as dangerous as their deficiency.

Excessive increase in blood potassium levels may occur as a result of uncontrolled, simultaneous intake of this group of drugs as well as supplements and other products containing large amounts of this mineral.

Diuretic herbs

Diuretic herbs allow you to get rid of excess water from the body, and also help to cleanse it of toxins. They are used in the treatment of:

  • certain kidney diseases (including kidney stones)
  • cystitis
  • edema

Natural diuretics include :

  • nettle
  • lovage root
  • leavesbirches
  • couch grass rhizome extract
  • green tea extract
  • horsetail
  • bearberry leaves
  • wilżyny root
  • parsley fruit
  • the strongest of them - dandelion

One of their main advantages is the fact that, when used as recommended, they act as a diuretic, but they do not flush out valuable electrolytes from the body, but like all natural and pharmacological remedies, herbs can cause side effects, and even if taken in inappropriate doses, it can harm your he alth.

An overdose of herbs can lead to dehydration and a decrease in blood volume. This is especially dangerous for young children, pregnant women and the elderly.

Help the development of the site, sharing the article with friends!

Category:

He alth