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The strongest diuretics from the list of diuretics
Strong diuretic folk remedies, used by doctors for many centuries, have long ago come to the fore. Today, when people talk about a strong diuretic drug, they will introduce diuretics of synthetic origin.
The most common strong diuretics are:
- Lasix (Furosemide)
- Aldactone (Spironolactone)
Lasix or Furosemide, perhaps the most powerful diuretic, is prescribed for patients with edema, hypertension, alkalosis, acute renal failure and acidosis. The mechanism of action of Furosemide is aimed at inhibiting the inverse absorption of chlorine and sodium ions in the kidneys.
Feature of Lasix is the speed of its impact on the patient: a few minutes after intravenous injection and one hour after ingestion. The duration of a positive effect on the body is inversely proportional to the rapidity of the onset of a positive effect and is up to 8 hours for oral administration and up to three - intravenously. Such rapidity of action makes these diuretics the strongest, capable of removing the edema of the lungs or the brain, if necessary.
In another potent diuretic, Aldactone (Spironolactone), the mechanism of action is different from Mannitol. Aldactone (Spironolactone) is an antagonist of aldosterone (the hormone of the adrenal cortex). Aldosterone is a mineralocorticoid that is involved in electrolyte metabolism and enhances the absorption of sodium ions, thereby inhibiting water in the body. This effect of aldosterone is blocked by Spironolactone, since an increase in sodium secretion provides a diuretic anti-edema action.
This powerful diuretic is prescribed in ascites, heart edema and nephrotic syndrome. A positive mild effect from spironolactone occurs on the 2nd-5th day and is moderately expressed. To strengthen it, prescribe ethacrylic acid, furosemide or hypothiazide, which will accelerate the excretion of sodium, and simultaneously reduce the loss of potassium.
Diuretics Mannitol is available in the form of a dry powder in vials of 20 g each. Before use, the vial of the drug must be dissolved in a five-percent solution of glucose or in 500 ml of saline, the dosage is calculated in the proportion of 0.5-1.5 g per kilogram of the patient's weight. The peculiarity of this strong diuretic is that it can be prescribed for acute kidney failure.
The mechanism of action of Mannitol is reduced to an increase in blood circulation in the kidneys, which will promote increased urination and withdrawal of the body from nephrotoxic substances. The drug consists of sodium chloride, sodium sulfacyl, and mannitol hexahydrate.
Many pathological processes in the body are accompanied by the development of edema syndrome, which impairs the patient's condition and for the relief of the syndrome require an effective diuretic.
Swelling of various localization, sometimes hidden, can cause serious disturbances in different organ systems. There are many critical situations, which are based on edema requiring emergency removal of excess fluid from the body. In this case, any strong diuretic be used.
Part II: More information about diuretics. Groups of diuretics. Scientific data
The main group of diuretics
Diuretics, or diuretic drugs, often used in the acute care, chronic violations by the kidney, cardiovascular, respiratory and nervous systems. This means that one can not do without a diuretic in the treatment of the vast number of diseases.
There are the following groups of diuretics
These drugs affect the way back to the kidney be sucked salt, which means that water will leave together with electrolytes. These diuretics help to quickly deal with hypertension, relieve edema, struggling with a variety of critical states. Drugs should only be used under medical supervision.
This group includes Lasix (furosemide), bumetanide, Torasemide, ethacrynic acid, which belong to the loop saluretikami; Hydrochlorothiazide, indapamide - group thiazides; and Diakarb, which is an inhibitor of the enzyme carbonic anhydrase kidney.
From the title it is clear that these diuretic medication is not removed from the body needed potassium and magnesium. His action of these drugs is directed to sodium excretion, and with it the water. But it is worth noting that the potassium-sparing diuretics are significantly inferior in strength saluretikami, so their use is rather limited.
This group of drugs include spironolactone, eplerenone. These drugs are often combined with a loop diuretic effect and to enhance the conservation of electrolytes.
This group of diuretics acts by increasing the plasma osmolality. This means that the liquid which is outside the blood vessels in the intercellular space, is sent into the bloodstream. Because diuretics are osmolar renal filtration without re-absorption, the amount of urine increases significantly. Together with a significant amount of sodium released urine, but without loss of potassium. Under the effect of osmolarity diuretics fluid volume increases rapidly, which can lead to hypertension, therefore it is necessary to monitor hemodynamics. The main drug in this group is Mannitol.
But not all diuretics have a pronounced effect. For the rapid elimination of edema suitable diuretic medication group saluretikov, namely, loop diuretics, and osmolar diuretics. The first group includes drugs: Lasix, Torasemide, bumetanide, xipamide, piretanide, ethacrynic acid; and to the second - Mannitol, Urea.
Lasix or Furosemide is a potent drug for edema of various origins.
This tool displays a significant amount of sodium and chlorine, is not giving these electrolytes absorbed back, and with them the body leaves the water. In addition to these substances in urine output large amounts of potassium, magnesium and calcium. The loss of these electrolytes can lead to serious complications. Therefore Lasix administered in difficult situations and under the control of blood electrolytes.
The indications for use are:
- diagnosed hypertension;
- treatment of edema of cardiac, hepatic, renal origin;
- hypertensive crisis;
- swelling of the lung tissue;
- brain edema;
- acute renal function failure.
For the treatment of edema as a result of chronic diseases used pills, and emergency Lasix administered intravenously. It is worth remembering contraindications and side effects of this drug that are associated with the active excretion of electrolytes from the body.
Lasix is contraindicated in:
- patients with hypersensitivity;
- insufficient amount of the circulating liquid;
- to prevent the passage of urine for urinary tract (stone, foreign body, tumor, blood clots, scarring, etc.);
- low potassium content in the plasma.
Lasix can have side effects associated with the excretion of potassium, magnesium in the form of heart disorders, digestive disorders, thromboembolic complications, impaired consciousness of varying severity, etc.
Torasemide is a loop diuretic as Lasix. This tool has good results in the treatment of functional impairment of the heart muscle, kidneys, liver cirrhosis, hypertension. In these pathologies are most often used torasemide tablets. The use in an emergency of this drug is not as common, but in these cases the best fit solution for intravenous administration.
Contraindications and side effects are similar to those of Lasix.
As Lasix and Torasemide related to loop saluretikami. Therefore, the mechanism of action of these pharmaceutical drugs have identical diuretic. Like all loop diuretics, bumetanide effective in edema associated with chronic cardiac pathologies, respiratory and renal systems, and in cirrhosis. In these cases, prescribed pills that are taken daily in the morning.
Emergency situations where necessary removing a large volume of fluid (diuresis) require intravenous or intramuscular injection. It is important to remember that this tool can not be used for hepatitis.
Xipamide - representative of loop diuretics like Lasix. Application of this agent aims mainly at hypertension. When this effect occurs already after an hour after administration and lasts for 12-24 hours. Even in a state xipamide renal insufficiency reduces circulating liquid.
Chronic administration of fluid volume will come to the original level, but hypotension persist due to the lack of effect on the substance constricts blood vessels. Assign this medicine for heart, kidney failure, ascites. The release form - tablets.
This diuretic used in the edematous syndrome of various origin, as well as hypertension. Form release - tablets and solution for injection. Of the negative effects of the drug should be noted orthostatic hypotension, decreased potassium in the blood, thus causing heart disorders, it may be a disorder of consciousness, seizures.
Ethacrynic acid, or Uregei also relates to a loop diuretic drugs. Effective drug for the relief of acute conditions, because the action starts to develop after 15-20 min. But for this purpose it is used to a lesser extent. More widespread ethacrynic acid obtained in the treatment of hypertension, edema associated with chronic cardiac, renal, hepatic failure. Enter the diuretic only with caution, because often develop complications such as phlebitis (vein inflammation).
Mannitol - osmolar is a diuretic. Mannitol is used more often than other drugs in this group, because it has fewer side effects.
The main indications are significantly different from those in the loop saluretiks, namely:
- brain edema and swelling;
- acute impairment of renal function (while maintaining the filter function);
- Complications after transfusion of blood substitutes;
- as a preparation for the forced diuresis.
Contraindications for the purpose osmolarity diuretics are the following states:
- complete lack of urination;
- lack of volume of circulating fluid;
- edema and pulmonary congestion;
- heart failure;
- high content of potassium in the plasma.
The negative manifestation of the use can be expressed in muscle weakness, dry mouth, upset varying degrees of consciousness, convulsions, hypertension, pulmonary edema, ischemic chest pain.
If the drug is used continuously or in large doses, it may be re-swelling of the brain, or the syndrome of "rebound".
In modern medicine diuretic, urea is not included because it has a significant number of complications. In addition, the effectiveness of Urea inferior mannitol. The indication for use is the brain edema and increased intracerebral pressure. Contraindications are identical to those of Mannitol.
It is important to remember that modern medicines are diuretics drugs, the use of which can lead to undesirable consequences, affecting different organ systems. Therefore, use of diuretics with a pronounced effect should be only under the supervision of important vital signs and in a hospital.