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Cardiovascular Drugs during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Diuretics are used to treat hypertension, sometimes alone or in conjunction with another drug regimen. Three basic categories of diuretics are: (1) loop diuretics, (2) potassium-sparing diuretics, and (3) thiazide diuretics. Agents in these categories are listed in Boxes 3.4 and 3.5.
Respiratory, endocrine, cardiac, and renal topics
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Heart failure usually results in salt and water retention, as evidenced by oedema and liver congestion. Diuretics are effective in eliminating excess extra-cellular fluid, thus improving symptoms; therefore, they remain the mainstay treatment of congestive heart failure. Their doses are described in Table 1.
Body fluids and electrolytes
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Commonly prescribed medication, such as diuretics, are used to help manage several conditions, including hypertension, heart failure, pulmonary oedema and chronic kidney disease. However, diuretics also have adverse effects, especially on the electrolyte balance as they increase the excretion of sodium, water and other electrolytes. There are four main types of diuretics: Loop diuretics.Thiazides, including thiazide-like diuretics.Osmotic diuretics.Potassium-sparing diuretics.
First description of Portuguese patients with cardiac amyloidosis and p.Val142Ile: more evidence of an “African variant” in Caucasians
Published in Scandinavian Cardiovascular Journal, 2023
Catarina Martins da Costa, Ana Filipa Amador, João Calvão, Alice Vasconcelos Porto, Susana Fernandes, Elisabete Martins, Filipe Macedo
Case one was diagnosed with HF with preserved ejection fraction (pEF) in December 2018. An electrocardiogram revealed atrioventricular of the first degree (remaining work up in Table 1). Diuretic treatment improved clinical status. In September 2019, the patient developed complete atrioventricular block and a permanent pacemaker was implanted. Later, atrial fibrillation was discovered. The patient developed sensoric polyneuropathy, with no functional limitation, as well as and hepatic and kidney (Grade 3a) dysfunction. Tafamidis treatment began in In January 2020. The patient developed NYHA III HF, LV systolic dysfunction (LVEF 32%), and was hospitalized three times for congestion and worsening renal function. Since then, the patient has remained clinically stable (NYHA II with no further hospitalizations).
Analysis of prescription status of antihypertensive drugs in Chinese patients with hypertension based on real-world study
Published in Annals of Medicine, 2023
Renren Yang, Jia Tang, Ming Kuang, Hongying Liu
Although thiazide-type diuretics were recommended as initial therapy for most patients [37], it was observed that the prescription proportion was fairly lower than that of ARBs and CCBs in the current study. The low preference for diuretics may be related to their adverse effects such as hypokalaemia. Diuretics have been recognized as an essential medicine for intensive hypertensive treatment. In a review, Sato et al. [38] have demonstrated that ARBs-based combination therapies with either CCBs or diuretics were well tolerated and effectively lower the BP throughout a 24-hour interval by their long-acting half-lives, nighttime BP lowering effect and improving adherence. A similar result was reported by a randomized controlled experiment in Japan [39]. What’s more, a sub analysis of a clinical study has also revealed that combining ARBs with diuretics may produce better cardiovascular outcomes than combining an ARB with BBs, even in individuals with poor blood pressure control [40]. Also, the present study showed that Diuretics + ARBs and Diuretics + CCBs + ARBs were the most commonly prescribed pattern in two-drug combination therapy and three-drug combination therapy respectively, which reconfirmed these results.
Machine learning algorithms identify hypokalaemia risk in people with hypertension in the United States National Health and Nutrition Examination Survey 1999–2018
Published in Annals of Medicine, 2023
Ziying Lin, Yuen Ting Cheng, Bernard Man Yung Cheung
The administration of renin-angiotensin system blockers (ACEIs/ARBs) is suggested by guidelines as the first approach to managing hypertension [21,32,33]. The combination of ACEIs/ARBs or potassium-sparing diuretics is a common strategy for hypertensive patients with a baseline use of diuretics, especially those with a high hypokalaemia risk or comorbid heart failure [34]. Our study showed that using potassium-sparing diuretics was associated with hypokalaemia. Although no causal relationship between potassium-sparing diuretics use and hypokalaemia could be ascertained in this study, the increased hypokalaemia risk in patients on potassium-sparing diuretics highlights the importance of a more comprehensive evaluation of the cause of hypokalaemia, including hyperaldosteronism and potential resistant hypertension [35,36]. Also, stricter blood pressure monitoring and re-evaluation of diuretics dosage are needed.