Insights into the Recent Scientific Evidences of Natural Therapeutic Treasures as Diuretic Agents
Debarshi Kar Mahapatra, Cristóbal Noé Aguilar, A. K. Haghi in Applied Pharmaceutical Practice and Nutraceuticals, 2021
There are many artificial drug medicines that are universally used for the treatment of high blood pressure, heart condition, and different water retention disorders.6 Modern day diuretics include ethacrynic acid, torsemide, spironolactone, hydrochlorothiazide, acetazolamide, methazol-amide, amiloride, triamterene, and mannitol (Table 4.1).7 But these medication have varied adverse effects like hypokalemia, hypomagnesemia, dilutional hyponatremia, allergic manifestations, hyperuricemia, symptom, drowsiness, fatigue, abdominal discomfort, rise in blood carbamide, nausea, dizziness, muscle cramps, headache, chills, polydipsia, confusion, and pain in chest.8 Because of these adverse effects, the local populations have rapidly moved toward the natural therapy.9 In the race to find a cure for water retention-related problems, many individuals are turning to natural diuretics.10 Herbal and natural merchandise of folks medicines are used for hundreds of years in each culture throughout world.11 Scientists and medical professionals have shown inflated interest within the field as they recognized truth health edges of those remedies.12 Herbal medication have gained importance and recognition in recent years as a result of their safety, economicity, and value effectiveness.13
Prevention of pre-eclampsia
Pankaj Desai in Pre-eclampsia, 2020
One small African study examined the effect of furosemide on hypertension and oedema in patients with pre-eclampsia experiencing high cardiac output. These were all women with late-onset pre-eclampsia. The study enrolled only 14 patients. Lower cardiac output, systolic blood pressure and diastolic blood pressure were recorded after furosemide administration with patient heart rates remaining stable. This encouraged the authors to conclude that the stability of the heart rate suggested that the change of cardiac output was as a result of a decrease in blood volume. They suggested that diuretics could be useful in the management of late-onset pre-eclampsia, indicating that an increase in water retention could play a role in the development of late-onset pre-eclampsia.5 However, too small a sample size eliminates the use of this study in clinical practice.
Etiology of Neonatal Respiratory Distress Syndrome and the Assessment of Lung Maturity
Jacques R. Bourbon in Pulmonary Surfactant: Biochemical, Functional, Regulatory, and Clinical Concepts, 2019
During the first days of life, premature neonates experience water retention as a consequence of complex mechanisms which associate renal immaturity with water balance disorders of hormonal origin.83 Water retention has consequences for lung function, and it was recently demonstrated that diuretic administration, if practiced early and sustained, improves the evolution of HMD.84
Management of fluid status and cardiovascular function in patients with diffuse skin inflammation
Published in Journal of Dermatological Treatment, 2019
Arash Taheri, Amanda D. Mansouri, Parisa Mansoori, Rahimullah Imran Asad
Patients with chronic, widespread skin inflammation, such as erythroderma, usually develop their pathology and vascular changes gradually over time. First, there is a mild reduction in blood pressure. Patients with access to water and good nutrition will compensate for this reduction in blood pressure by retaining salt and water. Fluid retention leads to an increase in intravascular and extravascular volume and presents as peripheral edema. After adequate compensations, these patients have sufficient preload and venous return to the heart and do not require intravascular fluid infusion. However, the blood pressure of most of these patients remains lower than their baseline due to peripheral vasodilation in the skin. Most patients with good cardiac reserve function can compensate for peripheral vasodilation and blood shunting with increased cardiac output and blood pumping (1). They can maintain their blood pressure at a level sufficient for internal organ perfusion. However, if the heart cannot support increased cardiac output, the patients’ blood pressure may remain too low. Patients with heart failure or reduced cardiac reserve cannot pump more blood to compensate for the shunting of blood through the skin. The resulting hypotension and internal organ hypo-perfusion cause severe compensatory fluid retention, which leads to a significant increase in central venous pressure and pulmonary vascular pressure, decompensated congestive heart failure, and pulmonary edema (17). This condition is called high-output heart failure (12).
Subjective Global Assessment of Nutritional Status in Head and Neck Cancer Patients Treated with Radiotherapy – A Prospective Observational Study from North East India
Published in Nutrition and Cancer, 2022
Hima Bora, Mouchumee Bhattacharyya, Apurba Kumar Kalita, Partha Pratim Medhi, Gautam Sarma, Jyotiman Nath, Manoj Kalita, Dimi Ingtipi, Biswajit Sarma
Physical examination: Three features suggestive of nutritional deficiency were to be noted and graded during physical examination of patients. These were, firstly, the Loss of Subcutaneous Fat- to be evaluated over the triceps, under the eyes, at the mid-axillary line over lower ribs, lower back and sides of the trunk. Secondly, the Loss of bulk and tone of muscles (Muscle Wasting) over the temple, clavicle, shoulder, scapula/ribs, quadriceps and interosseous muscle of hand were observed. Lastly, the Presence of edema over the ankles and/or sacral region along with presence of ascites was to be recorded as features of fluid retention. The presence of ascites was verified with 3 weekly whole abdomen ultrasonography. The findings were classified as None, Mild/Moderate and Severe for all the three features as described in SGA form.
Chemical pharmacotherapy for the treatment of orthostatic hypotension
Published in Expert Opinion on Pharmacotherapy, 2019
Published evidence of efficacy in treating nOH is based on several small studies carried out in the 1970s. A double-blind crossover study in 6 diabetics with OH found that fludrocortisone 0.1 mg b.i.d. was more effective than placebo in increasing supine and upright BP and improved symptoms of OH in 4 patients [63]. Subsequent open label studies reported improvement in symptoms and BP measurements in OH in 13 of 14 patients with diabetes [64] and 6 of 6 patients with Parkinson’s disease [65]. The use of fludrocortisone in treating nOH is long-established in clinical practice at typical doses of 0.05–0.2 mg daily [66]. The potential risks versus benefits should be carefully weighed, particularly at higher doses, because fludrocortisone aggravates supine hypertension and should not be used in patients who cannot tolerate fluid retention, such as those with congestive heart failure. About half of patients taking fludrocortisone will develop hypokalemia, which can be corrected with oral potassium supplementation. Ankle edema also occurs as the result of fluid retention. Fludrocortisone is not always sufficiently effective or well-tolerated. In a retrospective study of 1,767 patients prescribed fludrocortisone, use was discontinued in 467 (26%), with a median persistence of 254 days (interquartile range 119–783) [59]. Patients with nOH taking fludrocortisone have higher rates of all-cause hospitalizations as compared to those taking midodrine [67].
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