Heart failure
Henry J. Woodford in Essential Geriatrics, 2022
Loop diuretics display a threshold effect, i.e. a certain dose is needed to produce diuresis (not a standard dose-response curve). The effect is either ‘on' or ‘off'.19 Larger doses might have a diuretic effect for a bit longer but won't be much more effective. For a greater diuretic effect, it may be necessary to give the drug twice daily. There should be a notable diuresis within six hours of receiving the medication (e.g. patient-reported or from urine output monitoring, which should exceed 100 ml/hour in the six hours after diuretic receipt). When given in the morning, this should actually reduce nocturia. Because of the threshold effect, there's no logic in variable dosing (e.g. 80 mg furosemide am then 40 mg noon). Use the lowest dose that produces a diuretic effect and give this more often if a greater amount of fluid off-loading is required. In acute heart failure, along with urine output, daily weight measurements can demonstrate therapeutic efficacy. Urinary sodium estimation following diuretic administration is another possible method.9
Body fluids and electrolytes
Peate Ian, Dutton Helen in 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.
Current Trends in Performance- and Image-Enhancing Substance Use Among Gym Goers, Exercisers, and Athletes
Ornella Corazza, Andres Roman-Urrestarazu in Handbook of Novel Psychoactive Substances, 2018
Diuretics comprise a family of drugs designed to increase the amount of water and salt through increased production of urine. Choice of compounds is individual specific, with regards to individual sensitivity and preferences. Some claim certain compounds provide different aesthetic outcomes. This has not been demonstrated in the literature. More often, certain compounds are used because of their relative safety compared to others. For example, potassium-sparing compounds are more likely to be used by some individuals because of their perceived safety compared to loop-diuretics. Table 5.6 outlines the main pharmaceutical compounds used in bodybuilding. In competitive sport settings, diuretics may be used to manage body weight in weight-category sports (e.g., boxing, weightlifting) or to mask the use of prohibited substances (also referred to as ‘masking agents’). Dosages are dependent upon the substance used (Parkinson & Evans, 2006).
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).
Current evidence for pharmacologic therapy following stage 1 palliation for single ventricle congenital heart disease
Published in Expert Review of Cardiovascular Therapy, 2022
Meredith C. G. Broberg, Ira M Cheifetz, Sarah T Plummer
Diuretics are one of the most common medication types prescribed in the interstage period [54]. The goal of stage 1 palliation is adequate, but restrictive, pulmonary blood flow via a shunt or banded bilateral branch pulmonary arteries. However, most patients have excessive pulmonary blood flow early with the goal/anticipation that it will become more restrictive over time as the infant grows. Thus, diuretics are frequently prescribed to treat pulmonary congestion for symptomatic relief. However, there are no randomized trials supporting or discouraging their use in this patient population. Adverse effects of furosemide use in children with congenital heart disease include increased fracture risk [71], nephrocalcinosis [72, 73], and ototoxicity [74, 75]. Diuretic use, including loop diuretics and thiazide diuretics, also can lead to electrolyte disturbances and kidney dysfunction.
Common systemic medications that every optometrist should know
Published in Clinical and Experimental Optometry, 2022
Rachel Williams, Alex Hui
Hypertension is defined as sustained elevation of resting systolic blood pressure (≥ 130 mmHg), diastolic blood pressure (≥ 80 mmHg), or both. Hypertension is a common and important risk factor for cardiovascular and renal diseases. In 2017, an estimated 4.1 million working-age Australians (25.9%) had hypertension, of whom an estimated 21.6% were treated and controlled, 17% were treated but uncontrolled, and 61.4% were untreated.6 The pathogenesis of hypertension is multifactorial and complex. The most common blood pressure medications are angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, beta blockers, and diuretics. However, many patients use more than one class of medication to adequately control their hypertension. Vasodilators such as ACE inhibitors and calcium channel blockers aim to reduce blood pressure through vessel dilation. Beta blockers reduce cardiac output by reducing sympathetic influences. Diuretics are effective in reducing blood volume and cardiac output by increasing urine output from the kidneys.7