Brief characteristics of diuretics from the group of loop diuretics

Diuretics against edema

Spirinolactone, often used in the treatment of edema of various origins, neutralizes the steroid hormone aldosterone and reduces the permeability of the cell membrane.

The second group of diuretics has the ability to block enzymes of epithelial cells. These include, in particular, the drugs Triamterene and Amiloride. They have a slight effect on the patient’s body, reduce potassium loss, but their long-term use is not recommended, because in this case the level of uric acid excretion is significantly reduced.

Diuretics do not accumulate in the body and are excreted unchanged by the kidneys. In people suffering from liver diseases, the toxic effect of the drug on the body increases. The diuretic drug Amiloride is not used for monotherapy of edema syndrome. It should be remembered that taking the medicine without consulting a doctor is unacceptable.

Potassium-sparing drugs

Bufenox is a diuretic prescribed to treat high blood pressure in pregnant women. The effect of the medicine begins after 30 minutes and lasts 4-6 hours.

The diuretic alleviates the condition of patients suffering from chronic heart failure, nephritis, and hypertension. The doctor prescribes the dose of the diuretic drug individually, taking into account the following factors:

• patient's age;
• severity of the pathological process.

Diuretics should be taken with caution in acute renal failure, diabetes mellitus, gout, and in the first half of pregnancy. In some cases, the patient complains of thirst, dry mouth, and worsening general condition.

Spirinolactone (Veroshpiron) is an antagonist of the hormone aldosterone produced by the adrenal cortex. The drug has no effect on the renal tubules, but significantly reduces blood pressure in heart diseases and eliminates edema in patients suffering from cirrhosis of the liver. An important place in the complex treatment of ascites is given to the use of diuretics, but it should be remembered that dizziness, drowsiness, and skin rash may appear during therapy.

Harmless (safe) diuretic during pregnancy, edema, hypertension, for weight loss

Published: 14 Jan 2020, 17:12

There are times when it is more important to find a diuretic that is not as effective as it is safe. Especially when it comes to prescribing the drug to children, women expecting a child, people suffering from facial swelling, excess weight, or if there is a need for long-term use of a diuretic. Let's take a closer look at all of these situations, and which diuretics are more appropriate for each of them.

Safe diuretic during pregnancy

Finding a harmless diuretic during pregnancy is an extremely pressing issue. The appearance of edema in the later stages is a very common and undesirable phenomenon, with drugs such as Furosemide. Hypothiazide. Lasix. Spironolactone, Clopamide, Diacarb, Bumetanide, Oxodoline, Theophylline, Cyclomethiazide and Triamterene should not be taken during certain trimesters. But at other times and during lactation it is possible, but only as a last resort, since taking them can disrupt the functions of the fetal organs or cause various diseases in the fetus (such as thrombocytopenia).

The only harmless diuretics for a baby during this period of his life are diuretics synthesized on the basis of medicinal plants, such as Canephron or Phytolysin.

Harmless diuretic for edema

In addition to pregnancy, swelling of the extremities of the face can be caused by such general problems of the body as heart failure, hypertension, malfunction of the kidneys, or local problems (injuries, fluxes, skin inflammation, conditions after surgery, burns).

Regardless of the cause of the swelling, it is important to choose a harmless diuretic drug that can be used both once and for a long time, without fear for the patient’s health. Typically these drugs are thiazide and loop drugs, available in tablets, such as Hypothiazide or Furosemide.

Relatively recently, the two listed drugs for eliminating edema were replaced by a new and safe diuretic - Trifas. created on the basis of Torasemide.

Gentle diuretic tablets for hypertension

The need to select safe diuretic drugs for hypertension is usually discussed in the chronic form of the disease, when it is not so much the strength of the diuretic that is important, but its harmlessness to the body in terms of water and electrolyte balance. The fact is that all diuretics, together with water, remove certain elements from the body, so in order to avoid negative consequences from treatment with drugs of this group, it is necessary to establish what side diseases the patient has. So, for hypertension and osteoporosis, the safest diuretic is one that does not remove calcium from the body, that is, calcium-sparing diuretics. But if a hypertensive patient suffers from hyperkalemia, then it is necessary to include potassium-sparing drugs in the treatment process.

Safe diuretic for weight loss

In recent years, due to not entirely healthy food in the diet of most people, a low level of physical activity and propaganda in the media of thinness as a standard of female beauty, many different diets have appeared, including the use of various medications, such as diuretics.
Weight loss does occur when taking diuretics, but the resulting effect is not “weight loss”, but fluid loss. In other words, there is no fat burning. In this case, the resulting effect will be temporary, since the body will try to compensate for previously lost fluid by retaining it in the body.

The safest diuretic for weight loss are weak natural diuretics. consisting of various herbal mixtures that have a mild diuretic effect without affecting blood pressure or heart function. It is important for human safety when taking diuretics for the purpose of losing weight that they can only be taken against the background of a diet, which will break down fat into water, and diuretics will remove excess water from the body.

Safe diuretic for long-term use

The most harmless diuretics prescribed for long-term courses of treatment are mild diuretics, such as Diacarb. Amiloride, Indapamide. Triamterene and Spironolactone.

Almost all drugs recommended for long-term use belong to the thiazide group. They are usually prescribed to patients with chronic hypertension, heart failure or kidney disease in cases where the positive effect of taking the drugs does not necessarily occur immediately. It is important that the effect is mild and the medicine is taken in small doses. Only if these conditions are met, during long-term use of diuretics, will it be possible to reduce the risk of side effects from the drug to a minimum.

When are diuretics prescribed?

Diuretics are the best way to lower blood pressure in diabetes and heart failure. Potassium-sparing diuretics will help provide maintenance therapy with maximum effect. It is important to know that Veroshpiron has a less strong diuretic effect than other drugs.

Heart failure is a big problem for the patient. Diuretics can reduce the volume of intravascular fluid and lower blood pressure. During exacerbation of hypertension, medications are used to improve the patient's condition. In addition, diuretics reduce risk factors for water-salt imbalance. If you have problems with blood pressure due to gout, you should consult a doctor, since diuretics are prescribed only in emergency cases. Taking them leads to the formation of uric acid crystals, and the patient’s condition sharply worsens.

Compatibility with other medications

Before starting treatment with drugs from the group of loop diuretics, it is recommended to read information about their compatibility with other medications. This will prevent the development of adverse reactions and complications.

Please note that it is not advisable to combine the use of loop diuretics with the use of anti-inflammatory and antidiabetic drugs.

If you take loop diuretics and:

1. Probenecid or drugs with anti-inflammatory effects will experience a decrease in the therapeutic effect of the former.
2. Medicines that thin the blood increase the risk of bleeding.
3. Digitalis (a herbal drug) may cause arrhythmia.
4. Lithium , stool disorders in the form of diarrhea and vomiting may occur.
5. Propranolol , the heart rate may slow down and bradycardia will appear.
6. Drugs that are used to treat diabetes will experience an increase in the effectiveness of the latter.

Who's at risk

Acute renal failure is accompanied by the appearance of edema. But diuretics are not always used for treatment. If the patient's condition is severe, the drug is discontinued.

Diuretics are not prescribed if the kidney stone reaches a large size. In severe respiratory failure, treatment with diuretics worsens the patient's condition.

The use of diuretics in patients who are vomiting causes changes in blood pH. In case of significant fluid loss, diuretics are contraindicated. Their use is possible only after stabilization of the patient's condition.

In the second half of pregnancy, women often experience swelling in their arms and legs. The expectant mother should not take diuretics without consulting a doctor, as in this case blood pressure significantly decreases, thrombophlebitis develops, and hearing and vision deteriorate.

Mechanism of action

The mechanism of action of loop diuretics will become clear if you understand a little about the functioning of the kidney. The loop of Henle - a large part of the nephron (the elementary component of the kidney) - is a canal that has a descending and ascending limb. Urine enters the first part after glomerular filtration, a reverse outflow of water occurs here, but the ions of sodium, potassium, calcium and chlorine are practically not absorbed back, due to this the liquid inside the canal becomes hyperosmotic. In the ascending segment of the loop, reuptake of minerals occurs, due to this the molarity of urine changes, and it is excreted to other parts of the kidneys.

Loop diuretics weaken the muscle tone of the renal capillaries, thereby increasing the amount of glomerular filtrate that enters the tubules. Due to the increase in fluid volume in the ascending limb, the mechanism for reuptake of minerals is disrupted. They “do not have time” to be absorbed back, urine along with them leaves the nephron into the collecting cups.

Additionally, the effect of loop diuretics is enhanced by the fact that they inhibit the absorption of ions in the ascending limb. The urine becomes even more hyperosmotic and water begins to flow into the canal from nearby tissues to dilute this saturated solution. In physics, this process is called “osmosis.”

Diuretics for weight loss

Women often use diuretics to lose weight. They start taking them on the advice of family or friends, without thinking about the harm they cause to their body. Self-medication leads to the disappearance of several kilograms, but the woman develops serious complications that require long-term treatment.

Unsystematic use of diuretics can cause disturbances in the functioning of the heart. To avoid complications, it is necessary to lose weight through a balanced diet. People with concomitant diseases should not go to extremes. Diuretics and low-calorie foods, the need to constantly limit oneself lead to psychological stress. It should be remembered that excess weight cannot be removed only with the help of medications. An integrated approach is needed:

• exercise stress;
• diet;
• massage.

After treatment with diuretics, the patient may lose consciousness and develop swelling that cannot be eliminated within several months. The patient is diagnosed with disorders of the nervous system. A person’s appearance changes—the hair on the head becomes thinner and falls out.

Contraindications

Among them:

• Critical electrolyte imbalance.
• Pregnancy and breastfeeding period.
• Childhood years, up to 3 years.
• Intolerance to the active component of the drug or other substances included in the drug. Most common. Before the appointment, it is almost impossible to understand that there is a problem.
• Polyvalent allergic reaction. It is extremely rare. Characterized by multiple intolerance to different drugs.
• Renal and liver failure in critical phases. Not always. Only at the discretion of a specialist. Because in some cases, the use of loop diuretics, on the contrary, is mandatory.
• Glomerulonephritis with decompensation of the functions of the excretory system.
• Congenital and acquired heart defects.

The effect of diuretics on health

Taking diuretics can lead to dangerous consequences. The amount of alkaline substances in the blood plasma increases sharply.

In some cases, a patient taking potassium-sparing diuretics may experience the following symptoms:

• nausea;
• vomit;
• convulsions;
• skin rash;
• change in voice timbre;
• increase in cholesterol levels in the blood.

Often at night the leg cramps. The patient complains of cardiac arrhythmia, shortness of breath, and deterioration in general condition. Vomiting occurs suddenly and unrelated to food intake. It is usually preceded by nausea. After emptying the stomach, the patient’s condition does not improve; another sign of damage to the nervous system appears - headache. The person complains of a feeling of rotation of his own body, a feeling of instability, and weakness.

It must be remembered that diuretics are prescribed only by a doctor after examining the patient. They act quickly and allow you to cope with the unpleasant symptoms of the disease.

Side effects

When taking potassium-sparing diuretics, the following side effects may occur:

• development of urolithiasis;
• sensitivity to bright sunlight;
• nausea and vomiting;
• diarrhea or constipation;
• dizziness and headache;
• convulsions;
• skin rashes;
• fatigue;
• deterioration of erection;
• changes in the menstrual cycle.