Loop diuretics: the list of drugs, side effects, mechanism of action
Diuretic medicines, the impact of which falls on the loop of Henle (part of the nephron that connects the near and distant tubules) are called «loop diuretics». They have an influence on the filtration ability of the kidneys, allowing excretion of liquid and salt. These drugs are fast and strong diuretic effect, and do not create prerequisites for the development of diabetes, have no effect on cholesterol and represent the means of the average power. However, the side effects of loop diuretics are a significant drawback of these drugs.
The main indications for use of loop diuretics are:
- swelling caused by the overabundance of sodium in the body;
- high blood pressure;
- heart failure;
- increased concentration of calcium and potassium in blood plasma;
- renal failure.
Doctors note the following contraindications to loop diuretics:
- the lack of receipt of urine in the bladder;
- allergic reactions to drugs sulfonamide group;
- reduction of circulating blood volume;
- pregnancy and breast-feeding.
Mechanism of action
The mechanism of diuretic drugs is based on relaxation of the muscles of the blood vessels and increase renal blood flow, due to the fact that drugs increase the synthesis of prostaglandins in the endothelial cells of blood vessels. The effect of the drug begins after 0,5 to 1 hour, but often ends quickly in 4-6 hours. Loop diuretics provoke the failure in the counter-rotating mechanism of the loop of Henle and increase glomerular filtration (filtering of fluids that do not contain protein compounds), due to which there is a strengthening of the diuretic action.
In addition, loop diuretics decrease back the absorption of sodium and chloride ions, and in the loop of Henle inhibit the absorption of magnesium, increasing its excretion through urine. After the reduction of magnesium in the body and decreases the production of hormone produced by the parathyroid glands, thereby reducing the reverse absorption of calcium. Loop diuretics affect the renal blood flow, reduce cardiac load, and venous tone and increase the volume of urine.
The patient who began taking loop diuretics, need to pay attention to its compatibility with other drugs. Many combinations have contraindications and cause adverse effect:
- anti-inflammatory drugs significantly reduces the effect of diuretics;
- drugs to thin the blood often can cause bleeding;
- digitalis, which is a medicinal plant that may affect the heart rhythm;
- «Lithium» is causing vomiting and diarrhea;
- «Probenecid» reduces the effects of loop diuretics;
- «Inderal» slows the heart rate;
- antidiabetic agents provoke a decrease in the level of blood sugar.
List of drugs and method of administration of loop diuretics
The most fast-acting loop diuretics are those medicines:
- «Britomar» is a diuretic tablet, the quantity of active component in which is 5 or 10 milligrams. To use the tool, you at any convenient time for the patient, regardless of the meal. To use a diuretic in case of edema in heart failure need 10-20 mg 1 time a day. In cases of edema when kidney disease is 20 mg 1 time per day. Edema in liver disease require 5-10 mg per day in combination with other drugs prescribed by a doctor. High blood pressure — 5 mg per day. The diuretic effect starts about one hour after ingestion and lasts up to 10 hours.
- «Furosemide» exists in the form of tablets (40 milligrams), and in the form of solution for injection (10 milligrams). Orally taken in the morning, starting with 40 mg daily, if necessary daily dose increased to 160 mg Effect occurs within 0.5 h and lasts up to 4 h. the Solution is found intramuscularly and intravenously 20-40 mg per day, and takes effect within 4 minutes.
- «Furosemid» is made in the form of tablets (40 mg) and injectable solution (20 milligrams). Tablet dosage set individually from 1 to 3 tablets 1 time per day. The solution is administered intravenously and intramuscularly, ranging from 20 mg per day and increasing the dosage if required. Action is observed within 5 minutes after administration and lasts up to 8 hours.
- «Ethacrynic acid» is available in the form of tablets (50 milligrams) and in solution (50 milligrams). Oral diuretic start taking 50 mg, and gradually increasing the dose in cases of necessity. Injected intravenously to achieve a more rapid effect on 50 milligrams. The effect is observed after 30 minutes and lasts up to 8 hours.
«Butanox» presented in the form of tablets (1 mg) and injectable solution (0,025%). Tablets should be taken in the morning on an empty stomach 1 thing for 3-5 days, and then 1-2 more for 3 days. The solution is injected either intravenously or intramuscularly, with 0.5—1.5 mg, the next injection can be produced after 4-8 hours. The course of therapy is 3-4 days. The effect occurs within 2 hours.
«Diver» is a tablets of 5 and 10 milligrams. With a variety of edema to take the drug is 5 mg once a day, if necessary, gradually increasing the dosage to 40 mg. for high blood pressure drink half of a 5 mg pill once a day. The action of loop diuretics starts in 2 hours and lasts up to 18 hours.
«Lasix» is available in the form of a solution for infusion (10 mg) and tablets (40 milligrams). The solution is administered intravenously. In cases of mild edema used 20-40 mg per day, in the case of pulmonary edema — 40 mg. for high blood pressure — 80 mg per day in 2 admission. Oral is used with mild edema at a dosage of 20-80 mg daily, for high blood pressure — 80 mg per day in 2 admission. Diuretic takes effect within 2 hours after ingestion.
It is important to remember that the correct dose of drugs can be prescribed only by specialist, based on the individual characteristics of the patient.
There are a number of negative impacts, which cause loop diuretics to the human body: dehydration, low content of ions of sodium, potassium, calcium and magnesium in the blood plasma, reducing the amount of chlorides, the high content of uric acid, which might lead to gout — painful swollen joints mostly at the big toe, the suppression of insulin secretion, damage to the auditory and vestibular apparatus.