The physiologic basis of diuretic synergism: its role in treating diuretic resistance

Article Abstract:

Diuretics are drugs that remove excess water from the body, and are often prescribed when dietary restriction of salt (sodium chloride) intake has failed to produce a reduction in swelling. Diuretics are classified on the basis of what part of the kidney they affect. Frequently, after using a diuretic for some time, a patient will find that the drug has become ineffective, and that swelling returns. In these patients, the addition of a second diuretic of another class may provide dramatic relief from swelling. As blood flows through the kidney, sodium chloride is secreted to the tubules of the kidneys, and water follows the salt. The vast majority of these sodium chloride molecules are reabsorbed by the kidney's tubules along with water, leaving only a small portion of salt and water to be excreted as urine. Diuretics act by inhibiting some of this reabsorption of sodium chloride, which increases the loss of water through the urine. Some of the reasons that diuretics can become ineffective include too much dietary salt, kidney damage, heart failure, old age, and the simultaneous use of drugs that interfere with the diuretic action. Another cause for diuretic failure is the kidney's adaptation to the presence of the drug. When some of the kidney's cells are unable to absorb salt because of the diuretic, other cells enlarge and increase their salt-retaining activity. Adding a second diuretic from a different class can often eliminate this problem by preventing salt absorption from two separate areas of the kidney at one time. Combination therapy can lead to complications, such as massive fluid loss and loss of electrolytes, such as sodium and potassium. However, with careful attention, patients who have developed diuretic resistance to one drug may benefit from the addition of a second diuretic. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Edema, Diuretics

---

Renal mechanism of trimethoprim-induced hyperkalemia

Article Abstract:

Trimethoprim-induced hyperkalemia may be caused by blockage of sodium channels in the kidneys. Hyperkalemia is abnormally high blood levels of potassium. Trimethoprim is a drug often used to treat Pneumocystis carinii pneumonia in AIDS patients. A study examined trimethoprim-induced hyperkalemia in 30 AIDS patients. The AIDS patients' blood levels of potassium increased during treatment with high-dose trimethoprim despite normal adrenal gland function and kidney filtration rate. Thirty-nine male rats were divided into two groups. One group was treated with intravenous trimethoprim and the other received a placebo, an inactive substance. Treatment with trimethoprim decreased the excretion of potassium by the kidneys by 40% and increased secretion of sodium by 46%. Trimethoprim decreased the voltage inside distal kidney tubules by 66%.

Causes of, Complications and side effects, Kidneys, Potassium (Chemical element), Kidney, Potassium, Trimethoprim, Hyperkalemia

---

Low-dose diuretic to preserve bone density in older adults

Article Abstract:

The diuretic drug hydrochlorothiazide may strengthen bones in elderly people, according to a study of 309 elderly people. Bones become less dense as people age, increasing the risk of fractures.

Care and treatment, Aged, Elderly, Bones, Prevention, Bone density, Osteoporosis, Hydrochlorothiazide

Similar abstracts:

• Abstracts: The epidemiology and natural history of pressure ulcers in elderly nursing home residents. Risk factors for delirium in hospitalized elderly
• Abstracts: Clinical and microbiologic features of urethritis in men in Toulouse, France. Haemophilus parainfluenzae causing sexually transmitted urethritis: report of a case and evidence for a beta-lactamase plasmid mobilizable to Escherichia coli by an Inc-W plasmid
• Abstracts: Incidence and characteristics of preventable iatrogenic cardiac arrests. Clinical crossroads: an invitation
• Abstracts: Tuberculosis in patients with human immunodeficiency virus infection. part 2 The new tuberculosis
• Abstracts: Health consequences of contraceptive use and reproductive patterns: summary of a report from the US National Research Council

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.