Diuretics, the effect of which is on the part of the nephron connecting the near and far tubules, are called "loop diuretics." They affect the filtration capacity of the kidneys, allowing you to utilize fluid and salts from the body.
Such drugs have a quick and strong diuretic effect, they do not form the prerequisites for the appearance of diabetes mellitus, and also do not affect cholesterol and are medications of medium power.
Adverse reactions are considered a big minus of such drugs. Loop diuretics are a type of diuretic that has a targeted effect on the functioning of the kidney nephron.
When to take medication?
The main prescriptions for the use of loop diuretics are the following conditions:
- Swelling, which is caused by excessive sodium in the body.
- High blood pressure.
- Heart disease.
- High levels of calcium and potassium in the blood.
- Kidney damage.
Contraindications
Medical experts note the following prohibitions on the use of loop diuretic drugs:
- The absence of urine in the bladder.
- Pregnancy.
- A pathological condition that leads to a violation of the frequency, as well as the rhythm and sequence of excitation and contraction of the heart.
- Allergy.
- Deterioration of blood microcirculation.
- Lactation.
How do they act?
Loop diuretics begin to act after 30 minutes. The spectrum of action of diuretic drugs is based on the relaxation of blood vessels and increased renal blood flow, drugs improve the connection of prostaglandins in the endothelial cells of capillaries.
The drugs begin to act after about 30-60 minutes, and end after about six hours. Loop diuretics cause disturbances in the counter-rotational mechanism of the nephron and increase glomerular filtration.
In addition, the mechanism of action of loop diuretics is to reduce the reverse absorption of chlorine and sodium ions, and in the nephron, the absorption of magnesium is slowed down, thereby increasing the volume of its joint excretion with urine.
Loop diuretic drugs affect renal blood flow. In addition, they lower heart stress, as well as vein tone and increase urine volume.
What drugs do loop diuretics come into contact with?
It is better not to combine such diuretics with anti-inflammatory, as well as anti-diabetic and other medicines.
A patient who began to use a loop diuretic should pay attention to its compatibility with other drug groups. Most combinations have certain limitations and provoke a negative effect:
- Anti-inflammatory drugs greatly reduce the effects of loop diuretics.
- Blood thinners can cause bleeding.
- Digitalis, which is considered a medicinal plant, can affect the heart rhythm.
- Lithium preparations cause vomiting and diarrhea.
- "Probenecid" reduces the effect of loop diuretics.
- Anaprilin slows the heartbeat.
- Antidiabetic drugs provoke a decrease in blood sugar.
What drugs - loop or thiazide diuretics - are best taken?
The thiazide group of drugs is considered the most sparing. In most cases, it is these drugs that are prescribed to patients, y of whom there are slight deviations in the functioning of the kidneys, as well as the liver and other organs. Loop and other diuretic agents are prohibited for use in these cases. The disadvantages are weak clinical pharmacology, a person has to undergo a long course of therapy with the elimination of hypertension. With the help of loop diuretics, the healing process can be accelerated , but not everyone is allowed to take it.
Adverse reactions
There are a number of negative phenomena:
- Dehydration (gradual dehydration of the body, that is, loss of fluid, which can result in death for the patient).
- Reducing the level of chloride in the blood.
- Decreased insulin production.
Loop diuretics: list of drugs
The fastest medicines are:
- "Britomar" is a tablet with a diuretic effect, the amount of active substance in which is 5 or 1 mg. You can use the drug at any time convenient for a person, regardless of food intake. Use a diuretic when edema occurs with heart disease should be 10-20 mg once a day. If edema occurs in kidney disease, it is recommended to take 20 mg once a day. If swelling appeared with liver disease, then specialists prescribe 5-10 mg per day (together with other medicines). With high blood pressure - 5 mg per day.
- "Furosemide" is sold both in tablet form (40 mg) and in the form of a solution for injections (10 mg). The drug is taken orally in the morning, starting with 40 mg per day, if necessary, increase the daily dosage to 160 mg. A positive effect appears after half an hour and lasts up to 4 hours. The solution is used both intramuscularly and intravenously at 20-40 mg per day and begins to act after 4 minutes.
- "Ethacrylic acid" is produced in tablet form and in solution. They start to take the drug orally with a dosage of 50 mg, gradually increasing the concentration of the drug (if necessary). Intravenously (to achieve the fastest effect), 50 mg are prescribed. A positive effect can be observed after about 30 minutes, it can last up to eight hours.
In addition, the drugs of the loop diuretic group are:
- Bufenox.
- Diuver.
- Lasix.
These drugs will be discussed in more detail below.
Bufenox
The drug is available in the form of tablets (1 mg) and a solution for injections (0.025%). Tablets must be consumed in the morning on an empty stomach, 1 piece for five days, and after two pieces for another three days.
The solution is applied either intravenously or intramuscularly, at 0.5-1.5 mg, injections can be made approximately every four to eight hours. The duration of treatment is four days. A positive effect occurs within two hours.
For preventive purposes, a potassium-enriched diet is prescribed to prevent hypokalemia. Patients who receive large doses of Bufenox, in order to avoid the appearance of hyponatremia and hypochloremic alkalosis, can not limit the intake of sodium chloride in the body. There is a high probability of disturbances in the water-electrolyte balance in people with renal failure.
During therapy, it is necessary to regularly monitor the plasma electrolyte content, as well as residual nitrogen. If you have or increase azotemia and oliguria in people with severe progressive kidney damage, you need to stop taking "Bumetanida".
In addition, special care should be taken when taking alcohol, as well as during prolonged standing or performing physical exercises, with heat and a sharp transition to an upright position from a lying position due to increased orthostatic hypotensive effects.
Diuver
The medication is included in the list of loop preparations-diuretics. Diuver is a tablet with a dosage of 5 and 10 mg. For various edema, you need to use the medicine 5 mg once a day, if necessary, increase the dose to 40 mg. At high blood pressure take half a tablet (2.5 mg) once a day.
When using increased concentrations of Diuver for a long period of time, the likelihood of hypokalemia, as well as hyponatremia and metabolic alkalosis increases, in connection with which you should adhere to a diet.
The selection of the correct dosage of the drug for patients with ascites, which appeared as a result of cirrhosis of the liver, must be carried out in a medical institution. In addition, in such patients, the level of electrolytes in blood plasma should be constantly monitored.
People with diabetes should often check their glucose levels in urine and blood. Due to the likelihood of acute urinary retention, diuresis should be controlled for patients who have narrowing of the ureters and prostate hyperplasia, as well as patients in an unconscious state.
Lasix
The drug is in the form of a solution for injection and tablets. The solution is injected intravenously. With edema, the drug is prescribed in an amount of 20-40 mg per day, with pulmonary edema - 40 mg. With high blood pressure - 80 mg per day (two doses). With high blood pressure - 80 mg per day (two doses). The diuretic begins to “work” two hours after consumption.
Before starting loop diuretic therapy, a person should be examined for impaired renal function, especially if daily diuresis is greatly reduced. The fact is that the mechanism of loop diuretics is based on the relaxation of blood vessels and increased renal blood flow.
During treatment with a medicine, it is also necessary to control the work of vital organs, especially if the patient is forced to use Lasix in high concentrations. Unauthorized increase in dosage can lead to the appearance of symptoms of poisoning and severe hypovolemia.