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Loop diuretic

German: Schleifendiuretikum

1 Definition

Loop diuretics are highly effective diuretic drugs (diuretics). They can induce an increase of urine production of 30 to 40 liters per day, under the condition that infusions are used to replace lost fluid.

2 Pharmacology

Most loop diuretics are sulfonamide derivatives. The most well known and commonly used loop diuretics are:

Their effectiveness is based on the inhibition of Na-K-Cl cotransporters in the Henle loop of the nephron of the kidney. This is the place where they inhibit reuptake of sodium, potassium and chloride ions from the primary urine into the body which causes an increased salt concentration. The elevated salt concentration increases the water content of the urine via osmosis, thus increasing diuresis.

Due to linked processes, loop diuretics increase secretion of calcium and magnesium.

3 Application

Loop diuretics are used to flush out unnecessary accumulations of water in the body. The most common indications are:

4 Side effects

Common side effects are circulation issues, headache and thirst. Fluid loss can lead to elevated hematocrit levels, making it necessary to ensure sufficient fluid and electrolyte intake. Further side effects are vomiting, fatigue and low blood pressure.

An emerging hypokalemia can be partially compensated by giving potassium salts, e.g. potassium chloride. Another limiting factor to therapy with loop diuretics can be a slowly developing hyponatremia. This can only be alleviated by reducing fluid intake and giving lower doses of the loop diuretic.

5 Contraindications

The use of loop diuretics should be avoided in patients with severe liver dysfunction, hypokalemia, hyponatremia and hypovolemia.

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Specialties: Pharmaceutical drug

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