diureticos
Post on 26-Jun-2015
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The 3 Classes of Diuretics and Their Primary Sites of Action in the Nephron
For Internal Use Only
Adapted from: Oparil S and Weber MA. Hypertension.Elsevier/Sanders 2nd ed. 2005; Lip G and Bakris G. Handbook Hypertension Management. CMG 2006
Thiazide Diuretics
• Duration of action of 12–24 hours• Blood pressure lowering effect with low doses• Additive blood pressure lowering effect when used in combination with
other antihypertensive drugs• Main side effects:
- hypokalemia- hyponatremia- hyperglycemia- altered plasma lipid concentration- hyperuricemia or gout- impotence (reversible on withdrawal of treatment)
Bendroflumethiazide 1.25-2.5 mg once dailyChlorthalidone 12.5-25 mg once dailyHydrochlorothiazide 12.5-25 mg once dailyIndapamide 2.5 mg once daily or 1.5 mg
of sustained release (SR) preparation
For Internal Use OnlyLip G and Bakris G. Handbook Hypertension Management. CMG 2006
Loop Diuretics
• Bumetanide 0.5 – 2 mg/d• Furosemide 20 – 80 mg/d• Torsemide 2.5 – 10 mg/d
• Most commonly used for powerful diuresis (renal failure, severe heart failure with oedema)
• Rapid onset of action:• - 1 hour after oral administration• - peak at 30 min after intravenous administration
• Useful when blood pressure require extremely rapid lowering (brisk diuresis)
• Main side effects:- Hypokalemia- hyponatremia
Lip G and Bakris G. Handbook Hypertension Management. CMG 2006
For Internal Use Only
Diuretics that Cause Potassium Retension
• Triamterene 50 - 100 mg/d
• Amiloride 5 – 10 mg/d
• Spironolactone 25 – 100 mg/d
• Weak diuretics
• Little effect on blood pressure
• Cause retention potassium
• Combined to thiazide or loop diuretics to prevent or remedy hypokalemia
• Main side effects:
- hyperkalemia
- hyponatremia
- rashes
Lip G and Bakris G. Handbook Hypertension Management. CMG 2006
For Internal Use Only
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