Diuretics for heart failure


Diuretic medications in the therapy of high blood pressure have actually been utilized for over 50 years, these medications aid to decrease high blood pressure, conserving the body from excess liquid and also salts.

This feature is done by the kidneys, generating a bigger quantity of pee.

In heart failure, diuretics are advised usually.

They aid to boost the client’s problem, decrease the lots put in on the heart and also capillary, which is produced as a result of excess water in the body.

Diuretics for high blood pressure are consisted of in substance treatment, and also inhabit a significant area in the procedure of reducing high blood pressure. Numerous researches have actually revealed that medications with these buildings act securely on the client’s body, efficiently deal with high blood pressure spikes.

An perfect category of medications with a diuretic impact must think about all facets of their results on the body. Unfortunately, in the modern-day globe it does not exist, given that all diuretics have a varied chemical framework.

In this respect, they are essentially various from each various other, having various concepts of direct exposure and also the period of this activity on the body.

Earlier there were efforts to categorize according to which area of the kidney nephron they apply their impact. But, a variety of specific diuretic medications not just trigger the performance of the kidneys, yet additionally impact various other inner systems of the body.

Some medications, permeating in addition to the blood stream right into the kidneys, are energetic throughout the nephron.

In sight of this condition, it is not feasible to produce a systematic system that might integrate all the drugs of this team, conserving the body from excess water. The list below sorts of medications of this classification are differentiated:

  • The thiazide team is recommended for high blood pressure frequently. Pills act upon the body gradually and also extremely weakly, while the adverse effects from the consumption are never ever articulated.
  • The loophole team promotes the kidneys to accelerate and also boost pee manufacturing, hence aiding the body do away with water and also salt.
  • The potassium-sparing team offers a weak diuretic impact, yet boosts the performance of therapy with various other teams of diuretics.
  • Aldosterone villains obstruct the synthesis of the hormonal agent, which is liable for maintaining liquids and also salts in the body.
  • Natural diuretics – recovery plants and also natural herbs, on the basis of which diuretic products / casts are prepared.

As a guideline, the medical professional determines which diuretic to pick, whether it will certainly be the only ways or will certainly be consisted of in a certain therapy routine, relying on the client’s problem, the program of his ailment and also various other variables impacting it

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Classification

Group of medications and also seriousness of healing impactName of private agents
Thiazides, thiazide-like: healing efficiency – approximately 60%, standardHydrochlorothiazide, clopamide, hypothiazide, indapamide, chlortalidone
High performance loophole diuretics approximately 90%Furosemide, Lasix, Ethacrylic acid, Torasemide, Diuver
Low potassium maintaining ways: 30%Veroshpiron, Spironolactone, Triamtren, Amiloride

Separately, there are plant diuretics, they additionally have reduced performance – approximately 30%, yet the risk is marginal: Kanefron, Brusniver, Fitolizin.

There is an additional rank of diuretics, based upon the rate of the impact. For instance, Torasemide tablet computers, injectable are recommended with potassium prep work, the impact fasts, yet temporary.

Tonorma, Lozap-Plus, Tenorik – integrated with sartans, ACE preventions, beta-blockers, show a fast, much longer impact, boosting hypotension.

Potassium-saving medications such as Veroshpiron are suggested for hypertensive people, people struggling with hyperaldosteronism, diabetic issues mellitus, gout arthritis. They have a long term impact.

Hypothiazide, various other thiazide by-products act most gradually, the optimum task is displayed in 2-3 days, given that they collect the focus of the energetic compound.

Diuretics for heart failure: just how to take diuretic natural herbs from edema in heart failure

It is understood that high blood pressure (arterial high blood pressure, or AH) is identified by the security of hypertension, in which the heart is required to function intensively.

The lots causes a weakening of the heart muscle mass, and also the deficiency of the pumping feature of the body organ requires a hold-up in the discharging of salt and also liquid via the kidneys. This appears by stagnancy of excess water in the body, swelling of the arm or legs. In such situations, the medical professional suggests diuretics to the client.

Diuretics for high blood pressure and also heart failure are utilized for mix therapy. More on this later on in the short article.

In high blood pressure, an extra of salt creates a decrease in the smooth muscle mass of the vascular wall surfaces. From the results of diuretics in high blood pressure and also heart failure, the capillary expand, the circulation of salt ions from the kidney tubules right into the blood is decreased.

The smooth muscle mass of the bronchi and also biliary system additionally loosen up. The outcome of this antispasmodic impact of diuretics is the normalization of high blood pressure, eliminating excess liquid. Diuretics supplement medications for the therapy of high blood pressure.

The activity of diuretics in high blood pressure and also heart failure is differentiated by the level of impact on the architectural and also practical unit of the kidneys (nephron). This takes into account the duration of the therapeutic effect, the ability to relieve swelling, reduce high blood pressure. Depending on such indicators, diuretics are classified according to pharmacological groups:

  • The effect of these drugs is felt already an hour after administration, lasts 16-18 hours. Strong diuretics effectively suppress the process of chlorine and also sodium ions entering the blood, but increase potassium leaching (unfavorable for the heart). Loop preparations are used in case of hypertensive crises as high-speed drugs, are prescribed for a short period, and are considered acceptable for patients with various degrees of renal failure.
  • Thiazide drugs are prescribed in small doses for prolonged therapy of hypertension in the non-acute phase. They reduce blood volume, dilate blood vessels, thinning their walls, and reduce the amount of uric acid excreted from the body. It takes 2-4 weeks to achieve a steady normalization of pressure with thiazides.
  • Diuretics of this class are divided into hormonal and non-hormonal, achieve a healing impact on the second or third day. By stimulating the release of sodium ions, potassium-sparing diuretics reduce the potassium exodus from the body, purposefully act on the (distal) tubules of the kidneys that are distant from the center line of the body.

In modern medicine, diuretics are often used to maintain a certain condition of the patient, are often prescribed to older people. The cost of diuretics is considered affordable for many people. With arterial hypertension, potassium-sparing drugs are combined with loop and thiazide ones.

Diuretics for heart failure are similar to medicines for patients with hypertension.

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Thiazide

  • “Indapamide” is rapidly absorbed, acts 10-12 hours. The drug stops the reduction of the vascular walls, lowers blood pressure, does not cause a large volume of urination. One diuretic tablet taken in the morning is enough for a day, with an increase in the dose, the diuretic effect increases.
  • “Hydrochlorothiazide” (“Dichlothiazide”, “Hypothiazide”, “Nephrix”) pressure reduces slightly, but reduces the leaching of calcium, is indicated for osteoporosis. The medicine is well absorbed and after about an hour reaches its maximum concentration. After eating, 1-2 tablets are washed down with water 1 time per day.
  • Cyclomethiazide, (Navidrex) is recommended not only for hypertensive edema, but also in cases of kidney disease, glaucoma. It is also well absorbed, effectively accelerates urination, while maintaining the diuretic effect up to half a day. This diuretic is taken in the morning at 0,5 mg per day.

Loopback

  • Britomar (Diuver analog) – the basis of the drug is the substance torasemide, it concentrates in the blood after 1,5 hours. By stopping the entry of sodium and chlorine ions into the bloodstream in the tubular loop of the nephron, it reduces pressure in a state of low mobility. The diuretic is taken without reference to the food regimen of 20 mg per day.
  • “Lasix” is absorbed by 64% regardless of the dose, inhibits the entry of sodium and chlorine ions into the bloodstream in the tubular loop of the nephron, relieves swelling, but stimulates the outcome of potassium, calcium and magnesium from the body. The drug is taken at 40 mg 2 times a day.
  • “Furosemide” refers to a fast-acting diuretic, recommended for patients with severe forms of hypertension (resolved in renal failure). Within 3 hours, the drug enhances the excretion of sodium and chlorine, dilates peripheral vessels, and reduces pressure. The medicine is taken in the morning at 40 mg, if a second dose is required, wait 6 hours.

Potassium-sparing

  • “Veroshpiron” belongs to the group of hormonal preparations, is well absorbed and interferes with the influence of the hormone aldosterone, stimulates the excretion of sodium and water, reduces the leaching of potassium, and reduces the acidity of urine. The drug is taken 15 days at 100 mg per day.
  • “Amiloride” is a non-hormonal diuretic. The drug stimulates the excretion of sodium ions, chlorine, inhibits the leaching of potassium. Its effect is designed for distal tubules of the kidneys. The medicine is taken at 20 mg per day.

Charges of herbs that stimulate urination, differ from diuretics in a mild healing effect, do not give side effects.

Herbal decoctions and infusions according to folk recipes require systematic use, designed for a long time. Diuretics of this kind can be used for complex or supportive treatment, which does not eliminate the loss of magnesium and potassium.

For this reason, you need to regularly eat rice, oatmeal, raisins, dogrose, dried apricots (or fresh apricots), bananas.

Infusion based on drug collection:

  1. Carefully chop and mix equal parts of bearberry, St. John’s wort, nettle, dog rose, plantain.
  2. Scooping 1 tbsp. l collection, put in a convenient dish, pour 0,5 liters of boiling water, insist 1 hour, strain.
  3. Drink in small portions, stretching for 3 days.

Honey broth with burdock root:

  1. Grinding the root parts of the plant.
  2. Measure 3 tbsp. l raw materials in the pan and add 1 liter of boiling water.
  3. Simmer over low heat until 0,5 l of water is evaporated from the broth, sweeten with honey to taste (sugar can be).
  4. Drink 0,5 cup three times a day.

Diuretics for arterial hypertension are prescribed in a minimum dosage. If the swelling does not subside, the doctor increases the dose to the patient.

The feasibility of using different groups of diuretics is strongly affected by the high probability of side effects and addiction syndrome.

With prolonged use of diuretics, exceeding doses, there is a likelihood of diabetes mellitus, ion imbalance.

Side effects

  • Thiazides contribute to the concentration of uric acid, increase cholesterol, blood sugar, and in patients with diabetes insipidus lower urination.
  • Loop diuretics can cause potassium deficiency (hypokalemia), arrhythmia, muscle weakness, and cramping.
  • Hormonal diuretics provoke diarrhea, vomiting, migraine, cramps, rash, and sex drive disorder.
  • Common side effects for all groups of diuretics are drowsiness, fatigue, insomnia, dry mouth and thirst, weakness, nausea, and pain in the kidneys.

contraindications

  • hypokalemia;
  • decompensated liver cirrhosis;
  • acute renal and respiratory failure.

If the body ceases to respond to diuretics, excess fluid is not excreted.

This condition occurs with long-term use of diuretics, which is typical for patients suffering from severe forms of heart failure.

A list of common causes of resistance to diuretics includes hormonal disruptions, gastrointestinal tract and vascular system disorders. In such a situation, it is recommended to limit fluid intake.

Diuretics are diuretic drugs that help remove excess fluid from the body. Most often used to treat heart failure. The medicine is used both intravenously and orally.

Diuretics for heart failure are prescribed only by the attending physician, since the drugs differ in the strength of the effect. Therefore, at each stage of the disease, a separate type of drug is prescribed. Both synthetic and herbal diuretics are allowed.

They can be used only according to the instructions and under the supervision of a doctor.

Diuretics for heart failure: how to take diuretic herbs from edema in heart failure

In the treatment of arterial hypertension, chronic heart failure, a complex of medicines is used to improve the nutrition of the heart muscle. Sodium and calcium channel blockers are used, receptor blockers that are sensitive to angiotensin.

Diuretics for hypertension and heart failure are also indicated. Thanks to diuretics, excess fluid and salts are removed from the body, the load on the vessels is significantly reduced, and venous congestion is prevented.

The use of medicines from this group is necessary only under the supervision of a doctor because of the likelihood of side effects and complications.

Those medications that increase the excretion of water, salts from the body with urine are considered diuretics. These drugs are included in the top five drugs of the first line, which are used in the treatment of hypertension.

The pressure index decreases due to a decrease in the volume of circulating plasma, the total resistance of the vessels. The susceptibility of the vascular walls to vasoconstrictors is reduced. Diuretics affect the flow of ions through vascular cells.

Important: The use of diuretics in hypertension, as well as in heart failure, virtually eliminates the risk of death from heart attack, stroke.

Depending on the pharmacological properties, the severity of the therapeutic effect, diuretics are divided into 3 groups:

  1. Thiazide and thiazide-like. The severity of the therapeutic effect is about 40-60%. Due to the cumulative effect, the effect of the drug appears after several days from the beginning of the treatment course. Thiazides are included in the group of diuretics endowed with medium efficiency. Their advantage is the presence of a minimum list of side effects. Most often, Indapamide, Hypothiazide, and Hydrochlorothiazide are prescribed from this group.
  2. Loop diuretics. They have a high severity of therapeutic effect (over 90%). Preparations of this group of diuretics do a good job of eliminating water and mineral salts from the body, and have a pronounced hypotensive effect. However, they are endowed with a large list of side effects. Uncontrolled use of medicines from this group is dangerous to health. It includes such drugs “Diuver”, “Lasix”, “Furosemide”, “Torasemide”, “Clopamide”, “Ethacrine acid”.
  3. Potassium-sparing diuretics. They have the lowest manifestation of the therapeutic effect (below 30%). These diuretics are considered the safest. They are rarely prescribed as the main medicine. They are often used to enhance basic therapy. Preparations of this type are considered to be “Spironolactone”, “Veroshpiron.”

Separately isolated herbal preparations, fees. Their effectiveness is also low (less than 30 – 40%). Medicines made on the basis of herbal components gently eliminate mild edema. They are released in the form of phyto-collection, capsules, tablets. The most popular are Kanefron, Brusniver.

Diuretics are also divided into the following groups:

  • high-speed. They are released in the form of tablets, injectable solutions. The effect of their use is quick, but short-lived. They are prescribed along with potassium preparations. This group includes “Torasemide”, “Furosemide”;
  • a diuretic can be combined with beta-blockers, ACE inhibitors, sartans. Such combinations enhance the therapeutic effect, reduce the risk of adverse reactions. This group includes Tonorma, Tenorik, Lozap-Plus. Only a doctor should choose a treatment;
  • potassium-sparing. Their advantage is the absence of such a negative effect as leaching of potassium. The most common drug in this group is considered “Spironolactone.” Prescribe this type of pill to patients with hyperaldosteronism, gout, type diabetes. Contraindications to the use of these drugs are cirrhosis, hyperkalemia, renal failure.

Blood pressure can increase due to various factors. Some of them are capable of provoking cardiac edema, exacerbating the course of arterial hypertension. Swelling negatively affects the functioning of the heart muscle, contribute to the deposition of salts inside the joints, increase the load on the capillaries, blood vessels.

With hypertension, diuretics are usually prescribed for elderly patients, if there is heart failure, osteoporosis, as well as with an increase in only the upper arterial pressure (isolated systolic hypertension).

People suffering from hypertension are often prescribed diuretics of the thiazide group (or thiazide-like). The use of these medicines reduces the risk of heart attacks, strokes, and hypertensive crisis by about 40%.

Experts believe the prescription of drugs from this group is absolutely justified even if there is a high probability of the manifestation of negative consequences.

Taking diuretic medications for hypertension contributes to the manifestation of the following therapeutic effects:

  • lowering blood pressure;
  • reduced load on the heart, blood vessels;
  • prevention of salt deposition;
  • removal of excess fluid, removal of puffiness.

When treating hypertension, doctors prescribe the following diuretics from the list for patients:

In the absence of the proper effect after the treatment with thiazide diuretics, the doctor prescribes loop diuretics. Such an event is considered necessary for emergency care for hypertensive crisis, against a background of cardiac, renal failure.

In the absence of a therapeutic result after the use of low doses of diuretics, doctors do not recommend increasing the dosage. It will not be possible to normalize high blood pressure in this way, but side effects may occur. Instead of increasing the dose (with hypertension), experts recommend supplementing the treatment with medicines from another group or replacing the medicine used.

Under the influence of diuretics, the risk of developing diabetes increases, the rate of cholesterol in the blood increases. For this reason, diuretics are prescribed for young patients only in exceptional cases. Doctors also try not to prescribe these drugs for hypertensive patients, obese, and diabetes. These metabolic disorders do not provoke the following diuretics:

  • thiazide-like “Arifon”, “Arifon Retard”, “Indapamide”;
  • loop “Torasemide”.

The treatment of hypertension with diuretics has several disadvantages:

  1. The likelihood of such a distant side effect as the “wear” of the heart, kidneys.
  2. The appearance of “quick” side effects (sleep disturbance, decreased potency in men, increased urination, increased blood cholesterol, fatigue).
  3. Muting the symptoms of hypertension, and not eliminating the causes of this condition.
  4. Addiction to a diuretic drug, which is accompanied by a decrease in its effectiveness.

With this pathology, the blood supply to the organs is disturbed due to a malfunction in the heart. Heart failure is often accompanied by fluid retention in the blood. Moderately severe heart failure is manifested by the following symptoms: enlarged liver, shortness of breath, swelling, wheezing in the heart, cyanosis. More severe cases are manifested by cardiogenic shock, pulmonary edema, hypotension.

To restore normal blood circulation, reduce pressure on the heart muscle, and normalize the proper functioning of this organ in complex therapy, drugs such as diuretics should be present. They are prescribed to patients in whom heart failure provoked the appearance of edema, shortness of breath due to stagnation of fluid inside the lungs.

The use of diuretics helps to improve the patient’s condition. The conducted diuretic therapy (for heart failure) increases the tolerance of physical exertion, relieves swelling, improves the prognosis, prolonging the patient’s life.

Please note: About 80% of those suffering from heart failure (acute, chronic) suffer from ascites, swelling of the extremities. The most dangerous cases threaten the occurrence of dropsy of the internal organs.

Diuretic drugs in the treatment of heart failure are aimed at eliminating the symptoms of pathology, and not at treating the underlying cause of the disease. Accordingly, doctors prescribe diuretics only in combination with ACE inhibitors, beta blockers.

Reception Features

Taking diuretics is allowed only under the strict supervision of a doctor who can adjust the dose if necessary. Taking these medications helps to remove not only fluid from the body, but also such beneficial substances as potassium and magnesium.

It is necessary to take diuretics according to the dosage specified in the instructions or prescribed by the doctor. An overdose is dangerous by rapid dehydration, acute heart failure. These conditions can be fatal.

A random increase in the dose prescribed by the doctor should be accompanied by rehydration therapy with saline solutions. For this purpose, you can use “Rehydron.” In its absence, you can prepare the solution yourself from water (0,5 l), salt (2 tablespoons).

Diuretics for the treatment of heart failure are divided into the same groups, the choice of each depends on the characteristics of the pathology, so only a doctor can prescribe medications. At the same time, diuretics are always combined with drugs that treat the main pathology that caused hemodynamic failure: beta-blockers, glycosides, statins, anticoagulants.

Side effects

All side effects from taking diuretics in the treatment of hypertension, complicated or uncomplicated heart failure are combined in several groups:

  • the main one is disturbances of the water-electrolyte balance: dehydration, a sharp decrease in the concentration of the main trace elements in the bloodstream, which are manifested by tachycardia, arrhythmia, dry mouth, headaches, drowsiness;
  • dehydration is accompanied by metabolic disorders: hyperuricemia, hyperglycemia, hypophosphatemia, which give symptoms of parasthesia, tremor, impaired contractility of the heart muscle, joint pain, sometimes pathological fractures, diabetes mellitus can debut at this time, the first atherosclerotic plaques appear;
  • metabolic disorders are manifested by alkalosis (the predominance of the withdrawal of chlorine ions from the body) or acidosis (blocking bicarbonate reabsorption);
  • allergy manifests itself with skin rashes, hives, itching, attachment of a secondary infection to scratching, sometimes with Quincke edema, requiring hospitalization;
  • endocrine disorders occur against the background of competitive interaction of potassium-sparing drugs not only with aldosterone receptors, but also with progesterone, androgen receptors, as a result, sexual desire for the opposite sex is reduced, dysmenorrhea, amenorrhea, hypermenorrhea occur, erectile function is disturbed. The man becomes effeminate, the adenoma makes its debut.

In addition, loop means have the capacity to provoke hearing loss, disrupt the functioning of the vestibular apparatus. All teams can cause dyspepsia, disrupt kidney and liver function. Diuretics cause drowsiness, a feeling of chronic fatigue, migraine, vasculitis. They provoke orthostatic hypotension.

Plant Diuretics

The most safe are rightly considered plant diuretics, they are natural, practically have no contraindications for use. But effectiveness is also insignificant, therefore, they are used more as auxiliary agents in the treatment of cardiovascular pathologies.

The most popular is the vegetable collection of lingonberry leaf, string, rose hips, St. John’s wort – Brusniver. It is also available in an improved version with the addition of bearberry, which brings the properties of an antiseptic, demonstrates an anti-inflammatory, antimicrobial impact – this is Brusniver-T. The collection is brewed like ordinary tea, insisted for half a hr, divided into three doses (it is better to warm it to 30 ° C before use). The course is 21 days with a repeat in 10 days.

In second place is Kanefron. It consists of rosemary leaves, centaury, lovage. The drug relaxes the muscle fibers of the urinary system, relieves spasm, pastiness, inflammation. Reception – three times / day, the dosage is determined by the doctor. The only limitation is peptic ulcer disease, the neonatal duration.

Higher clinical education and learning. Kirov State Medical Academy (KSMA). The neighborhood specialist.

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Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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