The stronger the remedy, the greater the volume of fluid it will help your body naturally excrete through the kidneys and urine.
It seems to some that taking a strong remedy is a blessing. Especially when you need to get a quick result. But this is not so. It is necessary to take into account the features of the functioning of the body.
In some cases, it is right to take a fast diuretic, but not strong. The fluid that enters our body does not directly enter the bladder.
It enters the bloodstream through the gastrointestinal tract, thereby increasing the volume of circulating blood (hereinafter BCC). By the way, this is why taking such drugs can lower blood pressure. By decreasing bcc, we lower the pressure, the body no longer needs high pressure to push through a large volume of blood. The body uses this fluid and removes excess through the bladder.
Suppose, for some reason, the body functions abnormally. You decide to help him with a very strong cure for edema. What’s happening. Firstly, mineral salts in much larger quantities are washed out of the body. Than it is necessary.
Secondly, you take a potent drug, and a large amount of fluid is removed from the body. If you take such a drug on a regular basis – several times a week, your body begins to struggle with the fact that it loses fluid, and begins to store these excess fluids so that at the next loss of fluid, it will replenish the BCC.
It retains these excesses in tissues. Those. even more fluid begins to be deposited, and your swelling increases.
You, to reduce these edema, begin to take an even larger dose. The body is rebuilt again and begins to accumulate even more fluid. So you very quickly reach the maximum dose.
This, by the way, is one of the reasons why the self-administration of such drugs is highly undesirable. They should be prescribed by a doctor in combination with concomitant treatment, then such a negative effect will not occur.
Diuretics (diuretics) are effective time-tested treatments for acute and chronic heart failure. On the one hand, diuretics can be called the most “commonplace” means, which, along with glycosides, are probably most often used for heart failure. On the other hand, the use of diuretics in this type of cardiological pathology is perhaps the most unexplored part in clinical practice.
There are no direct data on the effect of diuretics on the clinical course (frequency of decompensation, mortality). According to some researchers (Opie LH, 1997, Taylor SH, 1995), such studies are unlikely to be carried out, because it is difficult to imagine the possibility of treating heart failure with only diuretics in the form of monotherapy (and even the control group of patients, receive a placebo).
If we use target doses when prescribing ACE inhibitors or β-blockers, we clearly present the stages of drug titration, then in the treatment of heart failure with diuretics we are guided only by general principles and it is here that we are forced to “improvise”.
The main pathogenetic mechanism and the main clinical symptom of congestive heart failure is the retention of sodium and fluid in the body, which leads to the development of edema, or, more precisely, the formation of edematous syndrome. However, it must be understood that this postulate is often exaggerated and not always with chronic heart failure, in particular FC I and II (functional class), there is an obvious fluid retention, and yet diuretics, and in a broader sense of the word – dehydration therapy plays the main role in the treatment of a large number of patients with chronic heart failure.
Since almost all modern diuretics are derivatives of sulfomoyl acid, they are characterized by the general principles of the formation of refractory treatment with diuretic drugs and, accordingly, the general principles of prevention of the situation.
The etiology of the development of refractory edematous syndrome are:
- Progression of chronic heart failure.
- Development and progression of prerenal chronic renal failure.
- Arterial hypotension.
- Excessive hyperactivation of neurohumoral systems.
- The presence of violations of acid-base metabolism and an imbalance of electrolytes in blood serum.
- Hypoproteinemia and cachexia.
- The formation of tolerance to the pharmacological action of a diuretic.
“Early refractory” to diuretics or “stage of inhibition.” It forms literally after several days of active treatment with diuretics. The etiology of this phenomenon is the activation of neurohormones (angitensin, catecholamines, aldosterone and vasopressin), as well as a reaction to hypovolemia, which has developed dramatically.
The likelihood of “early refractoriness” to diuretics is higher, the more persistently the doctor begins the dehydration therapy of the patient. Excessively high diuresis with an excess of the daily volume of urine output over the amount of fluid taken by ≤ 2,5 L guarantees the development of a “rebound” refractory to therapy. For the prevention of “early refractoriness” to diuretics, diuretics must be combined with ACE inhibitors.
“Late refractoriness” to diuretic therapy is formed 1-3 months after the start of treatment. The etiology of “late refractoriness” is hypertrophy of epithelial cells in response to increased absorption of electrolytes.
To prevent the development of refractory to diuretic therapy, a complex of preventive methods is required.
- Strict restriction of the use of salt, not water!
- The use of diuretics is strictly intravenous.
- The use of high doses of diuretics. There is evidence that in some cases it was possible to overcome refractoriness to diuretics with the intravenous use of furosemide (lasix) in a daily dose of up to 2000 mg. In particularly difficult situations, there is a recommendation for a bolus administration of furosemide (lasix) intravenously at a dose of 40-80 mg, followed by infusion at a rate of 10-40 mg per hour for 2 days.
- Normalization of blood pressure:
– the abolition of vasodilators, especially nitrates, which are prescribed without indications, regarding the diagnosis of coronary heart disease
– if there is a need to use steroid hormones (intravenously prednisone 180-240 mg orally), cordiamine;
– in critical cases, an intravenous infusion of dopamine is used
- Stabilization of the neurohumoral profile (use of ACE inhibitors and aldosterone antagonists, in particular aldactone / veroshpiron).
- Normalization of the protein profile, correction of hypoalbuminemia – the use of human donor albumin (people 200-400 ml per day), together with diuretics.
- Perhaps the additional use of drugs that increase the glomerular filtration rate (for example, aminophylline and positive inotropic drugs).
- The combination of several representatives of diuretic pharmacological drugs.
The combined use of active diuretics. It is believed that all three of the most commonly used loop diuretics – uregitis, lasix (furosemide) and bumetanide – have high and approximately the same diuretic efficacy.
Although in modern therapy of internal diseases of humans and animals there are a huge number of foreign and domestic clinical studies, according to which there are recommendations for the use of the new and most powerful loop diuretic – torasemide, sufficient experience in its use has not yet been accumulated.
The most advantageous is the combination of loop diuretics with thiazide ones, due to which sodium reabsorption is blocked in various parts of the nephron. The indicated combination is clinically more justified than using a combination of two loop diuretics, for example furosemide with uregitis, furosemide with bufenox, furosemide and torasemide.
It is obvious that a combination of two drugs from the group of loop diuretics can overcome tolerance to the prolonged use of one of them. However, thiazide diuretics have an effect on the distal nephron, respectively, the combination of lasix (furosemide) with hypothiazide will significantly expand the zone of inhibition of sodium reabsorption in the tubules. In addition, the above combination has an effect on two different electrolyte transporters in the tubules at the level of the apical cells.
The most popular diuretic combination in the world is the combination of lasix and metolazone. As previously mentioned, metolazone is the most lipophilic and long-acting thiazide diuretic, which provides the additive effect of this combination, in particular with the development of mild insufficiency.
It can be concluded that the optimal principle of combination therapy with diuretics for congestive heart failure refractory to therapy is a combination of high doses (furosemide) of lasix, which must be administered intravenously, with veroshpiron and a thiazide diuretic, and should be added to the above drugs 2 weeks after the start of therapy carbonic anhydrase inhibitor (diacarb) for 3-4 days.
It should also be noted that situations arise when even the above measures do not always make it possible to overcome refractoriness to dehydration therapy. In such cases, mechanical removal of excess fluid from the body cavities (pleurocentesis, pericardiocentesis and laparocentesis) or to extracorporeal dehydration methods (hemodialysis or isolated ultrafiltration) should be used.
Dehydration therapy is an essential component of successful therapy for patients with congestive heart failure. It is worth remembering that complex pathogenetic neurohumoral mechanisms take part in the formation of the edematous syndrome and improper dehydration can only cause the development of severe side effects and the ricochet retention of sodium and water ions in the body.
The use of diuretics should be clearly justified, it must be combined with drugs that provide neurohormonal modulation, such as aldosterone antagonists and ACE inhibitors, be only one of the links in the rational treatment of decompensated patients using an individual approach in each case.
- Coriander is a natural remedy for removing fluid. Allows to reduce pressure. When used in cooking, it is able to neutralize the dangerous carcinogens released during the preparation of fried meat.
- Nettle can save you from kidney disease, prevent the formation of stones. Fights bacteria in the body. Relieves inflammation and positively affects the intestinal microflora.
- Bearberry. The dry leaves of this plant are easy to find in any pharmacy. It is safe and has a strong diuretic effect. The main advantage is the presence of a narrow list of contraindications. An anti-inflammatory effect on the genitourinary system acts as an additional property. Even pregnant women and nursing mothers can use the plant for diuretic purposes. It is important only to comply with the deadlines – the course should last no more than 5 days, after which a break is made for a week.
- Yarrow flowers – decoctions based on them can increase fluid drainage. Women in the premenstrual period can take this composition 2 times a day to reduce the intensity of bleeding and reduce pain.
By the strength of the diuretic effect, the following drugs can be distinguished:
- strong – emergency diuretics – excrete more than 15% sodium, for example, “Furosemide”
- medium action – remove 10% sodium, Indapamide
- slow and weak diuretic drugs – excrete 10% sodium, Amilorid
The classification of basic drugs that can enhance the excretion of excess water from the body, that is, those that we can attribute to diuretics or diuretics, is traditionally based on the location of their action directly in the nephron.
The main classes of diuretics (diuretics) include drugs that affect the permeability of the tubules with respect to water and sodium, and are also able to inhibit reabsorption processes. These drugs due to their effect on the reabsorption of sodium and chlorine ions got their name – saluretics.
The bulk of modern diuretic drugs (with the exception of uregitis) are sulfanilamide derivatives, more precisely derivatives of sulfomoyl acid. The residue of sulfomoyl acid is also present in the molecules of thiazides (hydrochlorothiazide or hypothiazide), carbonic anhydrase inhibitors (acetazolamide or diacarb), loop diuretics (bumetanide, furosemide or bufenox).
Below we will consider only those drugs that are most indicated in the treatment of congestive circulatory failure. Until recently, loop diuretics have been widely used in the treatment of heart failure. However, according to the general opinion of leading experts, they should be prescribed only to those patients who have pronounced manifestations of circulatory failure, whereas thiazide diuretics can be used on their own in the early stages, either in combination with potassium-sparing diuretics, or in the form of combined preparations, such as diuretidine .
The difference in the pharmacological action of diuretics depends on the location of their action directly in the nephron and on its own mechanism of action on reabsorption processes.
In the area of the proximal renal tubules, carbonic anhydrase inhibitors and osmotic diuretics act.
For various diseases specific diuretics are provided, having a different mechanism of action.
- Drugs that affect the functioning of the renal tubule epithelium, list: Triamteren Amiloride, Ethacrylic acid, Torasemide, Bumetamide, Flurosemide, Indapamide, Clopamide, Metolazone, Chlortalidone, Methclothiazide, Bendroflumethiozide, Hydrochlorazolezid.
- Osmotic diuretics: Monitol.
- Potassium-sparing diuretics: Veroshpiron (Spironolactone) refers to antagonists of mineralocorticoid receptors.
Classification of diuretics by the effectiveness of leaching of sodium from the body:
- Ineffective – remove 5% sodium.
- Medium efficiency – 10% of sodium is excreted.
- Highly effective – remove more than 15% sodium.
Diuretic drugs come in synthetic or herbal origin. All groups of diuretics have different chemical structures, on the basis of which their classification is based. Classification of diuretics by the mechanism of action:
Each of these groups has a certain type of action on the body. It is on the basis of the peculiarities of the pharmacological action that the doctor selects a diuretic for a disease associated with increased swelling.
Osmotic diuretics are potent diuretics in the classification of diuretics, which are most often used as part of a comprehensive treatment of the most severe, acute cases. Such funds are not assigned in courses, but once. The principle of their action is based on a decrease in blood plasma pressure, which results in accelerated elimination of fluid from cells and tissues, elimination of swelling. These drugs are used for edema of the brain or lungs, acute poisoning, shock conditions.
Sulfanilamides are an extensive group of drugs, which include loop and thiazide diuretics. Thiazides are prescribed for arterial hypertension. The minimum dosages of these drugs are used as a prevention of stroke. Increasing the prophylactic dose is not recommended, as this can lead to hypokalemia.
If necessary, thiazides are used simultaneously with potassium-sparing diuretics. Loop diuretics provide an instant diuretic effect, affecting the filtration of the kidneys and accelerating the elimination of fluids and salts from the body. Medicines of this group act in the region of the ascending section of the Gentley loop.
Potassium-sparing diuretics are diuretics with a mild, gentle effect. They activate the withdrawal of sodium ions and chlorides, while reducing the yield of potassium. Medicines act directly on the distal tubules, which are “responsible” for the exchange of sodium and potassium ions. Diuretics of this group are prescribed for congenital Liddle syndrome, cirrhosis, glaucoma. They do not adversely affect glomerular filtration.
Doctors do not accidentally forbid patients to choose diuretics on their own: each group of diuretic drugs has exposure characteristics, its own contraindications and side effects. The use of powerful compounds provokes active elimination of potassium or accumulation of the element, dehydration, severe headaches, hypertensive crisis. With an overdose of potent loop diuretics, self-medication can end in failure.
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Potassium-sparing diuretics lower systolic (upper) blood pressure, reduce swelling, retain potassium in the body, and enhance the effect of other drugs. Often there are undesirable reactions, as with the use of hormonal agents.
With excessive accumulation of potassium, muscle paralysis or cardiac arrest may develop. With renal failure, diabetes mellitus, this group of diuretics is not suitable. Mandatory dose adjustment on an individual basis, monitoring by a cardiologist and nephrologist. Effective names: Aldactone, Veroshpiron.
It is prescribed for renal pathologies, hypertension, glaucoma, heart failure. Thiazide diuretics affect the distal tubules of the kidneys, reduce the reverse absorption of sodium and magnesium salts, reduce the production of uric acid, and activate the excretion of magnesium and potassium.
To reduce the frequency of side effects, they are combined with loop diuretics. Clopamide, Indap, Chlortalidone, Indapamide.
The mechanism of action is a decrease in blood plasma pressure, active passage of fluid through the renal glomeruli, and an improvement in the level of filtration. The result is the removal of excess water, the elimination of puffiness.
Osmotic diuretics are weak drugs that last up to six to eight hours. Intravenous administration recommended. Indications: glaucoma, pulmonary edema, brain, blood poisoning, drug overdose, severe burns. Effective formulations: Mannitol, Urea, Sorbitol.
The most powerful drugs with a diuretic effect. The components of the drugs act on the Gengle loop – the renal tubule directed toward the center of the organ. The loop-shaped formation back sucks the liquid with various substances.
Drugs of this group relax the vascular wall, activate blood flow in the kidneys, gradually reduce the volume of intercellular fluid, accelerate glomerular filtration. Loop diuretics reduce the reverse absorption of salts of magnesium, chlorine, sodium, potassium.
- quick effect (up to half an hour after taking);
- powerful impact;
- suitable for emergency care;
- valid up to six hours.
- Ethacrylic acid.
On a note! Strong formulations are used in critical cases. Diuretic drugs often provoke dangerous complications: hypertensive crisis, cerebral and pulmonary edema, excessive accumulation of potassium, renal and heart failure, and severe liver damage.
- palpable diuretic effect;
- “Soft” effect on the kidneys, heart, blood vessels;
- remove excess fluid, wash the bladder and kidneys;
- exhibit a mild laxative effect;
- saturate the body with useful components: mineral salts, vitamins, biologically active substances;
- suitable for long-term use (courses).
Medicinal plants or natural plant diuretics:
- wheat grass creeping;
- strawberry berries;
- chicory root;
- birch leaves and buds;
- cowberry leaves;
- cranberry berries.
Fruits, vegetables, gourds:
After taking the components of the drugs activate the excretion of harmful bacteria with urine. The use of diuretics is an essential element in the treatment of bladder diseases. Removing excess fluid does not allow toxins to accumulate in the body, pathogenic microorganisms do not have time to penetrate the upper parts of the urinary system.
During the reception, it is important to observe the frequency and dosage, use the tablets prescribed by the doctor. Diuretic drugs in some patients cause undesirable reactions: against the background of active excretion of urine hypokalemia develops, convulsions appear, heart failure is possible. For long-term use, plant diuretics and weak chemical diuretics are suitable, in urgent cases, potent synthetic compounds are prescribed.
It is impossible to structure this category as a whole, since all products are characterized by different chemical composition. There are 4 main types of products, each of which has its own pharmacological effect. In accordance with this, and depending on the specific disease of the patient, the doctor prescribes the right medicine. It is impossible to say unequivocally which diuretic is better – for each person it will be individual.
When are diuretics indicated?
Modern pharmacology offers a huge amount of drugs that differ in composition, mechanism of action, speed, duration of the diuretic effect.
Below are the main groups of drugs with the names and rating of diuretics.
Loop means remove excess fluid from the body, affecting the filtration of the kidneys – reduce the reverse absorption of potassium, which leads to increased excretion of potassium in the urine.
The drugs promise a quick diuretic effect, but they should not be consumed more than twice a day. This group of drugs has many side effects.
Loop diuretics are compatible with other diuretics and with cardiovascular drugs. Admission along with non-steroidal anti-inflammatory tablets is contraindicated.
Potassium-sparing agents actively inject sodium and chloride from the body, minimizing the elimination of potassium. Drugs of this group are most often used as adjunctive therapy in the treatment of arterial hypertension and congestive heart failure.
Natural diuretics are relatively safe and effective. Their advantage when used correctly is a small number of contraindications.
Bearberry, in addition to the diuretic effect, also has an anti-inflammatory effect on the genitourinary organs. This is very valuable, despite the fact that more than half of the visits to the doctor complaining of swelling are caused by diseases of the kidneys and urinary tract. This natural remedy can be used during pregnancy and lactation.
Some drinks have a diuretic effect, for example, green tea, coffee and cranberry juice, as well as products – watermelon, tomato, cucumber, carrots, eggplant, artichoke, celery and grapes.
When asked which diuretics are best used, the doctor will best answer. It is worth remembering that taking drugs uncontrollably can turn into unpleasant consequences.
Diuretics, for example, are able to remove potassium from the body (which increases fatigue), contribute to the deposition of salts, increase cholesterol and can even cause potency problems in men. Therefore, the best diuretics are those prescribed by your doctor!
In the body of every person there is excess fluid. Together with the consumption of products, it gradually accumulates in the cells of the body. Adipose tissue is also a kind of container for water, which does not naturally come out. This is the problem in connection with which you have to resort to the help of diuretics.
Useful minerals are also actively derived from urine. If you follow the doctor’s recommendations and take the medicine correctly, there will be no problems. But when trying to self-medicate, there may be a lack of potassium and other substances necessary for life. This will not end in anything good, because in this way the functioning of internal systems and individual organs is disrupted.
The mechanism of action of diuretics can be studied by the example of their pharmacodynamic effects. For example, a decrease in blood pressure is due to two systems:
- Decreased sodium concentration.
- Direct effect on blood vessels.
Thus, arterial hypertension can be stopped by a decrease in fluid volume and long-term maintenance of vascular tone.
A decrease in the oxygen demand of the heart muscle when using diuretics is associated with:
- with stress relief from myocardial cells;
- with improved microcirculation in the kidneys;
- with a decrease in platelet adhesion;
- with a decrease in the load on the left ventricle.
Some diuretics, for example, Mannitol, not only increase the amount of excreted fluid during edema, but are also able to increase the osmolar pressure of interstitial fluid.
Diuretics, due to their properties, relax the smooth muscles of arteries, bronchi, and bile ducts, have an antispasmodic effect.
Diuretics that affect the activity of the renal tubules prevent sodium from entering the body again and excrete the element along with the urine. Diuretics of medium effectiveness Methiclothiazide Bendroflumethioside, Cyclomethiazide make it difficult to absorb chlorine, and not just sodium. Because of this action, they are also called saluretics, which means “salt”.
Thiazide-like diuretics (Hypothiazide) are mainly prescribed for edema, kidney disease, or heart failure. Hypothiazide is especially popular as a hypotensive agent.
The drug removes excess sodium and reduces pressure in the arteries. In addition, thiazide drugs enhance the effect of medicines, the mechanism of action of which is aimed at lowering blood pressure.
With the appointment of an increased dose of these drugs, fluid excretion may increase without lowering blood pressure. Hypothiazide is also prescribed for diabetes insipidus and urolithiasis.
The most effective diuretics include Furosemide (Lasix). With the intravenous administration of this drug, the effect is observed after 10 minutes. The drug is relevant for;
- acute failure of the left ventricle of the heart, accompanied by pulmonary edema;
- peripheral edema;
- arterial hypertension;
- elimination of toxins.
Ethacrinic acid (Ureghit) is close in its action to Lasix, but acts a little longer.
The most common diuretic Monitol is administered intravenously. The drug enhances the osmotic pressure of plasma and lowers intracranial and intraocular pressure. Therefore, the drug is very effective in oliguria, which is the cause of burns, trauma or acute blood loss.
Aldosterone antagonists (Aldactone, Veroshpiron) prevent the absorption of sodium ions and inhibit the secretion of magnesium and potassium ions. Drugs of this group are indicated for edema, hypertension and congestive heart failure. Potassium-sparing diuretics practically do not penetrate the membranes.
Note! It must be borne in mind that when you can use only some diuretics, that is, the appointment of diuretics without taking into account this disease or self-medication can lead to irreversible consequences in the body.
Thiazide diuretics for type 2 diabetes mellitus are prescribed mainly to lower blood pressure, with edema and for the treatment of cardiovascular insufficiency.
Also, thiazide diuretics are used to treat most patients with arterial hypertension that lasts for a long time.
These drugs significantly reduce the sensitivity of cells to the hormone insulin, which leads to an increase in blood levels of glucose, triglycerides and cholesterol. This imposes significant restrictions on the use of these diuretics in type 2 diabetes.
However, recent clinical studies on the use of diuretics for type 2 diabetes have shown that these negative effects are most often observed with high doses of the drug. At low doses, side effects practically do not occur.
Important! In patients with type 2 diabetes, when prescribing thiazide diuretics, patients should eat as many fresh vegetables and fruits as possible. This will help offset the significant loss of potassium, sodium, and magnesium. In addition, the risk of lowering the body’s sensitivity to insulin should be considered.
In type 2 diabetes mellitus, the most commonly used drug is Indapamide, or rather, its derivative Arifon. Both Indapamide and Arifon have virtually no effect on carbohydrate and lipid metabolism, which is very important for type 2 diabetes.
Other diuretics for type 2 diabetes are prescribed much less often and only if certain conditions exist:
- loop diuretics for type 2 diabetes are mainly used only once in those cases when it is necessary to achieve rapid normalization of blood pressure;
- combined thiazide and combined potassium-sparing diuretics – when it is necessary to minimize potassium loss.
With some types of diseases, fluid retention occurs in the body, and swelling of the hands, feet, and face appears. For symptomatic treatment, improving the patient’s condition, special diuretics are used, which provoke an increased excretion of urine, which removes excess fluid and salts from the body. Diuretic drugs or diuretics help to cope with the severe course of diseases such as hypertension, heart failure, obesity, cirrhosis, intracranial pressure, swelling of the walls of blood vessels, and are used for kidney diseases.
Diuretic drugs are drugs of various chemical structures, which to a greater / lesser extent affect the increase in the intensity of the kidneys and, as a result, profuse urination. Thanks to diuretics in the tubules of the kidneys, reabsorption (absorption) of salts and water is inhibited, which leads to the rapid formation of urine and the excretion of these substances.
Removing excess fluid along with sodium from the body, diuretics relieve swelling, both external and internal, associated with diseases of the kidneys and liver, reduce the load on the heart, and reduce blood pressure. In addition to the obvious positive effect, different diuretics have a number of negative effects, so they should be taken only as directed by the doctor and in the specified dosage. It is not recommended to buy diuretics on your own, this can lead to complications:
- Removal of significant potassium reserves from the body. This mineral element helps to absorb carbohydrates, providing the body with energy, and is also involved in protein synthesis. The normal level of potassium ensures an even correct rhythm of heartbeats, the necessary force of contractions of the heart muscle, and controls electrophysiological cardiac processes.
- Some diuretics can cause an imbalance of potassium with sodium, which leads to arrhythmia, tachycardia, the appearance of extrasystoles – in some cases, this leads to death.
- A lack of potassium leads to a constant feeling of muscle weakness, apathetic mood, numbness of the extremities, causes seizures and drowsiness. Diuretics that lower the level of a mineral element in the body can cause arterial hypotension (lowering blood pressure), severe dizziness, urinary retention, and constipation.
- Change in hormonal levels. Some diuretics can lead to unpleasant consequences of a hormonal nature – this applies mainly to the long-term unauthorized use of diuretics. In this case, when taking diuretics, men have a risk of getting impotence, sometimes there is an increase in the mammary glands, and women risk a violation of the menstrual cycle and the appearance of facial hair.
- Individual reactions of the body. With the uncontrolled use of diuretics, the following side effects may occur – urticaria, itching, allergies, subcutaneous hemorrhage, and a decrease in white blood cell count. Especially careful should be taken diuretics for pregnant women, as well as people with diabetes – some diuretics are completely contraindicated in these groups of people. Diuretic drugs can contribute to the development of diabetes mellitus, as they increase cholesterol.
- Wear of the kidneys, heart. Diuretics create an additional burden on these organs, therefore, with prolonged use of diuretics, a deterioration can be observed.
These drugs contribute to the accelerated elimination of sodium. A distinctive feature is the almost complete absence of toxicity. This group is most often prescribed to patients suffering from puffiness due to heart failure.
It is characterized by a mild principle of action. Prescribed in cases of hypertension, helps to improve the condition with cirrhosis. A positive reaction occurs after 2 hours.
From the moment such drugs enter the blood, they increase its osmotic pressure, which entails the release of fluid from the tissues into the vessels. After the product is filtered in the kidneys, and without reverse absorption. Sodium and water do not return, but are actively excreted from the body.
It is realized in the form of a solution in ampoules. If you are looking for a fast diuretic, this is just what you need.
One of the reasons for this condition is a violation of the regulation of sodium metabolism, which begins to linger in the body. Along with sodium, water is also retained. The volume of circulating blood increases, in response to this, the capillaries narrow – this is called “an increase in peripheral resistance” – and the diastolic or “lower” pressure increases. To overcome this resistance, the heart increases the power of the ejection of blood: systolic or “upper” pressure rises.
Of course, this is not the only mechanism for the development of arterial hypertension, but it is easiest to influence it: it is enough to prescribe diuretics, which will remove excess sodium and water from the body. Some diuretics are also able to dilate blood vessels, thus also lowering blood pressure. But these funds begin to act no earlier than 3 hours after use, and to achieve maximum effect, several days of their regular use are necessary. Therefore, such drugs are prescribed for continuous use in order to prevent an increase in blood pressure, and not to reduce an already high one.
In addition, diuretics can be used for:
- edema of various origins (except in situations where edema is caused by renal failure);
- increased intracranial pressure;
- swelling of the brain, lungs – in this case, fast-acting diuretics are prescribed, usually intravenously;
- in case of some poisoning, in order to accelerate the elimination of toxic substances by the kidneys, simultaneously with the intravenous infusion of large volumes of fluid (forced diuresis).
A separate case – indications for diuretics of plant origin. They are usually recommended for infections of the renal pelvis and urinary tract. They have a weak anti-inflammatory effect, but this is not the main effect that alleviates the condition of patients. Creating a constant flow of urine, plant diuretics mechanically wash bacteria and their waste products, reducing the activity of inflammation.
No diuretic is in any way suitable for weight loss. The weight loss that occurs after taking a strong diuretic is only caused by dehydration, but not by breaking down fat. They do not display mythical “slags”. Moreover, a decrease in the volume of circulating blood due to dehydration increases the concentration of toxic substances in it and disrupts the normal metabolism.
Most diuretics are prescription drugs and require constant medical supervision. Therefore, when we offer our readers a rating of the best diuretics, we are obliged to warn you that it is exclusively for guidance and in no way advisory in nature.
Trade names: Diuver, Britomar, Trigrim.
A more modern analogue of the well-known furosemide, which will be discussed below. In comparison with it, potassium is not so “washed away” from the body. It acts relatively mildly: the effect develops 2 to 3 hours after ingestion and lasts up to 18 hours, usually without forcing the patient to “watch” around the toilet. However, individual reaction options are possible.
On the other hand, precisely because of this delayed action, torasemide is not suitable for forced diuresis during intoxication, and therefore it is usually prescribed for edema.
Contraindicated in pregnant women and children under 18 years of age.
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