Loop Or Highceiling Diuretics

Loop or high-ceiling diuretics act on the ascending loop of Henle by inhibiting chloride transport of sodium into the circulation. Sodium, potassium, calcium, and magnesium are lost. Loop or high-ceiling diuretics have little effect on blood sugar, but increase the uric acid level.

Loop or high-ceiling diuretics are potent and cause marked depletion of water and electrolytes. They are more potent than thiazides and two to three times more effective when inhibiting reabsorption of sodium. However, loop or high-ceiling diuretics are less effective as antihypertensive agents.

Loop or high-ceiling diuretics can increase renal blood flow up to 40%. This drug is commonly the choice for patients who have decreased kidney function or end-stage renal disease.

Loop or high-ceiling diuretics cause excretion of calcium and have a great saluretic (sodium-losing) affect that causes rapid diuresis, decreases vascular fluid volume, and decreased cardiac output and blood pressure.

Loop or high-ceiling diuretics causes a vasodilatory effect and increase renal blood flow before diuresis. The most common side effects are fluid and electrolyte imbalances such as hypokalemia, hyponatremia, hypocalcemia, hypomag-nesemia, and hypochloremia. Hypochloremic metabolic alkalosis may result. Orthostatic hypotension can also occur. Thrombocytopenia, skin disturbances, and transient deafness are seen rarely. Prolonged use can cause thiamine deficiency.

A list of loop diuretic drugs is provided in the Appendix. Detailed tables show doses, recommendations, expectations, side effects, contraindications, and more; available on the book's Web site (see URL in Appendix).

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