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Heiman.pharm.HTN.3

Loop Diuretics

QuestionAnswer
Loop diuretics Usually reserved for volume excess. Second line for hypertension. May be better for those with decreased renal function. Thiazides are contraindicated in those with creatinine clearance < 30 ml/min.
Mechanism of Action Act at the loop of Henle Inhibition of Na-K-Cl channel Prevents reabsorption of Na
Kinetics Both oral and IV preparations. Short onset especially with IV 15-30 minutes.Variable absorption.
Kinetics Furosemide is less bioavailable than others. Duration 6-8 hours. Renal and hepatic elimination. Torsemide less renally cleared. May be better for those with decreased renal function.
Adverse Effects Hypokalemia. Orthostatic hypotension. Dehydration. Hypomagnesemia. Ototoxicity. Hyperuricemia .
Cautions Gout May cause impaired glucose tolerance Additive hypotension Renal disease CrCl < 30 ml/min
Drug Interactions Other ototoxic drugs Aminoglycosides Lithium Changes in Na+ change Li+ excretion
Names Furosemide (Lasix)‏ Bumetanide (Bumex)‏ Torsemide (Demadex)‏ Ethacrynic acid (Edecrin)‏ IV preparation only
Created by: DianaB
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