Discussions By Condition: General well-being

Side Effects, Uses, and Interactions

Posted In: General well-being 0 Replies
  • Posted By: Vorioubre
  • January 13, 2011
  • 09:13 PM

Loop diuretics reduce NaCl reabsorption in the thick ascending limb of the loop of Henle. This is achieved by inhibiting the Na-K-2Cl carrier in the luminal membrane in this segment, thereby minimizing the entry of luminal sodium into the cell. The efficacy of the loop diuretics is dose-dependent, being determined largely by the rate at which the diuretic is delivered to its site of action: no diuresis is seen with very low doses, whereas a maximal effect is achieved at higher doses. The loop diuretics are highly protein-bound and therefore enter the urine primarily by tubular secretion in the proximal tubule, rather than by glomerular filtration... These doses may be doubled in patients with renal insufficiency. The dose should also be doubled for oral furosemide, since its bioavailability is only about 50 percent. There is, however, substantial interpatient and intrapatient variability in the degree of bioavailability of oral furosemide. Thus, the dose should be governed by the diuretic response; estimates of bioavailability are used only as a guide to initial therapy...

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