Loop Diuretics: What are they and how they work?

Описание: Loop #diuretics are medications used in the management and treatment of fluid overload conditions such as heart failure, nephrotic syndrome or cirrhosis, and #hypertension , in addition to #edemas .
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Top moments-
0:00 | Start
0:22 | Loop diuretics MOA
1:05 | Furosemide
1:56 | Torsemide
2:20 | Bunetemide
2:51 | Adverse effect
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The Na+/K+/2Cl- transporter protein, which is found in the walls of the ascending loop of Henle, is inhibited by these medications. These substances decrease salt or NaCl absorption, which dramatically boosts diuresis and increases urine output as a result.
But here is a catch, Blocking of the NKCC2 cotransporter makes potassium unable to be reabsorbed back into the lumen, which results in the loss of calcium and magnesium ions.
A secondary effect of loop diuretics is to increase the production of prostaglandins, which results in vasodilation and increased blood supply to the kidney.
The collective effects of decreased blood volume and vasodilation decrease blood pressure and ameliorate edema.
Several loop diuretics come in IV and oral forms.
Furosemide
Furosemide comes in oral tablet form in 20, 40, and 80 mg dosages. Injectable solutions come in 10 mg/mL doses. Oral solutions come in either 8 or 10 mg/mL doses.
The half-life for furosemide is 1.5 to 2 hours but can be up to 2.6 hours in those with renal/hepatic dysfunction or heart failure.
Torsemide comes in tablet form in 5, 10, 20, or 100 mg doses. The injectable solution is 10 mg/mL dosing. Torsemide is known to have the longest half-life at 3 to 4 hours and can be as long as 5 to 6 hours in patients with renal/hepatic dysfunction or heart failure.
Bumetanide comes in oral tablets of 0.5, 1, and 2 mg. The IV solution is 0.25 mg/mL. Bumetanide has a half-life of 1 hour and can be administered for 1.3 to 1.6 hours in those with renal/hepatic dysfunction or heart failure.
All three loops typically have a similar onset of action. Oral administration time between the three averages 30 to 60 minutes.

Adverse effects of loops Diuretics typically occur from electrolyte imbalances secondary to the diuresis effects, which include: hyponatremia, hypokalemia, hypochloremia, hypomagnesemia, metabolic alkalosis, prerenal azotemia, and dehydration.
The FDA has approved loop diuretics for treating hypertension alone or with the addition of other anti-hypertensives. However, loop diuretics alone are not used for first-line therapy.