Loop Diuretics
Overview
Overview
Inhibit the Na-K-2Cl cotransporter in the thick ascending limb of the loop of Henle, collapsing the medullary concentration gradient and producing potent natriuresis.
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Classification
Classification
Inhibit the Na-K-2Cl cotransporter in the thick ascending limb of the loop of Henle, collapsing the medullary concentration gradient and producing potent natriuresis.
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Mechanism of action
Mechanism of action
Furosemide, Bumetanide, Torsemide and Ethacrynic acid are important examples.
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Important members
Important members
Important members are furosemide, bumetanide, torsemide and ethacrynic acid.
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Clinical uses
Clinical uses
Rapid relief of congestion and oedema in heart, kidney or liver disease; selected use in severe hypertension, hypercalcaemia and hyperkalaemia alongside condition-specific therapy.
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Adverse effects
Adverse effects
Hypokalaemic metabolic alkalosis, hyponatraemia, hypomagnesaemia, volume depletion, hyperuricaemia and ototoxicity. Most are sulfonamides; Ethacrynic acid is structurally distinct.
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Contraindications and precautions
Contraindications and precautions
Monitor weight, fluid balance, blood pressure, kidney function and electrolytes. NSAIDs may blunt response; aminoglycosides can increase ototoxic risk.
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References
References
- Huxel C, Raja A, Ollivierre-Lawrence MD. Loop Diuretics. NCBI Bookshelf. Updated 2023. SOURCE:NCBI:LOOP_DIURETICS:2023