View Article

Abstract

Diuretics are at the centre of the ongoing debate about which medications should be used to start a hypertension treatment programme. One of the biggest issues is sorting out actual class specific effects, such as differentiating true class-specific effects of diuretics from those of beta blockers, because the majority of important studies contain sophisticated treatment algorithms and allow various background treatments. In placebo-controlled clinical investigations, thiazide diuretics were the first effective antihypertensive medications that were well tolerated and considerably decreased cardiovascular morbidity and death. Even yet, these medications are still regarded as essential therapeutic tools for the management of hypertension patients. A brief discussion of the treatment of resistant edoema and the use of diuretics in non-edematous states, such as essential hypertension and other conditions, is followed by a description of the successful use of diuretics in specific edematous states, such as congestive heart failure, chronic renal failure, nephrotic syndrome, and liver disease. Analysed are the components necessary to successfully induce enough natriuresis in such circumstances. The prevention and management of these side effects of diuretic medication are also discussed since attaining diuresis may induce substantial hypokalemia, hyponatremia, metabolic alkalosis, and worsening prerenal azotemia. Congestive heart failure, edoema, cirrhosis, bodybuilding, autism, toxaemia, and poisoning (forced diuresis) are some of the words that are important to know.

Keywords

Diuretics, Hypertension, edema, sulfonamide, furosemide

Reference

  1. Joint National Committee on Prevention Detection Evaluation and Treatment of High Blood Pressure. The 1984 report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Arch. Intern. Med. 1984; 144:1045–57. http://dx.doi.org/ 10.1001/archinte.1984.00350170211032 PMid:6143542
  2. World Health Organization/International Society of Hypertension Guidelines Subcommittee. 1999 World Health Organization– International Society of Hypertension guidelines for the management of hypertension. Guidelines Subcommittee. J. Hypertens.1999; 17: 151–83. 
  3. World Health Organization/International Society of Hypertension Writing Group. 2003 World Health Organization (WHO)/ International Society of Hypertension (ISH) statement on management of hypertension. J. Hypertens. 2003; 21: 1983–92. http://dx.doi.org /10.1097/00004872-200311000-00002 PMid:14597836
  4. Joint National Committee on Prevention Detection Evaluation and Treatment of High Blood Pressure. The 1988 report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Arch. Intern. Med. 1988; 148: 1023–38. http://dx.doi.org/ 10.1001/archinte.148.5.1023 PMid:3365073 
  5. Joint National Committee on Prevention Detection Evaluation and Treatment of High Blood Pressure. The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC V) (See comment). Arch. Intern. Med.1993; 153: 154–83. 
  6. Joint National Committee on Prevention Detection Evaluation and Treatment of High Blood Pressure. The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (See comment). (Erratum appears in Arch. Intern. Med. 1998; 158: 573.) Arch. Intern. Med.1997; 157: 2413–46. http://dx .doi.org/10.1001/archinte.157.21.2413 PMid:9385294
  7. Chalmers J, Chapman N. Development of blood pressure loweringtherapy: From trials to practice. In: Birkenhager W, Robertson J, Zanchetti A (eds). Handbook of Hypertension, Vol. 22: Hypertension in the twentieth century. Amsterdam: Elsevier, 2004; 504–25. 
  8. Collins R, Peto R, MacMahon S et al. Blood pressure, stroke, and coronary heart disease. Part 2, short-term reductions in blood pressure: Overview of randomised drug trials in their epidemiological context. Lancet 1990; 335: 827–38. http://dx.doi.org/10.1016/0140- 6736(90)90944-Z 
  9. Mac Mahon S, Peto R, Cutler J et al. Blood pressure, stroke, and coronary heart disease. Part 1, prolonged differences in blood pressure: Prospective observational studies corrected for the regression dilution bias. Lancet 1990; 335: 765–74. http://dx.doi.org/10.1016/0140- 6736(90)90878-9 
  10. Joint National Committee on Prevention Detection Evaluation and Treatment of High Blood Pressure. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (See comment). Hypertension2003; 42: 1206–52. 
  11. European Society of Hypertension–European Society of Cardiology Guidelines Committee. 2003 European Society of Hypertension– European Society of Cardiology guidelines for the management of arterial hypertension. J. Hypertens. 2003; 21: 1011–53. http://dx.doi.org/ 10.1097/00004872-200306000-00001 PMid:12777938 
  12. Sever P, Beevers G, Bulpitt C et al. Management guidelines in essential hypertension: Report of the second working party of the British Hypertension Society. BMJ 1993; 306: 983–7. http://dx.doi.org/ 10.1136/bmj.306.6883.983 PMid:8490481 PMCid:1677457 
  13. Ramsay L, Williams B, Johnston G et al. Guidelines for management of hypertension: Report of the third working party of the British Hypertension Society. J. Hum. Hypertens. 1999; 13: 569–92. http:// dx.doi.org/10.1038/sj.jhh.1000917 PMid:10482967 
  14. Williams B, Poulter NR, Brown MJ et al. British Hypertension Society guidelines for hypertension management 2004 (BHS-IV): Summary. BMJ 2004; 328: 634–40. http://dx.doi.org/10.1136/bmj.328.7440.634 PMid:15016698 PMCid:381142 
  15. Chalmers J, Chapman N. Development of blood pressure lowering therapy: From trials to practice. In: Birkenhager W, Robertson J, Zanchetti A (eds). Handbook of Hypertension, Vol. 22: Hypertension in the twentieth century. Amsterdam: Elsevier, 2004; 504–25. 
  16. Mancia G, De Backer G, Dominiczak A, et al. 2007 guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25:1105–1187.
  17. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289:2560–2572.http://dx.doi.org/10.1001/jama.289.19.2560 PMid:12748199 
  18. Liu L, Wang Z, Gong L, et al. Blood pressure reduction for the secondary prevention of stroke: a Chinese trial and a systematic review of the literature. Hypertens Res 2009; 32:1032–1040. http://dx.doi.org/ 10.1038/hr.2009.139 PMid:19798097
  19. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs. diuretic: the Antihypertensive and LipidLowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002; 288:2981–2997. 
  20. Collaborative Research Group. Major cardiovascular events in hypertensive patients randomized to doxazosin versus chlorthalidone: The Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2000; 283:1967–1975. http://dx.doi. org/10.1001/jama.283.15.1967 PMid:10789664 
  21. MRC Working Party. Medical Research Council trial of treatment of hypertension in older adults: principal results. BMJ 1992; 304:405–412 http://dx.doi.org/10.1136/bmj.304.6824.40PMid:1445513 PMCid:1995577 
  22. World Health Organization/International Society of Hypertension. Guidelines for the management of mild hypertension: Memorandum from a WHO/ISH meeting. J. Hypertens.1989; 7: 689–93. 
  23. World Health Organization/International Society of Hypertension Guidelines Sub-Committee. Guidelines for the management of mild hypertension: Memorandum from a World Health Organization/International Society of Hypertension meeting. Guidelines Subcommittee. J. Hypertens.1993; 11:905–18. 
  24. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension: final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA 1991; 265:3255–3264. http://dx.doi.org/ 10.1001/jama.1991.03460240051027 PMid:2046107
  25. Medical Research Council Working Party.MRC trial of treatment of mild hypertension: principal results. Br Med J (Clin Res Ed) 1985; 291:97–104 
  26. Martin Gallagher, Vlado Perkovic and John Chalmers. Nephrology, Diuretic: A modern day treatment option? 2006; 11:419-427.
  27. Rey E, LeLorier J, Burgess E, et al. Report of the Canadian Hypertension Society Consensus Conference: 3. Pharmacologic treatment of hypertensive disorders in pregnancy. CMAJ 1997; 157:1245–54. PMid:9361646 PMCid:1228354 
  28. Sibai BM, Frangieh AY. Management of severe preeclampsia. Curr Opin Obstet Gynecol 1996; 8(2):110–3. 
  29. Taylor SH. Diuretic therapy in Congestive heart failure Cardiol Rev. 2000 Mar-Apr; 8(2):104-14. 
  30. K. Prowse, M. Pain, A. D. Marston and G. Cumming, The treatment of salicylate poisoning using Mannitol and forced alkaline diuresis, Clinical Science (1970) 38, 327-337. PMid:4392609 
  31. Steve Martesky. Diuretic in body building: The good, the bad, The tragic July 2011.
  32. Elliott WJ, Meyer PM. Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis. Lancet 2007; 369:201– 207.
  33. Lemonnier E, Degrez C, Phelep M, Tyzio R, Josse F, Grandgeorge, Hadjikhani N, Ben-Ari Y. Translational psychiatry, (2012) Vol. 2, p. e202. 
  34. Lemonnier E, Ben Ari Y. The diuretic bumetanide decreases autistic behaviour in five infants treated during 3 months with no side effect Acta Paediatrica 2010; 99 (12):1885-8. http://dx.doi.org/10.1111/j.1651- 2227.2010.01933.x PMid:20608900 
  35. Siegel D, Hulley SB, Black DM, et al. Diuretics, serumand intracellular electrolyte levels, and ventricular arrhythmias in hypertensive men. JAMA 1992; 267:1083– 1089. http://dx.doi.org/10.1001/ jama.1992.03480080053026 PMid:1735925 
  36. Dahlof B, Lindholm LH, Hansson L, Schersten B, Ekbom T, Wester PO. Morbidity and mortality in the Swedish Trial in Old Patients with Hypertension (STOP-Hypertension). Lancet 1991; 338: 1281–5. http:/ /dx.doi.org/10.1016/0140-6736(91)92589-T
  37. Morgan TO. Efficacy of cilazapril compared with hydrochlorothiazide in the treatment of mild-to-moderate essential hypertension hypertension. Multicentre Study Group. Am. J. Med. 1989; 87 (6B):37S–41S. 
  38. Elaine Yeung, MD, Florence S. Wong, MD.The Management of Cirrhotic, FRCP(C) DisclosuresMedscape General Medicine. 2002;4 (4)
  39. Brater DC. Diuretic therapy. N Engl J Med 1998; 339:387. http:// dx.doi.org/10.1056/NEJM199808063390607 PMid:9691107
  40. Rose BD. Diuretics. Kidney Int 1991; 39:336. http://dx.doi.org/ 10.1038/ki.1991.43 PMid:2002648
  41. Brater DC, Voelker JR. Use of diuretics in patients with renal disease. In: Pharmacotherapy of Renal Disease and Hypertension (Contemporary Issues in Nephrology), Bennett WM, McCarron DA (Eds), Churchill Livingstone, New York 1987. Vol 17.
  42. Ellison DH. Diuretic drugs and the treatment of edema: from clinic to bench and back again. Am J Kidney Dis 1994; 23:623. PMid:8172204
  43. Brater DC. Analysis of the effect of indomethacin on the response to furosemide in man: effect of dose of furosemide. J Pharmacol Exp Ther 1979; 210:386. PMid:480189 
  44. Strom BL, Schinnar R, Apter AJ, et al. Absence of cross-reactivity between sulfonamide antibiotics and sulfonamide nonantibiotics. N Engl J Med 2003; 349:1628. 
  45. Myatt L, Miodovnik M. Prediction of preeclampsia. Semin Perinatol1999; 23:45-57. http://dx.doi.org/10.1016/S0146- 0005(99)80059-7 
  46. Smith GN, Walker M, Tessier JL, Millar KG. Increased incidence of preeclampsia in women conceiving by intrauterine insemination with donor versus partner sperm for treatment of primary infertility. Am J Obstet Gynecol 1997; 177:455–8 http://dx.doi.org/10.1016/S0002- 9378(97)70215-1
  47. Rath W Z. Treatment of hypertensive diseases in pregnancy—general recommendations and long-term oral therapy. Geburtshilfe Neonatol 1997; 201:240–6 [in German].

Photo
Jaya Mehetre
Corresponding author

Department of Quality Assurance, PRES College of Pharmacy (Women’s), Chincholi, Nashik-422102.

Photo
Kiran Dhamak
Co-author

Department of Quality Assurance, PRES College of Pharmacy (Women’s), Chincholi, Nashik-422102.

Photo
Kalpana Sable
Co-author

Department of Quality Assurance, PRES College of Pharmacy (Women’s), Chincholi, Nashik-422102.

Photo
Trupti Bhalekar
Co-author

Department of Quality Assurance, PRES College of Pharmacy (Women’s), Chincholi, Nashik-422102.

Jaya Mehetre*, Kiran Dhamak, Kalpana Sable, Trupti Bhalekar, Innovations In Diuretic Treatment: A Promising Solution For Chronic Diseases, Int. J. in Pharm. Sci., 2023, Vol 1, Issue 8, 129-139. https://doi.org/10.5281/zenodo.8249614

More related articles
Drug Resistance In Various Disorders...
T. V. Sowjanya, B. Akhila, N. Ahalya, T. Sai Ram, T. Maneesha, V....
Nanoparticles In Pharmaceutical Applications: Curr...
Aryan Mahesh Minekar , Nilesh Chougule, Seema Shinde, ...
Rifaximin As an Alternative Treatment for Patients with Hepatic Encephalopathy...
Luis Fernando Puello Meza, Melissa Sanabria Diaz, Juan Camilo Ramos Gomez, Oscar Alberto Jaraba Vita...
Comprehensive Review: Bioactive Components, Traditional Uses and Pharmacological...
Sakshi N. Nagre, Pooja P. Hulke, Ankit S. Kediya, Saksham N. Nagre, Tejas D. Pimple, Niket P. Vaidya...
Related Articles
A Review on Formulation and Evaluation of Herbal Shampoo...
Chandraprabha Dewangan , Rishi Kumar, Harish Sharma, Gyanesh Kumar Sahu, ...
To Formulate And Evaluate Herbal Hair Oil For Healthier Hair ...
Chand Pravin Dnyandeo , V. R. Muley, Prachi P. Udhapurkar , Ghule Govind Arjun, ...
Formulation And Evaluation Of Sustained Release Anastrozole Tablet For Treatment...
Vitthal S. Shinde, Vijay M. Kanade, Ajit B. Tuwar, Megha T. Salve, ...
Drug Resistance In Various Disorders...
T. V. Sowjanya, B. Akhila, N. Ahalya, T. Sai Ram, T. Maneesha, V. Pavithra, ...
More related articles
Drug Resistance In Various Disorders...
T. V. Sowjanya, B. Akhila, N. Ahalya, T. Sai Ram, T. Maneesha, V. Pavithra, ...
Nanoparticles In Pharmaceutical Applications: Current Trends And Future Prospect...
Aryan Mahesh Minekar , Nilesh Chougule, Seema Shinde, ...
Drug Resistance In Various Disorders...
T. V. Sowjanya, B. Akhila, N. Ahalya, T. Sai Ram, T. Maneesha, V. Pavithra, ...
Nanoparticles In Pharmaceutical Applications: Current Trends And Future Prospect...
Aryan Mahesh Minekar , Nilesh Chougule, Seema Shinde, ...