Diuretic Therapy in Acute Cardiac Failure

Introduction

A diuretic is one of the first medications prescribed to a patient with CHF. Diuretics promote the excretion of sodium and water through kidneys. These medications may not be necessary if the patient responds to activity recommendations, avoidance of excessive fluid intake, and a low sodium diet. (e.g. 2 g / day)

Diuretic Medications Used to Treat Cardiac Failure: -

Thiazide Diuretics

Bendroflumethiazide

Benzthiazide

Chlorothiazide

Hydrochlorothiazide

Hydroflumethiazide

Loop Diuretics

Ethacrinic acid

Furosemide (Lasix)

Torsemide (Torsinex)

Potassium-sparing Diuretics

Amiloride

Spironolactone (Aldactone)

Tiamterene

Administering and monitoring diuretic therapy

Administer it in the morning only to avoid nocturia

Check for electrolyte imbalances : -

Deletion of potassium, magnesium and sodium

Elevation of potassium with potassium sparing agents and calcium with thiazide

Monitor for adverse reactions : GIT symptoms like nausea, vomiting, diarrhoea, postural hypotension, dizziness; Glucose intolerance in thazide diuretics; ototoxicity in loop diuretics