What is diuretics and what they are. What is diuretics. Best diuretic products

Diuretics or diuretic products are often used to treat various pathological conditions provoked by excessive accumulation of fluid in the body. Their action is based on slowing the suction of salts and water in the renal tubules, due to which the amount of urine and the speed of its output increases. Diuretics are a large list of drugs that help reduce the content of fluid in tissues and remove swelling at various diseases, including at the arterial hypertension.

Dorganic drugs are medicinal products of synthetic or plant origin, which are intended to increase the emission of urine by the kidneys. Due to the action of diuretics, the removal from the body of salts is significantly enhanced, the amount of fluid in the tissues and cavities decreases. Data drugs found wide use in therapy hypertensive disease, low heart failure, liver and kidney diseases associated with circulatory impairment.

However, despite a wide range of pathologies that diuretic drugs help help, take them without appointing a doctor not recommended. Incorrect dosing mode or reconnaissance can lead to serious complications. Below is a list of diseases and pathologies, in the treatment of which diuretics are used:

hypertension;
heart swelling;
cirrhosis;
glaucoma;
acute renal or heart failure;
high secretion of aldosterone;
diabetes;
metabolic disease;
osteoporosis.

Mechanism of action of diuretics

The effectiveness of diuretic drugs with hypertensive disease is directly related to their ability to reduce sodium levels and expand blood vessels. It is to maintain vessels in a tone and a decrease in fluid concentration help to stop hypertension. Diuretic pills increased pressure Most often appoint elderly patients.

In addition, the reception of diuretics contributes to the relaxation of myocardium, improves blood microcirculation, reduces platelet gluing, reduces the load on the left ventricle of the heart. Due to this, a smaller amount of oxygen is required for the proper functioning of myocardium. Also, diuretic products can have antispasmodic effects by relaxing the smooth muscles of bronchi, arteries, biliary tract.

Classification and types of diuretic

What kind of diuretics are now clear, but should be dealt with what kind of diuretic products exist. Conditionally classified them in several criteria: by efficiency, the duration of action, as well as the effect of the effect. Depending on the state of the patient and the complexity of the disease, the doctor picks up the most suitable drug.

By efficiency:

strong ("Laziks", "Furosemid");
medium (hygroton, "", "oxodoline");
weak ("diakar", "Veroshpiron", "Triamtener");

By speed:

By duration of action:

long (about 4 days) - "Veroshpiron", "Eplerenon", "Chlortalidon";
middle (no more than 14 hours) - "hypothiazide", "", "Indapamide", "Klopamide";
short action (less than 8 hours) - "Furosemid", "Laziks", "Manit", "Stacrinic acid".

Depending on which pharmacological action has a drug, there is a separate classification.

Tiazid diuretics

This kind of diuretic tablets is considered one of the most common. They are prescribed most often because therapeutic effect It is achieved in a few hours. The average duration of their action is 12 hours, which allows you to set a one-time daily reception. These drugs quickly absorbed in the intestines and are not understood as patients. One of the advantages of such diuretic products is that they retain the acid-alkaline balance of the blood.

The effect of thiazide diuretics is as follows:

the inverse suction of sodium and chlorine is suppressed;
significantly increases the removal of magnesium and potassium;
the separation of uric acid decreases.

Tiazide diuretics - a list of effective drugs:

"Chlortalidon";
"Indap";
"Hypothiazide";
"Cyclomethazide";
"Indapamide";
"Klopamide."

They are prescribed with various diseases of the liver and kidney, essential hypertension, glaucoma and other pathologies related, with an excessive content in the body of the liquid.

Potassiabelling drugs

This type of diuretic is considered to be more gentle, as it contributes to the delay in potassium in the body. They are often prescribed together with other medicines to strengthen the effect of the latter. This type of diuretics effectively reduces systolic pressure, so they are used for therapy of hypertensive disease in a complex with other means. It is also shown to use their use when the edema of various etiology, heart failure.

Kaline-saving drugs include: Aldakton, Amiloride. Take such diuretics with caution, since due to their hormonal impact there are side effects. In patients - men can develop impotence, women - failure menstrual cycle, pain in lactic glands, bleeding. With a long course, high doses may occur hypercalemia - hit large number Potassium in blood. Such a state can cause a heart stop or lead to paralysis.

Important: It is especially dangerous to the use of potassium-saving diuretics in patients with renal failure and diabetes. These drugs should be taken only under the supervision of the doctor.

Loop diuretics

The most powerful diuretic preparations are precisely loopers. They affect the loop of Gengle - renal channels, directed towards the center of the kidney and performing the function of reverse absorption of liquids and minerals. These diuretics act as follows:

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reduce the inverse absorption of magnesium, potassium, chlorine, sodium;
strengthen the blood flow in the kidneys;
increase glomerular filtration;
gradually reduce the volume of extracellular fluid;
relax the vascular muscle.

The effect of looped diuretic occurs quite quickly, in just half an hour and lasts up to 6-7 hours. This type of drugs are rarely prescribed, only in particularly critical cases, since they have many side effects.

Loop diuretics, list of the most popular:

Osmotic diuretics

The effect of diuretic products of this kind is to reduce the pressure in the plasma of blood, which leads to a decrease in the swelling and the removal of excessive fluid. At the same time, the movement of blood in the renal gloms becomes higher, which contributes to the increase in filtration. Below are the names of diuret tablets working on this principle:

"Mannitt";
"Mannitol";
"Urea";
"Sorbito".

"Mannitt" has a long action, which cannot be said about the rest of the drugs. Medicinal preparations of this series are used exclusively in acute cases. They are prescribed if the patient developed the following pathological conditions:

Osmotic diuretics belong to potential drugs. That is why they are appointed at all, and not as a course therapy.

Carboanhydrase inhibitors

One of the drugs of this group is diakar. For normal conditions carboangeerase helps the formation of coal acid kidneys from carbon dioxide and water. Diakarb blocks the production of this enzyme, contributing to the washing of sodium, which in turn pulls water. At the same time there is a loss of potassium.

Diakarb gives a weak effect that develops relatively quickly. The duration of its action can be about 10 hours. Apply this drug if the patient has been observed:

high eye pressure;
gout;
barbiturate or Salicylate poisoning.

Aldosterone antagonists

This type of drugs helps block aldosterone receptors, as a result of which the hormone ceases to act on the kidneys. As a result, the reabsorption of water and sodium is disturbed, which leads to a diuretic action. The frequently used means of this species is considered "Spironolactone" ("Veroshpiriron", "Veroshpilacton"). It is used in a complex with loop or thiazide diuretics.

Thanks to the latest research, a new direction was discovered in the use of this drug. Locking aldosterone receptors located in myocardium helps to stop cardiac remodeling (replacement of muscle tissue connective). The use of spironolactone in the composition of complex therapy reduces mortality after the myocardial infarction by 30%.

Other an interesting feature The drug is its ability to block testosterone receptors, which can lead to the development of gynecomastia and even impotence. In the female part of patients, this property of drugs is used in the treatment of diseases provoked by the high level of testosterone.

Please note: diuretics containing spironolactone are potassium-saving.

Vegetable means

Along with drugs, vegetable diuretics are often used quite often. Their effect on the body is softer, and the side effects are practically absent. Diuretic plant origin not only contribute to the removal of excessive fluid, but also help to saturate the organism with mineral salts, vitamins, have an easy laxative effect. Among vegetables and fruits, diuretic action have: parsley, celery, watermelon, cucumbers, pumpkin and many other products. You can get rid of the extra liquid with the help of diuretic informations from strawberry berries, birch leaves, lingers, pyzhma and shepherd bags.

However, despite the fact that plant diuretic products are significantly inferior to drug drugs, it is also necessary to consult with the doctor to find out the cause of pathology. Depending on the etiology of edema, the doctor will select the most suitable option.

Treatment of champions and herbs is often necessary with renal edema. These tools besides diuretic render anti-inflammatory and antibacterial effect. This is especially important in the presence of diseases of the urinary system. Among other things, plant remedies are allowed for use in pregnant women and children.

Drinking herbal teas need short courses. Prolonged use can provoke addictive, and the effectiveness of therapy will gradually decrease. Also, with a debt, it is possible to eliminate important potassium and sodium microelements from the body. Therefore, the use of plant diuretics should also be controlled by blood indicators.

Sideflines

Another reason for making diuretics should only be a doctor is to correlate benefit and harm medicines. Depending on the severity of pathology, the Doctor will solve the issue of the need to apply certain drugs. Attentive approach when choosing medicines will minimize the risk of developing unpleasant side effects.

Most often when taking diuret tablets, the following problems were noted:

reduction of blood pressure, sometimes to very low marks;
general weakness, increased fatigue;
dizziness or headaches;
the feeling of "goosebumps" on the skin;
photosensitivity;
the development of anorexia;
improving blood sugar;
appearance of dyspeptic phenomena;
nausea, vomiting;
cholecystitis;
pancreatitis;
change of blood composition (reduction of platelets, an increase in lymphocytes and monocytes);
reduced sexual function.

Even if earlier, when receiving diuretics, the patient's side effects did not register, it still should not be taken by these drugs without appointing a doctor. The uncontrolled reception of such medication can lead to serious and often irreversible complications.

Contraindications

The use of diuretics must be treated very carefully. In these drugs, there are many contraindications listed in the instructions for them. They are categorically impossible if:

there is intolerance to one of the components of the drug;
pregnancy confirmed;
diagnosed sugar diabetes;
swelling caused by decompensated cirrhosis of the liver;
there is a renal or respiratory failure;
hypokalemia is observed.

Relative contraindications are considered:

ventricular arrhythmia;
insufficient heart activity;
receiving lithium salts;
the use of heart glycosides.

In addition, it is recommended to be careful when combining diuretic tablets from high pressure with ACE inhibitors. With the simultaneous reception of these drugs, the effect of diuretic is significantly enhanced, which can lead to a sharp drop in blood pressure and dehydration.

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Diuretic products or diuretics are substances that have a different chemical structure, but there are general property. Diuretic effect - the effect of diuretic on the human body, its ability to accelerate blood filtering, derive fluid from the body. Such therapy is good for hypertension, helps to remove the swelling and prevent the development of other diseases. What is diuretics and how are they dangerous and useful?

Mechanism of action

The main mechanism of action is the effect of drugs on the kidneys, nephrons and all occurring processes. The principle of one is to stimulate the kidneys so that they produce more urine. Diuretics lead to slowing the suction of salts, water, accelerate the formation and withdrawal of urine, reduce the level of fluid in the body. The diuretic remove the swelling, purify the body and normalize the acid-alkaline balance. The clinical pharmacology of diuretics is as follows. The decrease in blood pressure due to the fact that sodium concentration is reduced and the effects on the vessels are affected. Their properties allow you to relax biliary paths and arteries.

How and with what to take?

Reception of drugs affects blood pressure.

Most often prescribed in a complex with other drugs that reduce blood pressure. For proper application Diuretics need to follow the rules and control some parameters:

volume of drilled liquid per day;
measure the pressure twice a day;
measure body weight, abdominal and heads.

This data is necessary to the doctor to correct the dosage of the drug. If nausea appears, dizziness should be reported to the doctor. Take diuretics need to be followed by some recommendations:

Comply with a diet with low sodium and salt.
Take preparations that contain potassium, or replace them with products that are rich in potassium.
With potassium therapy, it is necessary, on the contrary, eliminate products with potassium.
Do not use sleeping pills and alcohol that can provoke complications.

Types of drugs

Diuretic drugs are prescribed based on the disease, as they differ in the mechanism of action. Varieties: thiazide, potassium-saving, loop and osmotic. Tiazide diuretics are used in the treatment of hypertension, because they perfectly reduce blood pressure. The dosage is small, because a thiazide diuretic effect affects metabolism. The use of diuretics in the complex allows you to achieve a maximum effect with minimal side effects on health. Pharmacokinetics of drugs, like loop diuretics. Thiazids are secreted into the Lightweight Light in the proximal canal.

Diuretics of this group are often used to treat increased blood pressure.

Pokali-saving contribute to the withdrawal of chlorides and sodium from the body, but reduce the elimination of potassium. They act near the distal tubules, where sodium and potassium ions are met. A rather weak class of diuretics, which means that they are inferior to others by strength and reaction rate. Apply with diuretics withdrawing magnesium and calcium to reduce the loss of ions. The effect of loop diuretics occurs in the loop of Genela. The properties of the diuretic this group: an increase in the blood flow in the kidneys, the removal of magnesium and calcium, glomeric filtering, reducing venous tone, increasing the diurea.

Indications for the use of diuretics of the osmotic group: glaucoma, edema of organs, peritonitis, cases where urine is not formed. In addition, applied in poisoning and overdose. Refer to potent, prescribe intravenously, because they are not absorbed into the gastrointestinal tract. The best intravenous diuretic of this group is "Monitol". There are other diuretic agents that are not part of any of these groups, but manifesting a diuretic effect.

Types of diuretics in efficiency

According to the efficiency of washing sodium, hypotensive diuretics are:

Pusty - loopers, raise leaching by 5-25%.
Moderately valid - thiazide, increase the excretion by 5-10%.
Weselves or lightweight - potassium-saving and osmotic, increase sodium yield by 5%.

Indications for use

Thiazides are used to prevent arterial hypertension.

Diuretics are prescribed in hypertension, cardiac and acute renal failure, with heart swelling, glaucoma, cirrhrodes. Studies have shown that the hypotensive effect is inherent in most diuretics, which are available in a pharmacy. Preventive in arterial hypertension are thiazid-like diuretic drugs, in addition, they reduce the risk of stroke. In high doses and systematically take thiazids is not recommended so that hypokalemia does not occur. The instruction will make it clear what indications for the use of a drug, among the diuretic there are those that are contraindicated under reduced pressure. Diuretic therapy can be active at moderate doses and supporting during constant reception.

Diuretics with hypertension

In hypertension, preparations are prescribed to reduce the volume of circulating blood in order to reduce the load on the heart and the increased resistance of the vascular walls. In the treatment of hypertension, a beta-adrenoblor diuretics is used, thus increasing the efficiency of drugs. It is often used "nifedipine" because it does not affect the metabolism. Daily nifedipine reduces blood pressure and performs a protective function for internal organs. "Nifedipine" is well combined with different groups of drugs: beta blockers, ACE inhibitors.

Diuretics at swelling

In the swelling, the reception of diuretic drugs will be more efficient with the diet.

Edema - a problem for many people. This is the initial symptom of negative processes that occur in the body. Edems of the limbs flag about the stitch. In case of violation of the kidney functions, the swelling of the face appears. One-sided swelling is rare and is associated with the defeat of the central nervous system. Digested withdrawal liquid and have a therapeutic effect on the whole organism. When receiving diuretic, a diet that contributes to the early disappearance of the symptom is prescribed.

Diuretics with renal failure

Diuretics and kidneys have always been closely connected. So, with renal failure and jade diuretics, the swelling is removed, derived excess water. With weak symptoms, natural diuretics are recommended: celery, carrots, strawberries, cucumbers, beets. Among synthetic are the most effective "Aldakton", "Britomar", "Hypothiazide", "Diiouver", "Furosemid". In chronic renal failure, loopers are prescribed. Tiazid diuretics with CPN are less common, as they are less effective. Other diuretic classes are contraindicated, as they increase the risk of complications. When urolithiasis prescribe therapy, based on the origin of the stones:

stones from potassium salts, calcium or phosphates will cure calcium diuretics;

Many more than once heard such a term as "Diurek". What it is, we will try to figure out below. This group Preparations has its own classification, properties and features

Diuretik - what is it?

Diuretic means are also called diuretic medical staff. They are synthetic or vegetable medications that are able to increase the selection by the urine kidney. Due to this, water is enhanced with urinas, and the level of fluid in the cavities and tissues of the body is reduced. Because of this, swells disappear or even disappear. Diuretics are preparations that have been widely used in hypertension therapy (elevated blood pressure). They are often used to treat low-rise heart failure of a stagnant type, as well as a number of shortness of liver and diseases associated with circulatory impairment that provoke stagnant in the body. Often, diuretic medical preparations are used to reduce or fully eliminate symptoms of meteorism, which sometimes accompanies PMS or manifests itself during menstruation. With strict observance of the treatment and dosage mode, they do not cause strong side effects. They are safe enough to use.

during pregnancy

Many gynecologists do not advise drinking diuretics during pregnancy. Preparations may be unsafe for the fetus and mother health. Negative action was open not so long ago. Previously, diuretic preparations were used to reduce swelling in pregnant women, counteraction of preeclampsia, etc.

Diuretics: classification

There are various types of diuretic medical preparations. Each category has its own flaws. To date, there are such groups of drugs:

Loop medical staff.

Tiazide drugs.
. Tiazid-like funds.

We will talk about these groups in more detail below.

Loop diuretics

This category of drugs is the most common. It includes such drugs as "Stacrinic acid", "Toramisid", "Furosemid", "PIRTENDID", "BUMETANID". Despite the fact that in the chemical structure, they can differ significantly, these diuretics action mechanism is the same. These medical preparations inhibit the reabsorption of substances such as sodium, chlorine and potassium. The name "loop diuretics" is associated with their mechanism of action. Resorption occurs in the ascending proportion of loops Genla. It is carried out due to the blockade of sodium ions, chlorine, potassium in the apical membrane of the canal epithelium cell. Due to this, it is suppressed by the operation of the turning and countercurrent system in the kidneys. In addition, the diuretics of this type are able to expand the vessels of the cortical substance.

Side Effects of Loop Diuretics

The strength of the effect of these medical preparations is extremely large: they can increase the diuresis by 25%. In contrast to other drugs, losing the effect with the normalization of the BCC, the loop diuretics continues to function in these conditions. It is thanks to strong diuretic action that they can provoke such side effects. The most rare and heavy is the fall of blood pressure, hypovolemia, a decrease in the level of SCF and renal blood flow. because of increased level The removal of hydrogen, chlorine and potassium is not excluded metabolic alkalosis. Sometimes loop diuretics provoke hyponatremia and hypokalemia. In rare cases - hyperglycemia, hyperuricemia. Other side effects are: evil, nausea, weakness. The medicine often provokes constant or temporary deafness, as well as neutropenia. All medical staff of this type, which have been listed above are derived from the body with kidney, metabolizing in the liver.

Indications for loop diuretics

These medical preparations are prescribed with any types of heart failure. And especially they are necessary in case of diseases such as heart failure refractory type and pulmonary edema. Medicines are also effective in hyponatremia, hypoalbuminemia, hypokalemia, hypochloremia, and renal failure. The loop diuretics continue to work when other groups of diuretic and their combinations are ineffective. This is their great value. Therefore, this type is so common - the loop diuretic. What it is, we have already figured out.

Tiazide diuretics

These medical preparations and their derivatives ("Indapamide", "Chlorotalidon" and "Metolason") are used quite often. First of all, this is due to their high absorption rate in the gastrointestinal tract, as well as a good level of patient-carrying level. Tiazide diuretics are less powerful than loopers, but due to the large duration of the action are shown to people with such chronic ailments, such as the arterial hypertension of the essential type and the notifying heart failure of the stagnant type. Tiazide diuretics are prescribed for oral administration. Diuresis, as a rule, begins after 1-2 hours, but the therapeutic antihypertensive effect in some cases can only be observed after 3 months of continuous treatment. The ancestor of this group is chlorothiazide. It is distinguished by low fat-solventness, and consequently, both small bioavailability. Because of this, the therapeutic effect requires higher drug dosages. The drug "Chlortalidon" is pretty slowly absorbed, so its duration of action is somewhat larger. Means "Metolas" is often very effective in patients with reduced kidney function, unlike other medical staffs of this category.

Diuretics of potassie-saving

There is also preserving potassium diuretic. What it is? These drugs are used for hypertension therapy in combination with other types of drugs. They interfere with the overhaul of potassium organism, which is a common side effect of diuretic drugs of other categories. Hypokalemia is a decrease in plasma potassium. It is a constant satellite of thiazide diuretic, which are often prescribed for hypertension therapy. When the level of potassium is much dropped, then the patient begins to experience weakness, it is quickly tired, he has a cardiac arrhythmia. To prevent this, along with thiazide drugs, potassium-saving diuretics are often appointed. They hold in the body along with the potassium also other necessary minerals - magnesium and calcium. At the same time, they practically do not delay the output of excess liquid and sodium. The lack of potassium-saving medical preparations is as follows. Plasma potassium level may increase excessive (more than 5 mmol / l.). This condition is called hyperkalemia. It is able to cause muscle paralysis and heart rhythm disturbances, up to its complete stop. The development of pathology is most possible in patients with renal failure.

Use for the treatment of hypertension

Diuretics have proven themselves well with hypertension. They contribute to the removal of fluid from the body, which reduces pressure. A proven fact is that diuretic drugs are more effective for the treatment of elderly patients in comparison with beta adrenoblockers. Diuretic medical preparations are included in the list of first line medicines, which are used to normalize blood pressure. According to the recommendations of US physicians, this category should be used for hypertension starting therapy (uncomplicated). because of much Hell control, as well as reducing cardiovascular risks in treatment, special attention is paid to metabolic effects that are characteristic of antihypertensive medical preparations. It is also important to influence them on the flow of associated ailments and organoprotective characteristics.

Tiazid-like and thiazide medical staff at hypertension

Previously, hypertension, as a rule, was treated with loop diuretics. But now they are more used for therapy of renal, heart failure and edema. Research results showed good tiazide type drugs. They improve hypertension forecast. However, a decrease in the risk of coronary complications when using these funds was not so pronounced in comparison with the expected results. The use of tiazide drugs increases the likelihood of arrhythmias. Some patients have even sudden arrhythmic death. Also, there are also impairment of carbohydrate and lipid exchanges, as well as hyperuricemia. It may be aggravated by the flow of atherosclerosis and diabetes. Medps of this group are often combined with potassium-saving diuretic.

The next level of the evolution of diuretics for the treatment of hypertension steel thiazid-like funds. In particular, their heddonaster synthesized in 1974 was well proven - the Medicreparation "Indapamide". The advantage is that thiazide-like products are much less influenced by the reabsorption of sodium, and therefore, significantly less potassium from the body is removed. Therefore, negative metabolic and diabetegenic effects are practically absent. It has now yet been proven that the drug "Indapamide" used in small dosages, except for diuretic action, is able to perform a role due to vasodilatory activity and stimulating the production of prostaglandin E2.

In modern conditions, thiazide and thiazid-like medical staff are very widely used not only to reduce the blood pressure, but also in preventive purposes, as well as for therapy of lesions of target organs. Data drugs are very often prescribed as part of combined therapy courses. They have proven themselves perfectly and therefore widely used in different countries World.

Diuretric agents (diuretics) are chemicals with different structural structures that perform the function of reabsorption of sodium and water ions and increasing the removal of fluid from the body.

The expected effect of treatment of many diseases depends on the correct choice of diuretics, Since they are, although they are called diuretic, differ in the mechanism of action, that is, they are inhomogeneous: some more act on the channel level, others mainly affect the renal hemodynamics, affecting the tubules at least.

Preparations of the first group (carboanhydrase inhibitors, acetasolamide, osmotic diuretics) in medical practice are not very common, which cannot be said about strong looping diuretic, which operate at the level of the rising loop of Genla, whose head representative is a furosemide, very widely used in therapeutic practice.

Close on strength and mechanism for loop diuretics Quinazalon and chlorobenzamides, capable of acting gently, but for a long time (more than a day).

Pterydines and carboxamides are a special group of diuretic. Patients revealed to often use similar drugs, they are known as potassium-saving diuretics. They do not have a negative effect on glomerular filtration, act more than a day and can be assigned to patients with chronic renal failure (CPN).

Basic Classes of Medical Diuretics:

More detailed information on drug diuretics will be given further in the course of the article.

Diuretics in products

Not always and not everyone needs to certainly buy diuretics in a pharmacy. And not everyone who is really necessary, go to the doctor, discharge the recipe and accept how the doctor appointed. Many people move to a diet depleted by a cook salt, giving preference to the products that, by virtue of their natural properties, are well removed from the body an excessive fluid. In addition, instead of traditional tea, diuretic fees can be used.

Recently, it became specially popularity, which consists of laxative and diuretic herbs. All of this, of course, may probably be useful if a person does not have any health problems, and edema on the face or on the legs are associated with the blatant violation of the power regime, excessive addiction to salty dishes or due to elementary fatigue.

The list of diuretic trees make up everywhere growing, and therefore well-known representatives of flora:

Chamomile;
Horsetail;
Lamberry (leaves);
Toloknyanka;
Chicory;
Highlander bird;
Burdock;
Flax (seeds);
Birch leaves and kidneys;
Juniper;
Rosehip, which has a light diuretic effect and is a source of vitamin C;
Parsley (roots);
Greens of dill.

Some of these plants are part of the diuretic collection implemented by the pharmacy network.

The choice of diuretic plants against edema based on the patient's health status:

Dorganic products that can be replenished with the goal of fighting swells make up the following list:

Interesting in this regard can be baked potato. Being a source of potassium, it simultaneously has a diuretic effect. Those who want to lose weight can be tried three-day potato diet (And you can stretch it for a week if enough forces). So: 1 kg of potatoes baked in uniform, use during the day, picking up ordinary water. Result: 3 days - minus 3 kg and no edema.

Unfortunately, there are situations when there is no such treatment and no matter how good diuretic properties did not possess the gifts of nature, it may be necessary to appoint real diuretics. However, before proceeding to the use of synthetic diuretic drugs, it would be nice to explore the characteristics of some representatives of this pharmaceutical group.

Video: Natural Diuretics

Loop diuretics

the action of the main types of diuretics

Act

The drug diuretics (PD) include drugs whose action begins quickly (from a quarter of an hour before half an hour) and continues from 2 (bometadine, furosemide) to 6 hours (ToramSemid). In addition to its basic action (diuretic), the diuretic this group expects a change in some hemodynamic parameters, which is especially noticeable when intravenous their introduction.

This property of loop diuretics is used to reduce the finite diastolic pressure (CDD) and the final diastolic volume (BDD) of the left ventricle at legally delicate insufficiency, as well as drops of pressure in a small circle at. In addition, loop diuretics reduce the volume of extracellular fluid and affect respiratory operation (help reduce signs of shortness of breath).

Given the listed advantages of loop diuretics, they are often used in combination with other drugs. to provide emergency care for cardiovascular or renal pathology.

Video: Action of various diuretics on the human body

Representatives

Most of the most famous and used for many years have been considered a furosemide, but other diuretic products are included in this group:

Furosemid (Laziks). After taking inside an empty stomach, otherwise you will have to wait longer, the drug begins to act in half an hour - an hour, intravenous introduction speeds up the process and reduces the time to 5 minutes. Furosemide is not long delayed for a long time, half of it is removed from the urine in 4-6 hours (when taken inside) and after a couple of hours when intravenous use.
Toramsemid It differs from Furosemid a longer therapeutic effect, and potassium is less lost. It is used in renal and and even there is an opinion that when CPN is more effective than the famous Furosemide.
Bometanide(Jurieta, Burrinex). It is distinguished by rapid suction and the beginning of a diuretic action, since after half an hour the drug makes itself felt. It is used for swelling of the face and, with hypertension due to severe renal failure.
PIRTANENID - Very strong diuretic (more powerful furosemide). In addition to the main properties, has other abilities. Pitrened reduces blood coagulation, blocks "slow" calcium channels (peripheral vasodilator), and can be used as a hypotensive agent (this action is even ahead of the diuretic effect), so it is often prescribed to reduce pressure at 1-2 degrees (monotherapy) or as part of a combined treatment in more complex cases. In addition, the drug is prescribed with renal and heart failure and edema of various origin.
Stacrinic acidmore familiar under a different name - ugit. It is characterized by a strong diuretic, but a short action, which depends on the method of application (from 2 to 4-6 hours). Ugrate can be prescribed together with Foursmend, because they have miscellaneous place Applications. Stacrinic acid is used in the swelling of any nature, but its contraindications should be known: Anururia, Oliguria, hepatic coma, disruption of acid-alkaline equilibrium.

It should be noted that the representatives of this group are by no means potassium-saving, but, in addition, they lead to an increase in the removal of other trace elements: magnesium, sodium, chlorine, calcium.

Doctors always take into account this circumstance and prescribe drugs recovers - Panangin, orotat potassium, asparks. By the way, patients would also be very helpful to know about such a feature of loop diuretics and not apply them uncontrollably, even if diuret pills are sold in a pharmacy without a recipe.

Tiazid diuretics and their close "relatives"

Double Effect

Thiazid diuretics (TD) are produced mainly in tablet form and are often prescribed in combination with other hypotensive means to reduce blood pressure and reduce swelling. Dorganic tablets of this group blocked the reverse transport of sodium and chlorine, What leads to a decrease in the amount of plasma, extracellular fluid, as well as a drop in cardiac output and peripheral vascular resistance, and, it became a decrease in blood pressure. These processes are provided at the expense of humoral and intracellular mechanisms that regulate the sodium level with a decrease in the volume of fluid.

However, the long-term use of tiazid diuretics can cause patients with multidirectional reactions - some cease to respond to therapy. In such patients with a reduced plasma volume, there is a high level of humoral factors responsible for increasing the OPS (general peripheral resistance), it is renin, angiotensin, aldosterone. In such cases, in order to potenize the action of TDs, hypotensive drugs are prescribed, which are called (angiothenzine enzyme). Joint efforts (TD + ACE inhibitors) they reach the desired effect and help the patient to cope with swelling at hypertension and with the hypertension itself. By the way, there are also combined drugs, so to speak, "2 in 1", which frees from the need to buy diuretic separately from antihypertensive.

Why are they like hypertensive?

Tiazid diuretics differ from loop not only by the fact that with terrible force does not withdraw the heart muscles necessary for the work, they have a significant difference in their duration. If the period of the diuretic effect of PD is limited to 3-6 hours, then even for the shortest TD, this time is lengthened to 18 hours, others have even greater abilities and have a therapeutic effect during the day or more.

Patients usually love diuret tablets of TD groups, because they have a constant soft diuretic effect. The bladder will not be filled with fun and does not cause a person practically not to leave the toilet, everything happens almost physiologically, so these funds can be used at work or even on a trip.

Thiazid diuretics with hypertension in order to reduce blood pressure can be used independently or in combination with other hypotensive or potassium-saving diuretic. Some patients are quite small doses of TD, which provides a good effect, however, it comes slower (approximately a month later).

The use of TD allows noticeable to reduce the number of such adverse reactions as:

(drop in serum potassium level);
Hyperlipoproteinemia (increasing lipids and lipoproteins, which contributes to the development of atherosclerosis);
arising against the background of a lack of potassium, sodium, magnesium, chlorine.

In short, thiazid diuretics and doctors, and patients are recognized as good diuretic, having a hypotensive effect and non-straining psyche and the bladder of the patient.

Close "relatives" of TD is considered nontyhazide sulfonilamide diuretic, Acting on the cortical segment of the loop of Genla, and drugs occupying an intermediate position between sulfanyamide and loop diuretics (xipamide) and assigned to hypertension.

Diuretic pills from the group of thiazid diuretics

Many representatives of this group are familiar with patients who have long suffering from arterial hypertension. They are sold at a pharmacy without a recipe and are almost always available:

Hydrochlorostiazide (Ezidrex, hypothiazide). It can be attributed to medium diuretics (according to strength and duration). It slightly increases the removal of sodium, potassium and chlorine, but acid-alkaline equilibrium does not violate. It is prescribed after eating 1 or 2 times a day and its action shows after 1-2 hours, the hypotensive effect holds 12-18 hours. The drug can be used intermittently or long (in severe cases). Hypothiazide requires a diet enriched by potassium and decline daily consumption crash salt. If the patient has renal pathology, then a combination with potassium-saving diuretics and potassium drugs is not recommended.
Indapamide (Indapon, Arifon, Pamid) is a drug that combines hypotensive and diuretic effects at the same time, that is, it can be said that Indapamide is a diuretic for swelling, reduced pressure. To its merits can be attributed to those facts that he does not affect the functional abilities of the kidneys, does not change the indicators of the lipid spectrum, and, in addition, it has the abilities to protect the heart and vessels.
Chlortalidon (Gigroton, Oxodoline) refers to non-phase sulfonilamine diuretics (SD), has an average and a pronounced effect that can last up to 3 days. In their behavior, chlorotalidone somewhat resembles hypothiazide.
Klopamide (Brinaldix) - according to the power, duration of action and pharmacodynamics, is similar to chlorortalidone and hypothiazide.

Table: Comparison of some loop and thiazid diuretics

Dorganic drugs saving potassium

Painting diuretics (CSD) are considered to be light, but with a long effect. True, he comes, mostly, not the first day. Expect such manifestation of diuretic abilities, as from looped diuretic or even thiazide, is not worth it. IN this case More you can rely on triamtenen, which is able to start shooting edema on the third hour after reception, but it will not be so much expressed, so patients do not always notice.

CSD in most cases are prescribed as diuretics from edema, While with hypertension, they are perceived only as auxiliary means. Wonderful diuretics are obtained by combining potassium-saving with thiazidov: triamteren + hypothiazide. Depending on the number of the main active substance (triamtenen), good diuret tablets are obtained - triampur, diazide, maczid. In a similar way, a complex drug modretics, consisting of amyloride, hypothiazide and furosemide or a city can be obtained.

A little about the potassium-saving

Of course, list all drugs along with their merits and disadvantages, synonyms and mechanism of action of any group of diuretic funds is not possible, therefore, as in the previous cases, we will only dwell on typical representatives of the potassium-saving diuretics:

Spironolakton (Veroshpiron, Aldakton) - a lightweight drug with a long effect, which begins to manifest from 3-5 days and keeps a couple of days after cancellation. As a hypotensive rapid response agent is not suitable, since in this regard, it starts to act only after a half months. Of course, the patient will not wait so much so much, but it is still prescribed in combination with other hypotensive or diuretic in case of non-trimmed periodic edema or for long-term treatment of hypertension, without fear that even with a decrease in blood pressure, it will have a negative impact. Veroshpirirov does not show its hypotensive effect at low and normal arterial pressure. Due to the fact that Spironolactone refers to steroid drugs, the side effects of it, besides hypercalemia, specific: gynecomastia, male type of female, that is, directly associated with hormonal imbalance.
Triamteren. (Daittech, Pterofen) - a light diuretic, according to behavior, it looks like a spirironolactone, is distinguished by a small independent diuretic effect, manifested in a couple of hours after the reception and ongoing on average 13-15 hours. His hypotensive effect is superior to Khironolakton. The elderly patients more often gives side effects: development can lead to kidney strikes due to the fact that potassium begins to postpone in the tubules. As a result, urine in such people can change the color and become blue or blue. This, as a rule, is very frightened by patients and their relatives.
Amyloride (Midamor) is a weak diuretic that displays sodium and chlorine, but saving potassium. Although the own diuretic effect is insignificant, the amyloride is able to stimulate the diuretic effect of Furosemide, Ugret, as well as thiazid diuretics. In order to reduce potassium loss, used in combination with hypothiazide (modretics) for the treatment of arterial hypertension and heart failure.

When should I not use diuretics?

Indications, contraindications and side effects are precisely those annotation items to any medicinal product on which the patient stops his gaze, passing pharmacokinetics and pharmacodynamics.

To the diuretic should also be treated at least in this plan, without assigning them to weight loss:

Strong diuretics will derive a few liters of water, and the scales will show a loss of a couple of kilograms. Do not share, it's not for long.
Powerful diuretic will require fluid replenishment, everyone knows that after the reception of the same Furosemide, the thirst comes, the body wants to return the lost water back, so it is better to use for weight loss folk remedieswithout fear that they will bring everything and all will lead to undesirable side reactions.
And finally, the author of the article, having a higher medical education and having tried many medicines for themselves, did not meet a person who would be able to defeat obesity with the help of diuretic products, so to speak, was convinced of personal experience.

Caution should be treated with diuretic and. The development of the syndrome often begins with the appearance of feet edema, however, given the complexity of such a disease, as a diabetes, which is considered systemic pathology, cannot be engaged in amateur in diabetes - the appointment of diuretic during diabetes is exclusively in the competence of the attending physician. Other origin (fatigue, heart failure) also require an individual approach. Of course, with fuel associated with fatigue lower extremities, most likely come folk medicinesWhile synthetic preparations may simply be needed.

Under the edema of the person, if a person has not overrelated with food and drinks, it is also better to visit the doctor, perhaps the renal problems and the doctor know how to solve them. It is not necessary to rush to the use of diuretic drugs, it is likely that diuretic products will help if the pathology did not go far.

And here a special case

Another special case is pregnancy. Edema during pregnancy, especially in the second half, the phenomenon is often and in part - natural. Additional load caused by hormonal perestroika with an increase in the amount of progesterone and created by a pregnant uterus will make themselves felt. The length of the legs increases for a couple of centimeters, it becomes hard to walk, but, meanwhile, during pregnancy, swelling can be a sign that has smoking consequences in other cases.

Regular visit to the female consultation and the fulfillment of the doctors' recommendations is designed to protect a woman, and swelling, if they provoke physiological causes, will be held after childbirth, however, it is extremely undesirable to appoint a furosemide in such a situation. Pregnant and sometimes (but not in the first months) are prescribed thiazid diuretics, but again - it makes a doctor who is watching a woman.

When does the doctor appoint a diuretic?

People in the overwhelming majority and themselves know when diuretic drugs are prescribed, but in other cases having a large experience of heart problems still wondering why they are suddenly prescribed Veroshpiron and even refuse to accept him, referring to other age troubles (incontinence of urine and so on).

In this regard, I want to provide a reasonable list of readings so that the patient does not think that it is just a personal whiff:

Arterial hypertension(AG), which has not yet complicated renal failure. Diuretics due to the reduction of the BCC (the volume of circulating blood) and systolic emissions lead to a decrease in systolic pressure in the first days of treatment. It should be noted that the pressure does not fall uncontrollably, the blood pressure decreases moderately, postural hypotension does not develop. Long-term treatment leads to a decrease in the diuretic effect and normalization of systolic ejection due to its own compensatory mechanisms (increasing the content of renin and aldosterone), further unauthorized loss of fluid is terminated, and the hypotensive effect is maintained regardless of high level renin, which is associated with a decrease in sodium concentration in cells and increasing potassium in the walls of the vessels. As a result - after 1.5-2 months, the diastolic pressure is normalized (the cardiac output remains unchanged). Often, patients in front of the doctor put a reasonable question: are the diuretics applied in hypertension, addictive? No, it is either absent, or so little worm that this circumstance can be neglected. The use of these drugs, as noted by the patients themselves, does not lead to impotence and a decrease in libido, which is considered the undisputed plus of diuretic.
Chronic blood circulation failure (HNT) with edema, as well as agriculture with violation of glomerular filtration requires the use of powerful diuretic tools with a short or mid-period of action (furosemide, yard). The main advantages of these drugs make it possible to apply them in fairly serious situations for emergency therapy - brain edema, lungs, poisoning with potent substances that are derived by the kidneys, for example, barbiturates.
Secondary hyperaldosteronism(consequence of hypertension and HNT) or Prevention hypokalemiai are an indication for the purpose of the potassium-saving diuretics with a light diuretic and hypotensive effect.
Nonachar diabetes;
Glaucoma.

Video: Lecture on the use of diuretics in heart failure

Unwanted diuretic effect

Disorders associated with the elimination of trace elements

Diuretic drugs, withdrawing ions of chemical elements, which are not unnecessary for the body, cannot but give side effects. Basically, these are disorders of electrolyte equilibrium, which are capable of causeing heart rate (arrhythmia), arterial hypotension, and that the most terrible for the male half is impotence. Thus, a list of the main unwanted manifestations of diuretics:

Reducing potassium level (hypokalemia) -the main lack of diuretics;
Fall level (hypomagnation). Such abilities are endowed, mainly looped diuretics, tiazidovye derive magnesium, but at least, and potassium-saving, on the contrary, delay its elimination.
Calcium elimination. And again looped diuretics, which even in one-time can be removed to 30% Ca 2+. Tiazide belongs to this element ambiguous: some increase the removal with urine, other noteworthy calcium, delay it in the body and thereby cause hypercalcemia.. Potassium-saving (Veroshpiron, triamtenene, etc.) - also belong to not withdrawing calcium, but, increasing its reabsorption in the tubules, can lead to hypercalcemia.
Reducing sodium concentration (hypongartemia) It is often observed with self-controlled diuretic drugs in an independent and uncontrolled appointment, which will manifest itself with muscle weakness, drowsiness, malaise, nausea.

Important: mental disorders and coma (very desirable to have this fact in view of people using diuretics to lose weight) may become symptoms of "bustling" of diuretics.

Arrhythmic complications, metabolic disorders

Serious restrictions on the use of diuretics are arrhythmiaSince diuretics are these arrhythmias and cause. It is believed that the long-term therapy of arterial hypertension of diuretic (especially thiazide) is able to cause not only a violation of the rhythm, but also sudden coronary death. The provoking factors of the development of arrhythmias are considered:

Hypokalemia, which leads to pathological changes in the electrocardiogram (myocardial instability, the elongated Q-T syndrome);
Pronounced, which in itself contributes to the rhythm violation;
Stress;
Purpose of β agonists.

Table: Diuretrics and Typical Side Effects

Other side effects of diuretics:

Diuretics can reduce the weight of myocardial LVs within 11%, where the most active in this regard is recognized indapamide.
Treatment with strong or moderate diuretic, often leads to an increase in blood serum ( hyperuricemia). Especially the same phenomenon is characteristic of people having excess weight. Gout or chronic nephropathyThough in rare cases, but it can be a consequence of the use of diuretics.
In some cases, a persistent increase in blood glucose can develop - hyperglycemiacapable of transforming into progressive diabetes.
The beginning of the use of thiazid diuretics in hypertension is accompanied by violation of the lipid spectrum (), which is manifested by an increase in the blood serum of LDL and LPONP (atherogenic lipoproteins), but in the future, everything is usually returned to normal.
Powerful (furosemid, yard) and moderate (thiazide) diuretics are able to influence acid-alkaline equilibrium and with prolonged use to bring it to the imbalance, causing metabolic alkalosiswhich corrected potassium chloride. Meanwhile, the treatment of potassium-saving drugs may be accompanied by an increase in blood potassium (hypercalemia) and metabolic acidosis.

Contraindications for the use of diuretics

Contraindications for the use of diuretics, as well as for other drugs, are common, relative and absolute, but they are not so much, so you can accommodate in the same list:

Renal and liver failure that prevent the use of very many drugs of this group, in addition to amylorride, which, with lesions of the liver, is still assigned;
Diuretics do not apply during the early construction;
Some contraindications for sugar diabetes provided relative to the hydrochlorostiazide;
Hypovolemia and pronounced are strict contraindications to the appointment of Furosemide and Uzhgeit;
Incomplete atrioventricular and hypercalemia absolutely do not allow the use of potassium-saving diuretic products;
It is forbidden to combine several diuretics that do not take potassium.

Dangerous combinations

Given that the drugs of this group often have to be prescribed together with other pharmaceutical agents, it is necessary to keep in mind the possible reactions of this combination. For example:

Towing potassium diuretic is dangerous to combine with Digitalis derivatives, since the risk of arrhythmia is created;
Spironolactone and triamteren (potassium), used together with digoxin, too, often lead to a rhythm violation, so this combination requires constant control of Digoxin in the patient's plasma.
The diuretics that do not take potassium are poorly combined, and with a rich diet, and with potassium preparations.
Medicines that themselves increase the content of glucose in the blood, even more enhance the hyperglycemic effect of diuretics.
Antibiotics aminoglycosium and cephalosporine in combination with loop diuretics can lead to a toxic level of these drugs in the kidneys and the defeat of the latter, except for this aminoglycosides (Canamycin, streptomycin, gentamicin) with looped diuretic increases the likelihood of such a complication as the lesion of the vestibular apparatus and hearing organs
The ability to reduce the diuretic effect on some diuretics possess NSAIDs (nonsteroidal anti-inflammatory drugs).

At the moment, the questions answers: A. Olesya Valerievna, Ph.D., teacher of medical school

What is a diuretic effect?

The natural process of education and urine isolation to a person is called diuresis. So, medications, as well as some kind of food (for example, tea with milk, watermelon) influence this process (have a diuretic effect) and thereby lead to the so-called diuretic effect.

Diuretic effect is the action of diuretics on the human body. Diuretics are diuretic drugs, that is, funds causing reinforced urination, that is, a person who accepted a diuretic will go to the toilet.

For example, they say: diuretic effect lasts 10 hours. This means that for ten hours after the prime diuretic, a person will have more frequent urination.

Diuretic. Immediately shows the origin of the word from urin - Watering or urethra - part of the human urinary system. Prefix di means negation, the rejection, that is, in our case, the yoral yield from the body. This is the effect of rheating of a diuretic system to more intensive work in order to prevent or treatment.

After taking diuretics (diuretic drugs) in the body there is a diuretic effect (diuretic). With the help of such drugs, excessive fluid from the body. They are used in medicine for the treatment of diseases related to kidney associated.

Diuretic effect is the same as a diuretic effect. From natural diuretics are good, for example, cranberry and brusal frusters: In addition to the diuretic effect - good prevention Diseases of the kidneys

Also, the diuretic effect is beer, coffee - which do not need to drink a lot, and better not to drink them.

Good health! 🙂

Diuretic effect, this is a medical term, usually written on the instructions for the drug. In common, this is called a diuretic, that is, this is what causes frequent urges Go to the toilet by little. They should be prescribed by the doctor, in certain diseases.

Diuretic effect is a diuretic. When it is necessary to remove water from the body, diuretics are diuretic drugs. For example, you have hypertension and along with other drugs, the doctor prescribes diuretic drugs to reduce blood pressure. However, it is not necessary to get involved in them.

Diuretic effect is associated with the action of drugs. There are so-called diuretics, after the use of which the development of urine increases. Thus, excess water and salt from the body are removed.

Diuretic effect is the consequences of receiving diuretics, which are expressed in increased desire urination. And a person walks in a small quality; As long as this effect does not end. That is, after such drugs, the body is released from liquid.

However, not only medications possess such action. After a large amount of beer, too, you often go to the toilet.