[When do combinations of diuretics make sense?].
Diuretics are commonly prescribed by physicians to contract the ECF volume. In two clinical situations combining different classes of diuretics make sense: First, if a loop diuretic at maximal dose alone does not lead to sufficient diuresis or second, if the side effect of a diuretic needs to be corrected by adding a diuretic of another class. The latter is clinically often used to counteract loop or thiazide diuretic-induced hypokalemia by the addition of a potassium sparing diuretic. Key to a reasonable combination of diuretics is understanding of the pharmaco-kinetics and knowledge of the molecular targets of the diuretics involved.
Fuster
Daniel
D
Universitätsklinik für Nephrologie und Hypertonie, Inselspital, Bern. daniel.fuster@insel.ch
D002752:Chlorthalidone / Q000008:administration & dosage / Q000627:therapeutic use; D004232:Diuretics / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology; D004359:Drug Therapy, Combination; D005665:Furosemide / Q000008:administration & dosage / Q000627:therapeutic use*; D005919:Glomerular Filtration Rate; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage / Q000627:therapeutic use; D007668:Kidney / Q000187:drug effects; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors
D004232:Diuretics; D049994:Sodium Potassium Chloride Symporter Inhibitors; D006852:Hydrochlorothiazide; D005665:Furosemide; D002752:Chlorthalidone