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Loop diuretics usually have a ceiling effect whereby doses greater than a certain maximum amount will not increase the clinical effect of the drug. Also, there is a threshold minimum concentration of loop diuretics that needs to be achieved at the thick ascending limb to enable the onset of abrupt diuresis.
Furosemide, sold under the brand name Lasix among others, is a loop diuretic medication used to treat edema due to heart failure, liver scarring, or kidney disease. [4] Furosemide may also be used for the treatment of high blood pressure . [ 4 ]
For loop diuretics, thiazide diuretics and thiazide-like diuretics, their common side effects include hypokalemia, hyponatremia, metabolic alkalosis and hyperglycaemia. [4] For potassium-sparing diuretics, its common side effects include hyponatremia, hyperkalemia, metabolic acidosis and sexual dysfunction specifically for spironolactone. [4] [5]
The thiazides and potassium-sparing diuretics are considered to be calcium-sparing diuretics. [6] The thiazides cause a net decrease in calcium lost in urine. [7] The potassium-sparing diuretics cause a net increase in calcium lost in urine, but the increase is much smaller than the increase associated with other diuretic classes. [7]
Common side effects include headache, increased urination, diarrhea, cough, and dizziness. [1] Other side effects may include hearing loss and low blood potassium. [1] Torasemide is a sulfonamide and loop diuretic. [1] Use is not recommended in pregnancy or breastfeeding. [2] It works by decreasing the reabsorption of sodium by the kidneys. [1]
Amiloride is often used together with another diuretic, such as a thiazide or loop diuretic. [2] It is taken by mouth. [1] Onset of action is about two hours and it lasts for about a day. [2] Common side effects include high blood potassium, vomiting, loss of appetite, rash, and headache. [1]
Other serious side effects may include hearing loss and low blood platelets. [2] Blood tests are recommended regularly for those on treatment. [2] Safety during pregnancy and breastfeeding is unclear. [3] Bumetanide is a loop diuretic and works by decreasing the reabsorption of sodium by the kidneys. [4] [2]
Thiazide diuretics also increase calcium reabsorption at the distal tubule. By lowering the sodium concentration in the tubule epithelial cells, thiazides indirectly increase the activity of the basolateral Na + /Ca 2+ antiporter to maintain intracellular Na + level, facilitating Ca 2+ to leave the epithelial cells into the renal interstitium.