Why thiazides are contraindicated in CHF?
Why thiazides are contraindicated in CHF?
“Our studies suggest that those patients should be very cautious with taking thiazide since it can drop the blood pressure and reduce blood flow to the kidney and the brain and cause dizziness without increasing salt excretion.”
Why are thiazide diuretics used in heart failure?
Thiazides lower blood pressure by inhibiting sodium transport in the distal convoluted tubule, thereby modestly reducing plasma volume. Such a volume reduction can decrease the risk of heart failure, which is increasing in prevalence worldwide.
What do you monitor with thiazides?
Monitoring diuretics
- Re-check blood pressure, renal function and electrolytes within 4-6 weeks of commencing therapy.
- If blood pressure is not adequately controlled by a low dose of thiazide, an additional antihypertensive agent should be considered rather than increasing the dose.
What is the difference between loop diuretics with thiazide?
Thiazides decrease the urinary excretion of calcium, while loop-diuretics have the opposite effect. The possibility of loop-diuretic induced osteopenia cannot be ruled out, which should be considered when choosing between thiazides and loop-diuretics for the treatment of mild to moderate CHF.
Which diuretic is best for CHF?
Loop diuretics remain the diuretic of choice for treating patients with heart failure. Furosemide, torsemide and bumetanide are the agents widely available for clinical use, with furosemide the predominant agent of the three.
Which diuretic is contraindicated in heart failure?
Combination of aminoglycosides and loop diuretics should be avoided because of the risk of ototoxicity. A low sodium diet (less than 2.4 g sodium) and fluid restriction (less than 1.5 l fluid) can reduce the need to use higher doses in advanced heart failure.
How does thiazide reduce blood pressure?
By decreasing sodium reabsorption, thiazide use acutely results in an increase in fluid loss to urine, which leads to decreased extracellular fluid (ECF) and plasma volume. This volume loss results in diminished venous return, increased renin release, reduced cardiac output and decreased blood pressure [7].
What are the side effects of thiazide diuretics?
The side effects associated with thiazide diuretics include:
- Hypokalemia (decrease in potassium levels in the blood)
- Hyponatremia (decrease in sodium levels in the blood)
- Metabolic alkalosis (increase in body’s pH with an increase in bicarbonates)
- Hypercalcemia (increase in calcium levels in the blood)
Why do thiazides cause hypokalemia?
The mechanism responsible for this drug-induced hypokalemia involves increased renal excretion of potassium. In the distal convoluted tubule, thiazide diuretics deliver a high sodium load with a resulting physiological secretion of potassium.
Why are thiazides better than loop for hypertension?
Thiazide-type diuretics are useful first-line agents in the treatment of hypertension because they have been proven to reduce cardiovascular mortality and morbidity in systolic and diastolic forms of hypertension and do so at low cost.
Is Lasix a thiazide?
Lasix (thiazides) is an anthranilic acid derivative that is used as a strong diuretic in adults and children to treat excessive fluid accumulation (edema) caused by congestive heart failure, liver failure, renal failure, and nephritic syndrome.