Edema pharmacotherapy in patients with hepatic cirrhosis and congestive heart failure: loop diuretics in focus

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Abstract

The article covers similarities and differences of edema syndrome pathogenesis in congestive heart failure and hepatic cirrhosis as well as sites of action of different diuretics types. The regimen of salt restriction and such medications as spironolactone, eplerenone and acetazolamide are not widely used in everyday clinical practice. Compared with furosemide, torasemide is a more popular diuretic because of better pharmacodynamics profile and safety. Torasemide is a pharmacologic agent with anti-aldosterone and antihypertensive effects. It also has dose-related diuretic effect. When used in dosage of 2.5-5 mg it predominantly has antihypertensive and anti-aldosterone effects with weak natriuretic action that allows its use in everyday hypertension therapy. In medium dosage of 5-20 mg it is more often used in edema syndrome treatment whether in monotherapy or in combination with other diuretics except for loop diuretics. The anti-aldosterone mechanism is based on torasemide ability to block aldosterone receptors in kidneys and heart and lower aldosteron secretion in adrenal glands. It allows to slow down remodeling processes of heart muscle in patients with congestive heart failure and explains positive effects in edema of different genesis management.

About the authors

G. G Ketova

South Ural State Medical University of the Ministry of Health of the Russian Federation

д-р мед. наук, проф. каф. поликлинической терапии и клинической фармакологии, зав. отд-нием клин. фармакологии клиники 454092, Russian Federation, Chelyabinsk, ul. Vorovskogo, d. 64

A. Yu Popov

S.V.Ochapovsky Clinical Hospital №1 of the Ministry of Health of the Krasnodar Region

зав. хирургическим отд-нием №1 350029, Russian Federation, Krasnodar, ul. 1 Maia, d. 16

A. E Babich

S.V.Ochapovsky Clinical Hospital №1 of the Ministry of Health of the Krasnodar Region

Email: Anna-babich1@yandex.ru
врач-терапевт хирургического отд-ния №1 350029, Russian Federation, Krasnodar, ul. 1 Maia, d. 16

E. V Luchinina

V.I.Razumovsky Saratov State Medical University of the Ministry of Health of the Russian Federation

канд. мед. наук, доц. каф. профпатологии, гематологии и клин. фармакологии 410012, Russian Federation, Saratov, ul. Bol'shaia Kazach'ia, d. 112

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