natural and pharmaceutical products have the property of removing excess fluid from the body, these are diuretics. These drugs reduce absorption by the tubules of the kidneys. The main part of the incoming fluid is eliminated during urination. Diuretics ensure the rapid production of urine and increase its content by collecting fluid from the cells. They help to alleviate the patient's condition with edema, abnormalities in the kidneys, high blood pressure. A large selection of these drugs allows you to choose an individual remedy.

Classification

The classification of new generation diuretics in pharmacology is diverse. By analyzing their functions, it is easy to find a suitable and fast acting medicine for solving individual problems. By origin, they are divided into natural - food, teas, tinctures and decoctions and medication - drops, solutions, tablets for internal use, they can be found in pharmacies. According to the strength of the impact, they are strong, medium intensity and light. According to the duration of long-term use, short-term and "ceiling".

What diuretics are prescribed?

course and active substance the doctor selects individually for each case.

If the choice of medicines is made on the advice of the attending physician, the course and the active substance are selected separately for each case. This helps in as soon as possible solve health problems. For this, a clinical classification is used:

• Strong and powerful diuretics - suitable for removing transudate formations and hypotension. Most often they are used once to relieve symptoms. Examples include Furosemide, Torsemide, Bumetamide, Peritanide, and others.
• Diuretics of medium intensity are designed for use in a course. They are used to treat glaucoma, hypertension, heart and kidney failure, myxedema, and diabetes. For example: Clopamid, Hypotiasis, Indapamide, Dichlordiaz, Chlotalidon, etc.
• Potassium-sparing urinary preparation has insufficient diuretic effect. However, they are the safest and most gentle in their properties. They don't wash useful magnesium and potassium. Examples: Amiloride, Spironolactone, Triamterene.
• A good diuretic - inhibitors - is a kind of mild medication. Their circle of influence is determined by a decrease in the eye and pressure inside the skull. Means such as "Dichlorphenamide" and "Diakarb".
• Diuretics with an osmotic effect - are a group of strong action and are needed for complex therapy with pulmonary and cerebral edema, shocks, sepsis, glaucoma, with prolonged urination disorders, etc. These are Monitol, Glycerin, Urea.

How to use diuretics?

When do the potent drink?

These medicines are also known as loop or ceiling medicines. They are fast acting. This includes Bumetamide, Furosemide, Torsemide, ethacrynic acid, Peritanide. They start working within an hour. Diuretic effect continues throughout the day. In other situations, diuretics are prescribed in tablet form. Powerful diuretics have an effect in the presence of edematous syndrome, the causes of which are kidney and heart diseases, nephrotic syndrome, puffiness, hepatic cirrhosis.

Regular intake of powerful drugs is addictive, weakens their effect. Pharmacology says that in order for the effect of drugs to be good, they should be used in small courses, sometimes taking breaks. Strong diuretics are often useful in the treatment of acute forms of diseases such as pulmonary edema, intoxication, renal failure in acute form, drug overdose, hypercalcemia.

How does a medium intensity drug work?

Blood pressure normalizes within a month.

Products of medium impact belong to the group of thiazides. Examples are: "Hypothiazide", "Dichlorothiazide", "Indapamide", "Chlorthalidone", "Clopamide". These are products that last 60 minutes. greatest effect visible after a few hours. Such preparations work well with a glomerular filtration rate of at least 30 ml/min. Recommendations - chronic edema, arterial hypertension, heart disease, nephrotic syndrome, liver inflammation, diabetes, kidney stones. The most common use of thiazide group products is arterial pressure. Such drugs are prescribed in small dosages - this volume is enough to ensure the effect of antihypertension. Normalization of blood pressure occurs within a month. The most suitable for such deviations is considered "Impamid". Such diuretics have a number of side effects:

• violation of electro-water balance;
• hypotension;
• headaches, weakness may be present;
• dizziness;
• nausea and vomiting;
• loose stools or constipation;
• cholecystitis;
• sexual deviations (especially for men);
• pancreatitis;
• low platelets;
• skin rashes.

Light diuretics

To diuretics easy the categories include the drugs Triamteren, Spironolactone, Diakarb, Veroshpiron, Mannitol, Amiloride. They provide soft and natural influence on the body, safer. Due to the mild effect, they are best used in complex therapy or preventive purposes. In addition, potassium is very important in the body. Such a microelement is excreted when taking diuretics. But light diuretics are potassium-sparing.

Indications for use for men and women

For cardiovascular disorders, diuretics are used.

Diuretic products can be auxiliary in a wide range of diseases:

• cardiovascular disorders;
• varicose veins;
• hypertension disease of the pelvic organs;
• hepatic abnormalities;
• kidney pathology;
• pregnancy;
• allergic reactions;
• puffiness, obesity, etc.

With edema

When the patient is subject to swelling on the limbs, face, abdomen, etc., a strong diuretic can be drunk. Suitable "Furosemide", "Torasemide", "Piretanide", "Xipamide", "Bumetanide". These medicines should be used regularly and take breaks from time to time. Intermittent use does not allow you to get used to the drugs, that is, their effect continues to be effective. According to the rules of pharmacology, the use of diuretics is indicated once a day until the swelling of the extremities decreases. Next, it is recommended to take a break.

In addition to these drugs, you can take medium-strength diuretics, such as Hypothiazid, Chlorthalidone, Polithiazid, Metozalon, Clopamide, Indapamide. They are prescribed to drink 1 time per day. However, they give the result with a course of therapy for long period time, pauses are not needed here.

With a small puffiness, which is caused by diseases mild form or minor functional disorders, potassium-sparing agents are suitable - Amiloride, Spironolactone or Triamteren. The dose of such a diuretic is greater than that of thiazide and powerful diuretics, therefore it is divided into several doses, the period of their use is 14-20 days. If the problem persists, the course can be retaken.

For pregnant

During pregnancy, diuretic drugs alone do not help, complex therapy is necessary.

During gestation, the use of diuretic tablets, drops and solutions is not recommended. Such a contraindication occurs because these drugs wash out water and salts. And this can adversely affect the health of not only the expectant mother, but also the newborn. The diuretic removes water from the vessels, but the swelling does not subside, this can lead to excessive thickening of the blood. This situation provokes placental abruption, thrombosis, miscarriage, etc.

It is impossible to solve the problem with puffiness in pregnant women by using diuretics. To alleviate the condition, it is necessary to consult a doctor who will help draw up a complex therapy. For example, the patient is first prescribed "Furosemide" - it should be drunk for no more than 2 days. It expels fluid from organic tissues. Then, to remove water, you can take Triampur or Spironolactone for a week.

This group of drugs includes drugs of various chemical structures that inhibit the reabsorption of water and salts in the tubules of the kidneys, and increase their excretion in the urine.

Drugs that increase the rate of urine formation are used for cardiac edema (chronic heart failure, CHF), renal and hepatic edema. In all these forms of pathology (especially in CHF), the patient has a positive sodium balance (that is, the amount of sodium taken with food exceeds its excretion). The excretion of sodium from the body is accompanied by a decrease in edema. That's why highest value have those diuretics that increase, first of all, natriuresis.

In the formation of urine leading role three processes play:

1) filtration;

2) reabsorption;

3) tubular secretion.

These processes are due to the peculiarities of the morpho-functional organization of the kidney. It is known that the medulla of the kidney consists of nephrons, which have in their structure a vascular glomerulus located in the Shumlyansky-Bowman capsule, where blood plasma is filtered and primary urine is formed, devoid of high-molecular proteins and other compounds. The normal daily glomerular filtrate is about 150 liters and contains approximately 1.2 kg of sodium.

Filtration is a passive process; is provided by the pumping function of the heart, the oncotic pressure of the undifferentiated part of the plasma, as well as the number of functioning glomeruli.

Primary urine enters the second section - the tubules, which are divided into the proximal, distal sections and the loop of Henley. In the tubules, the process of reabsorption (that is, reverse absorption) into the blood of water, sodium, potassium, chlorine, bicarbonate, etc. takes place. Also, amino acids, vitamins, glucose, proteins, microelements are completely reabsorbed in this area. This process takes place with the participation of a number of enzymes (carbonic anhydrase, etc.). Secretory processes are also observed in the tubules, as a result of which some metabolites, xenobiotics (for example, penicillin, etc.) are released. As a result of reabsorption, secondary urine is formed, excreted from the body healthy person in the amount of 1.5 l and containing 0.005 kg of sodium per day.

Sodium reabsorption occurs mainly in the distal tubules under the action of the hormone of the adrenal cortex - aldosterone. In the case of an increase in the level of aldosterone, sodium and water are retained in the body (which happens with heart failure, liver diseases, etc.). The release of aldosterone is stimulated by angiotensin-II, and therefore one of the functions of the latter is the mediated retention of sodium in the body, and hence water.

In the distal tubules, the processes of reabsorption during

dy is also affected by antidiuretic hormone (ADH), or vasopressin (a hormone from the posterior pituitary gland). ADH, by facilitating the reabsorption of water, reduces the volume of urine, increasing its osmolarity.

Atriopeptides or natriuretic factors have also been isolated, which are normally produced in the auricles when they are too big stretch blood and regulate water-sodium homeostasis.

All the main drugs of the diuretic group act on reabsorption processes, inhibit them, although tubular water reabsorption is reduced by only 1%.

For use in clinical practice have importance classifications dividing diuretics according to the strength of action, the speed of onset of the effect and the duration of action.

CLASSIFICATION OF DIURETICS

I. Powerful, or strongly acting ("ceiling") diuretics

Furosemide, ethacrynic acid;

II. Medium-strength diuretics, benzothia derivatives

diazine (thiazide diuretics)

dichlothiazide, polythiazide;

III. Potassium-sparing diuretics

1) aldosterone antagonists:

Spironolactone (veroshpiron, "Gedeon Richter");

2) with an unknown mechanism of action:

Triamterene, amiloride.

In terms of strength, these are weak diuretics.

IV. Carbonic anhydrase inhibitors:

Diacarb.

This drug, as a diuretic, also belongs to weak diuretics.

All four of the above groups of agents primarily remove salts, primarily sodium and potassium, as well as anions of chlorine, bicarbonates, phosphates. That is why the drugs of these four groups are called saluretics.

V Osmotic diuretics

Mannitol, urea, concentrated solutions of glu

goats, glycerin.

These diuretics are excreted in separate group because they primarily remove water from the body.

The use of diuretics is designed to change the balance of sodium in the body, making it negative. Only in this case, increased sodium excretion will be accompanied by an increase in the excretion of water from the body and a decrease in edema.

The first group - "ceiling, high", strong, powerful diuretics (High ceiling diuretics).

FUROSEMIDE (Furosemidum; in tab. 0.04; 1% solution in amp. 2 ml) - is considered a loop diuretic, since the diuretic effect is associated with inhibition of the reabsorption of sodium and chlorine ions throughout the loop of Henle, especially in its ascending section .

Ethacrynic acid (uregit; Acidum etacrinicum; Uregit; in tab. 0.05; 0.1).

The drugs of this group inhibit sodium reabsorption by 10-20%, therefore they are powerful, short-acting diuretics. Pharmacological effect both drugs are almost the same. The mechanism of action of furosemide is associated with the fact that it significantly increases renal blood flow (by increasing the synthesis of prostaglandins in the kidneys). In addition, this drug inhibits energy production processes (oxidative phosphorylation and glycolysis) in the kidneys, which are essential for ion reabsorption. Furosemide moderately (twice) increases the excretion of potassium and bicarbonate ion in the urine, to a greater extent calcium and magnesium, but reduces the excretion uric acid. In addition to the diuretic effect, furosemide has the following actions, due to both a direct effect on all smooth muscles of the vascular wall, and a decrease in the sodium content in them, which, as a result, reduces the sensitivity of myocytes to catecholamines:

1. Direct pacemaker;

2. Antiarrhythmic;

3. Vasodilator;

4. Contrinsular.

When taken orally, the effect occurs within an hour, and the duration of action is 4-8 hours. At intravenous administration the diuretic effect occurs after 3-5 minutes (in / m after 10-15 minutes), reaching a maximum after 30 minutes. In general, the effect lasts about 1.5-3 hours.

Side effects.

One of the most frequently encountered adverse reactions is hypokalemia, which is accompanied by weakness of all muscles, anorexia, constipation and heart rhythm disturbances. This is also facilitated by the development of hypochloremic alkalosis, although this effect is not of particular importance, since the effect of these drugs does not depend on the reaction of the environment.

Basic principles of dealing with hypokalemia:

Intermittent administration of diuretics

loss of potassium;

Combining them with potassium-sparing diuretics;

Restriction of sodium in food;

Enrichment by rich in potassium diets (raisins, dried apricots, pe

brown potatoes, bananas);

Purpose of potassium preparations (asparkam, panangin).

The drugs of this group also delay the secretion of uric acid, thereby causing the phenomena of hyperuricemia. This is especially important to consider in patients with gout.

In addition to hyperuricemia, drugs can cause hyperglycemia and exacerbation of diabetes. This effect is most likely in patients with latent and manifest types of diabetes.

Contributing to an increase in the concentration of atrium in the endolymph inner ear, these drugs cause an ototoxic effect (hearing damage). At the same time, if the use of furosemide causes reversible changes, then the use of uregit, as a rule, is accompanied by irreversible hearing impairment.

It should also be said about the impossibility of combining furosemide and ethacrynic acid with nephro- and ototoxic antibiotics (ceporin, cephaloridine - first-generation cephalosporins), aminoglycoside antibiotics (streptomycin, kanamycin, etc.), which also have damaging side effects on the hearing organ.

When using drugs inside, minor, mild dyspeptic disorders are noted.

At the time of admission, it is possible skin rashes, a decrease in the number of red blood cells, white blood cells, damage to the liver, pancreas. In the experiment, drugs sometimes have a teratogenic effect.

Indications for use:

In tablets:

1. When chronic edema caused by chronic

heart failure, liver cirrhosis, chronic

cal nephritis;

2. As drugs of choice for heart failure with

severe hemodynamic disorders;

3. In the complex therapy of patients with hypertensive

In solution (in/in):

1. When acute edema brain and lungs (dehydration

rapia, removal of water from tissues);

2. If necessary, forced diuresis

(for acute drug poisoning and poisoning

others chemicals, which stand out

especially with urine);

3. Hypercalcemia of various origins;

4. With a hypertensive crisis;

5. In acute heart failure.

The dose of furosemide, however, like any other diuretic, is considered to be correctly selected when for a given patient diuresis during the period of active therapy increases to 1.5-2 liters / day.

Ethacrynic acid has the same indications for use as furosemide, with the exception of hypertension, as it is not suitable for long-term use.

Contraindications to the appointment of powerful diuretics:

Hypovolemia, severe anemia, renal and hepatic

failure.

The drugs of powerful, but short-term action also include torasemide, bumetanide, pyretanide.

Moderate strength diuretics (benzothiadiazine derivatives or thiazide diuretics)

A typical representative of DICHLOTHIAZIDE (Dichlothiazidum; in tab. 0.025 and 0.100). Well absorbed from the gastrointestinal tract. The diuretic effect develops after 30-60 minutes, reaches a maximum after two hours and lasts 10-12 hours.

The drugs of this group reduce the active reabsorption of chlorine, respectively, the passive reabsorption of sodium and water in a wide part of the ascending part of the loop of Henle.

The mechanism of action of the drug is associated with a decrease in the energy supply of the process of chlorine transfer through the basement membrane. In addition, thiazide diuretics moderately inhibit the activity of carbonic anhydrase, which also increases natriuresis. Chlorine cut under the action this drug is carried out in an amount equivalent to natriuresis (that is, chloruresis also increases by 5-8%). When using the drug, there is a moderate loss of hydrocarbonate anion, magnesium, but an increase in blood plasma of calcium and uric acid ions.

Among all diuretics, thiazides have the most pronounced kaliuretic effect; meanwhile, thiazides also have the most pronounced antihypertensive effect, which is explained by the diuretic effect (decrease in BCC), as well as a decrease in the sodium content in vascular wall, which reduces the vasoconstrictive reactions of biologically active substances. Dichlothiazide also potentiates the action of antihypertensive drugs used simultaneously with it.

This drug reduces diuresis and thirst in diabetes insipidus, while reducing the increased osmotic pressure of blood plasma.

Advantages of thiazide diuretics:

1. sufficient activity of action;

2. act quickly enough (after 1 hour);

3. act long enough (up to 10-12 hours);

4. do not cause pronounced changes in acid-base

condition.

Disadvantages of thiazide diuretics:

1. Since the drugs of this group act predominantly

in the distal tubules, they are more likely to cause

hypokalemia. For the same reason, hypomagnesia develops.

emia, and magnesium ions are necessary for the intake of potassium

inside the cell.

2. The use of thiazides leads to a delay in the body with

lei uric acid, which can provoke arthralgia

in a patient with gout.

3. Drugs increase blood sugar, which causes pain

those with diabetes mellitus can lead to an exacerbation of the disease

4. Dyspeptic disorders (nausea, vomiting, diarrhea,

weakness).

5. Rare, but dangerous complication- the development of pancreatitis,

CNS lesions.

Indications for use:

1. Most widely used in chronic edema,

associated with chronic heart failure, pa

liver (cirrhosis), kidney (nephrotic syndrome)

2. When complex treatment patients with hypertension

3. With glaucoma.

4. When diabetes insipidus(paradoxical effect, mechanism

which is not clear, but the BCC decreases, therefore, reduce

feeling thirsty).

5. With idiopathic calciuria and oxalate stones.

6. With edematous syndrome of newborns.

Similar in activity to thiazides, but superior to them in duration of action, are the drugs CLOPAMIDE (BRINALDIX) and OXODOLIN (HYGROTON), as well as INDAPAMIDE and CHLORTHALIDONE.

potassium-sparing diuretics

SPIRONOLACTONE (veroshpiron; Spironolactonum, Verospironum, "Gedeon Richter", Hungary; in tab. 0, 025) is a weak potassium-sparing diuretic, which is a competitive aldosterone antagonist. Spironolactone by chemical structure very similar to aldosterone (steroid), and therefore blocks aldosterone receptors in the distal tubules of the nephron, which disrupts the reverse flow (reabsorption) of sodium into the renal epithelium cell and increases the excretion of sodium and water in the urine. This diuretic effect develops slowly - after 2-5 days and is rather weakly expressed. Inhibition of reabsorption of sodium filtered in the glomeruli is no more than 3%. At the same time, the inhibition of kaliuresis appears immediately after the administration of the drug. The activity of spironolactone is independent of the acid-base state. The drug has a significant duration of action (up to several days). This is a slow but long-acting. The drug increases calciuresis, has a direct positive inotropic effect on the heart muscle.

Indications for use:

1. Primary hyperaldosteronism (Kon's syndrome - a tumor

adrenals). In this pathology, veroshpiron is used

yut as a drug of conservative therapy.

2. With secondary hyperaldosteronism, which develops with

chronic heart failure, liver cirrhosis,

nephropathic syndrome.

3. In the complex therapy of patients with hypertension.

4. Spironolactone is indicated for combination with other

diuretic, causing hypokalemia, that is, for cor

correction of potassium balance, disturbed by the use

other diuretics (thiazides, diacarb).

5. The drug is prescribed for gout and diabetes.

6. Spironolactone is also prescribed to enhance cardiotony

cal action of cardiac glycosides (here also

wives the fact that spironolactone inhibits kaliuresis).

Side effects:

1. Dyspeptic disorders (abdominal pain, diarrhea).

2. When long-term use together with drugs

potassium - hyperkalemia.

3. Drowsiness, headaches, skin rashes.

4. Hormonal disorders (the drug has a steroid

structure): - in men - gynecomastia may occur;

In women, virilization and menstrual irregularities

5. Thrombocytopenia.

The drug of the same group is TRIAMTEREN (pterofen). Available in capsules of 50 mg. Weak potassium-sparing diuretic, the onset of action after 2-4 hours, the duration of the effect is 7-16 hours. Violates sodium reabsorption in the collecting ducts and inhibits kaliuresis (distal). The drug enhances the action of other diuretics, especially thiazides, preventing the development of hypokalemia. Promotes the excretion of urates. It has a hypotensive effect of sufficient strength. The drug should not be prescribed to pregnant women, as there is an inhibition of reductase, an enzyme that translates folic acid in folinic.

Potassium-sparing diuretic of weak strength, according to the average duration of action, is also the drug Amiloride (tab. 5 mg). TRIAMPUR is a combination of triamterene and dichlothiazide.

PRODUCTS - CARBOANHYDRASE INHIBITORS (CAG)

DIACARB (Diacarbum; phonurite, diamox; in powders and tablets of 0, 25 or in ampoules of 125; 250; 500 mg). The drug is a diuretic of medium speed and duration of action (the effect occurs after 1-3 hours and lasts about 10 hours, with intravenous administration - after 30-60 minutes, for 3-4 hours).

The drug inhibits the enzyme carbonic anhydrase, which normally contributes to the combination of carbon dioxide and water in nephrocytes with the formation of carbonic acid. The acid dissociates into a hydrogen proton and a bicarbonate anion, which enters the blood, and a hydrogen proton into the lumen of the tubules, exchanging for a reabsorbed sodium ion, which, together with the bicarbonate anion, replenishes the alkaline reserve of the blood.

A decrease in the activity of CAG with the use of diacarb occurs in the proximal parts of the nephron, which leads to a decrease in the formation of carbonic acid tubules in the cells. This leads to a decrease in the entry into the blood of the bicarbonate anion, which serves to replenish the alkaline reserve of the blood, and the entry into the urine of the hydrogen ion, which is exchanged for the sodium ion. As a result, the excretion of sodium in the urine in the form of bicarbonates increases; chlorine reabsorption changes little. The latter, combined with a decrease in the formation and entry into the blood of a hydrocarbonate anion, leads to the development of hyperchloremic acidosis. There is a compensatory increase in kaliuresis, which leads to hypokalemia.

Reducing the activity of CAG by diacarb in endothelial cells, cells of the choroid plexus leads to a decrease in secretion and an improvement in outflow cerebrospinal fluid, which contributes to the reduction intracranial pressure. Diacarb lowers production intraocular fluid and reduces intraocular pressure especially significant in patients with acute glaucoma.

The exchange of sodium for potassium leads to the fact that this diuretic, being a relatively weak diuretic (inhibition of sodium reabsorption is not more than 3%), causes severe hypokalemia. In addition, due to the fact that sodium bicarbonate does not go back into the blood to replenish alkaline reserves, severe acidosis develops, and under conditions of acidosis, the action of diacarb stops. Thus, we can conclude that diacarb is rarely used as a diuretic.

Indications for use:

1. In the treatment of patients with an acute attack of glaucoma (you can in/in). 2. Traumatic brain injury with increased intracranial pressure

3. With some forms of small seizures of epilepsy. 4. In combination with loop diuretics for prophylaxis or

elimination of metabolic alkalosis. 5. In case of poisoning with salicylates or barbiturates to increase

diuresis and alkalinity of urine.

6. With a significant increase in the content of uric acid in

blood with the threat of its precipitation in leukemia, treatment

cytostatics.

7. For the prevention of altitude sickness.

Diakarb appoint 0, 25 - 1 tablet per 1 dose per day daily for 3 - 4 days, followed by a break for 2-3

days, then such courses and repeat for 2-3 weeks.

OSMOTIC DIURETICS

This group of diuretics includes mannitol, concentrated glucose solutions, glycerin. Combine these drugs in one group general arrangements actions. The latter determine that the diuretic effect of these diuretics is strong, powerful.

MANNITOL (MANNIT; Mannitolum) is a six-hydric alcohol, which is the most powerful of the existing osmotic diuretics. It is able to increase diuresis by 20% of the total sodium filtered in the glomeruli.

Produced in hermetically sealed bottles of 500 ml containing 30, 0 of the drug, as well as in ampoules of 200, 400, 500 ml of a 15% solution.

It comes out slowly. When administered intravenously, being in the blood, mannitol, like other diuretics of this group, sharply increases the osmotic pressure in the blood plasma, which leads to an influx of fluid from the tissues into the blood and an increase in BCC ("drying effect"). This leads to a decrease in the reabsorption of sodium and water in the distal part of the nephron, and also causes an increase in filtration in the glomeruli. In addition, mannitol is well filtered through the glomerular membrane and creates a high osmotic pressure in the urine, and is not reabsorbed in the tubules. Mannitol does not undergo biotransformation and is excreted unchanged, and therefore constantly attracts water and primarily removes it. The use of osmotic diuretics is not accompanied by hypokalemia and changes in the acid-base state.

According to the ability to remove water from the body, mannitol is almost the most powerful drug.

Indications for use:

1. Prevention of development or elimination of cerebral edema

(shock, brain tumor, abscess) is the most common

spread indication.

2. Mannitol is indicated as a dehydration therapy

with pulmonary edema that occurred after a toxic effect

on them gasoline, turpentine, formalin; as well as edema

3. When conducting forced diuresis, in particular when

drug poisoning (barbiturates,

salicylates, sulfonamides, PAS, boric acid),

transfusion of incompatible blood.

4. When acute attack glaucoma.

5. To reduce damage to the tubules of the kidneys during a sharp

drop in filtration (in patients with shocks, burns,

sepsis, peritonitis, osteomyelitis, in which prepa

rat improves renal blood flow), in severe poisoning

hemolytic poisons (precipitation of proteins,

hemoglobin - the risk of blockage of the renal tubules and

development of anuria).

Side effects:

Headache, nausea, vomiting, sometimes allergic reactions

18.03.2016

Diuretics can have a strong effect on the kidneys, speeding up the process of urine excretion. What drugs are prescribed for kidney problems, we will give the names of these drugs below.

Why are diuretics needed?

Natural urine-removing agents, the names of which are given below, are prescribed for:

• Cardiac problems, edema in vascular diseases.
• How effective remedy reducing high pressure.
• Removal of toxins from the body in case of poisoning.

Diuretics for edema cope with various diseases: urinary, vascular system and heart. The cause of the pathology was a delay in the body of sodium, diuretics cope with this, providing good treatment swelling of the legs, eyes and other parts of the body.

Types of Diuretics

Treatment of different pathologies involves the use of drugs that have different effects. What pills for pressure are:

• Drugs that affect the functioning of the epithelium of the renal tubules: Triamterene, Amiloride, Hydrochlorothiazide, Ethacrynic acid, Torasemide, Bumetamide, Flurosemide, Indapamide, Clopamid, Metolazone, Chlorthalidone, Meticlothiazide, Bendroflumethiazide, Cyclomethiazide.
• Potassium-sparing drugs: Spironolactone (Veroshpiron).
• Osmotic diuretics: Monitol.

According to the degree of sodium leaching from the body, diuretics can be divided into:

• Ineffective, capable of removing 5% sodium.
• Having an average efficiency, removing 10% of sodium.
• FROM high efficiency, removing from 15% sodium.

Indications for use

Diuretics are used to treat pressure, the action of the drug allows you to relieve swelling of the legs and eyes. The use of drugs is recommended for osteoporosis. Drugs that can affect the functioning of the kidneys are prescribed to reduce eye pressure. Treatment high blood pressure The eye allows you to quickly deal with the problem without causing consequences.

Contraindications for use

Diuretics for edema may have a number of contraindications, their use is unacceptable for cirrhosis of the liver and hypokalemia. Drug treatment is not performed for patients with intolerance to a number of sulfanilamide derivatives (sugar-lowering and antibacterial drugs).

The use of drugs is unacceptable in acute respiratory and liver failure. Drugs of the thiazide category (Meticlothiazide, Bendroflumethiazide, Cyclomethiazide, Hydrochlorothiazide) are not prescribed for diabetes mellitus, the patient may have an increase in blood sugar. Relative contraindications is the presence of gastric arrhythmias.

Patients taking sodium salts and cardiac glycosides should take drugs of the diuretic series with extreme caution. Do not prescribe osmotic diuretics in the presence of heart failure.

Side effects

Diuretic pills for edema can cause side effects. They contribute to the concentration of uric acid in the blood, so in patients with gout, an exacerbation of the disease is observed. Treatment of eye pressure and swelling of the legs with the wrong dosage can cause fights in the head, diarrhea, nausea, general weakness, sensation of dry mouth, drowsiness. When the balance of ions is disturbed, arrhythmia occurs, spasms in the muscles of the skeleton, muscle weakness, increased blood sugar levels, decreased libido in men, allergies.

Diuretics for swelling of the face, legs and eye pressure Furosemide leads to dry mouth, frequent urination, dizziness, nausea, and a decrease in the level of calcium, magnesium and potassium in the blood. In violation of the exchange of ions, the amount of uric acid, glucose, calcium increases. If you do not stop treatment, this can lead to paresthesia, skin rashes, and hearing loss. Diuretic Uregit is able to provide negative impact by ear, leading to general undesirable consequences.

What kind side effects aldosterone antagonists have: skin rashes, gynecomastia, convulsions, fights in the head, vomiting, diarrhea. If the treatment is incorrect in women, there is a violation menstrual cycle, hirsutism, impotence in men is possible. In the wrong treatment of heart failure, osmotic diuretics lead to an increase in the amount of plasma, increasing the workload on the heart. This can cause pulmonary edema in the treatment of heart failure.

Diuretics for pressure

During the pressure of the eyes and the whole body, swelling of the legs is observed, what remedy can be used in this case? All drugs that are prescribed for high blood pressure and eye pressure are divided into two large categories:

• Drugs that relieve hypertensive crisis, quickly increasing high blood pressure and eye pressure;
• Drugs aimed at treating high blood pressure, maintaining it within the normal range.

In fact, drugs fused to a sharp drop in pressure are means emergency assistance, their action allows you to quickly bring down blood pressure and eye pressure. In turn, drugs for long-term therapy are drugs that are prescribed during remission to control and maintain pressure at a normal, stable level.

For elimination hypertensive crisis diuretic drugs are used strong action: Piretanide, Xipamide, Bumetanide, Furosemide, Torasemide and ethacrynic acid. But in practice, all drugs with a pronounced effect are prescribed. They are usually administered intravenously for maximum results.

Treatment with drugs that have a strong effect should not exceed 1-4 days. After stopping the attack, they should be canceled by prescribing treatment with drugs of another group. They are slow acting, not as powerful and are necessary to keep the pressure at a normal constant level.

For supporting normal pressure mid-level diuretics (thiazide diuretics) are used, including: Metozalon, Indapamide, Clopamid, Chlorthalidone, Hypothiazid. In hypertension, the drug of choice is Indapamide, since its effect is much stronger in comparison with other thiazide diuretics. It is able to evenly reduce blood pressure, maintaining it during the day for normal level, not allowing rise in the morning hours. It is recommended to take the remedy for a long time, the duration of treatment can only be determined by a doctor.

Diuretics for weight loss

IN Lately Diuretics for weight loss have become very popular. The myth that diuretic diet pills are effective negative action for those who believe in it. This delusion even has scientific rationale, because adipose tissue 90% consists of water. It is from here that many believe that diuretic drugs for weight loss can be extremely effective.

In fact, diuretics for weight loss work a little differently. Diuretic drugs for weight loss really have an anti-atherogenic effect, which lies in the destruction of plaques with cholesterol. For example, Indapamide helps to lower blood cholesterol levels. But when using diuretics, you can only get rid of the fluid in the body, and the fat will remain in the same place. The drug is able to provide active influence on the vessels, reducing the likelihood of developing heart failure, atherosclerosis and stroke.

As you know, diuretic drugs can have an effect on a number of body systems, especially on the urinary tract. If they are taken correctly, then this allows you to restore the ratio of electrolytes and water balance in the body. And the receipt of funds in large doses capable of leading to negative consequences and even be a threat to life.

It must be understood that the body, along with the liquid, loses important ions that can regulate the work of all organs. Such weight loss occurs solely due to dehydration of the body. If the ionic balance is disturbed, then weakness, interruptions in the rhythm of the heart, dizziness, hypertension, and visual impairment may occur. In rare cases, an overdose of diuretics leads to hallucinations and collapse.

Diuretics during pregnancy and lactation

Swelling of the legs during pregnancy is becoming extremely common. In most cases, swelling of the legs can be observed already in the last months of gestation, when the weight of the uterus begins to compress the vena cava. Puffiness of the legs in a future mother should not be ignored, as this may indicate the presence of kidney failure or even the formation of histosis. In case the use special diet failed to bring the desired effect, it is necessary to prescribe natural or synthetic diuretics.

Diuretics during pregnancy during swelling of the legs and other parts of the body are contraindicated in most cases. Therefore, it is strictly forbidden to take them without an appointment. On the early dates pregnancy, diuretics of all groups are prohibited. At a later date, the appointment of diuretics is allowed, but with high caution. Taking medicines aimed at removing fluid from the body, a pregnant woman can put at risk not only herself, but also the child. Diuretics chosen in the wrong way or their dosage can lead to blood disorders, jaundice, kidney problems, visual and hearing impairment.

With swelling of the legs, it is also not recommended to get involved in folk diuretics at home, as they are also unsafe. When taking them, you should be extremely careful. Frequent use of renal preparations can lead to disturbances in electrolyte balance, having a direct impact on the subsequent development of pregnancy. For the period of bearing a child, women are advised to exclude juniper fruits, strawberries, parsley root from the diet. To the safest diuretics plant origin can be classified as an orthosiphon. He has soft action and its use is permissible during breastfeeding.

In a situation where it is not possible to do without the use of diuretics, doctors may prescribe combined means, for example, Kanefron. But you need to be careful when choosing tablets, since the drops contain alcohol. You can use the drug at almost any stage of pregnancy. Another phyto-remedy that is allowed to be used during pregnancy is Phytolysin. Assign its use in the absence acute inflammation in the kidneys.

Instead of diuretics, doctors may prescribe Eufillin in some cases. Despite the fact that the drug can be classified as a bronchodilator, it also has a diuretic effect. During breastfeeding, before prescribing the drug, the doctor must compare the need to use the drug and the presence possible risks. Euphyllin is contraindicated for women with heart problems, hypertension and epilepsy.

Popular diuretic drugs

Diuretic effective drugs, which affect the functioning of the renal tubules, do not allow sodium to penetrate back into the body and excrete it together with urine. Thiazide-like diuretics (Meticlothiazide, Bendroflumethiazide, Cyclomethiazide) contribute to the difficulty of absorption of not only sodium, but also chlorine. As a result of this action, they are also called saluretics (from English word salt).

Diuretics with an average efficiency (Hypothiazide) are mainly prescribed in the presence of kidney disease, heart failure and swelling. Especially often such a drug is prescribed in the form antihypertensive drug. The drug helps to eliminate excess sodium and lowers blood pressure.

In addition, diuretic drugs of average efficiency can enhance the effect of drugs for arterial hypertension. In the event that there is an appointment of more than high dosage such diuretics, there may be an increase in the excretion of fluid from the body without changes in blood pressure. Hypothiazide can be used for diabetes insipidus and the presence of stones. Active substances of such a drug prevent the formation of salt in the kidneys and reduce the concentration of calcium ions.

Arifon (Indapamide) differs from other diuretic drugs in its ability not only to remove excess fluid from the body, but also to expand blood vessels and relieve spasms. Furosemide or Lasix can be considered one of the most effective diuretics. With intravenous administration of such a drug, its action begins after 10 minutes. It has gained great popularity in left ventricular acute insufficiency accompanied by pulmonary edema, peripheral edema, arterial hypertension, to eliminate toxins. According to the proposed action, Uregit (ethacrynic acid) is similar to Lasix, but has a longer effect.

natural diuretics

Folk diuretics were used long before drugs were created. It is completely safe to use such drugs at home, although they are weaker in their action than artificial diuretics, but they have a mild effect.

If folk diuretics in decoctions are taken in the correct dosage, then they can be used long time without side effects. But even while taking funds at home, it is recommended to determine the causes of fluid retention in the body.

For example, with swelling and disorders in the work of the heart, it is recommended to drink a decoction of birch and strawberry leaves at home. Birch leaf compresses can be used in the presence of edema of the extremities. medicinal properties cranberries, shepherd's bag, tansy helps to cope with inflammation Bladder and kidneys. With edema, rose hips, flax seeds, orthosiphon, and bearberry are popular remedies. In the postoperative period, in order to prevent edema and with prolonged antibiotic treatment, it is recommended to drink rosehip tea.

Orthosiphon has become a traditional tea for the normalization of kidney function. It is able to have not only a diuretic effect, but also act as an anti-inflammatory agent and antispasmodic. In addition to herbs that have medicinal action and those capable of removing excess fluid from the body use pumpkin, melons, celery and parsley. As a substitute for a salad of greens in the presence of puffiness, you can make a salad of cucumber and dandelion leaves.

Diuretics are recommended to be taken with the utmost care, as they have a number of contraindications. If swelling and high blood pressure occur, it is recommended to consult a doctor. Do not self-medicate.

Excreted from the body with urine. But the effects of certain diseases, excess weight, intake medicines and disruption adversely affect urinary function. There are headaches, apathy, swelling due to a decrease in immunity. If the body itself cannot remove negative elements with urine, this will be noticeable by a change in well-being. In this case best remedy will become diuretic products that will help restore balance in the body.

Balanced diet

Before starting treatment, it is necessary to completely change the diet. Food should be rich in fiber, but it is better to exclude animal fats or reduce the amount of consumption to a minimum. Do not use a lot of salt and spices. Harmful chemicals, alcohol and tobacco should be avoided altogether.

During treatment, you need to know which products are diuretic, and which, on the contrary, contribute to stagnation harmful substances. In addition, with a diet, you need to additionally drink a lot of water per day, about 20 glasses. In this case, it is better to drink water, and coffee and tea of ​​strong infusion should be excluded.

Greens must be present in the diet - parsley, dill, celery, cumin, garlic, green onion and vegetables. These products do not have a diuretic effect, but they replace the lack of salt in the diet and supplement the body with microelements. positive impact salads with vegetables, which must be supplemented with berries - lingonberries, black currants or cranberries, have on the urinary system. The potassium they contain promotes rapid elimination excess fluid from the body.

Diuretic Products

Enough is always available a large number of fruits and vegetables. Of course, they all have their own, but the most diuretic foods are melon and watermelon. They effectively remove excess water from the body and help cleanse toxins. Known Enough watermelon diet, which allows you to clean the urinary system from sand and small stones.

Vegetable juices are considered excellent tool to remove liquid. For example, you can mix the juices of carrots, cucumbers and beets in equal proportions. According to the recommendations of nutritionists, you need to mix juices so that the body does not get used to specific product. Besides, more people do it beneficial vitamins.

Approximately a third of a glass is able to act as Only in this case the body is replenished with vitamins and there is no risk of side effects.

Diuretic Recipes

To remove excess fluid, you can prepare teas and cocktails, where products with a diuretic effect play the main role. For example, leaves horsetail and birch, brewed and infused, will be an excellent diuretic tea. At all, birch leaves are a means of removing fluid from the body. That is why there are so many recipes for making teas based on it.

But it is worth noting that you can use any herbs as diuretic products only after consultation with your doctor.

Fluid Withdrawal Tips

In fact, there are a lot of products that allow you to rid the body of excess fluid and toxins. You need to choose what suits the body, taking into account individual features.

Diuretic products:

1. pumpkin juice,
2. viburnum combined with honey,
3. cranberries with honey
4. chokeberry,
5. berry berries,
6. blackberry,
7. oat seeds,
8. dried apricots.

Everything listed products have a good diuretic effect. At the same time, they can be consumed fresh or frozen, as well as in the form of decoctions.

It is worth noting once again that all ongoing treatment should be under the strict supervision of a specialist.

Excess fluid in any body can lead to edema, which is clear sign the presence of any disease that needs to be diagnosed and treated as soon as possible. With edema, the doctor usually, in addition to the main treatment, prescribes diuretics, which are sold in excess in pharmacies, but more often advises taking folk diuretics at home, which are no worse at removing excess fluid from the body and for cleansing.

When to Take Diuretics

At home, you can prepare decoctions and infusions that can relieve swelling when various diseases. Indications for the use of diuretics are such diseases:

• Increased blood pressure.
• Pregnancy.
• Heart disease.
• Edema.
• Diseases of the kidneys.
• Obesity.
• Diseases of the gallbladder and liver.

Folk diuretics that can be used at home include not only decoctions and infusions from medicinal herbs, but also plain water, juices, berries, fruits.

Recipes for folk diuretics

Cranberry is considered a good diuretic of natural origin. In order to remove excess fluid from the body, you can use not only berries, but also leaves. Cranberry is a natural diuretic plant. Works great for inflammation of the kidneys. Not only removes liquid, but also removes inflammatory process. The berry can be used for hypertension and pregnancy.

• How to use cranberries

- Berries 2 tbsp. l.

— Water 200 ml.

- Sugar 30 gr.

Place the berries crushed with a blender in a saucepan. Pour in water and add sugar. Boil. Cool and drink several times a day.

Cranberry juice - very good drink which can be taken by pregnant women. It supplies vitamins to the body and removes excess fluid.

• Cowberry

One more useful berry which exhibits diuretic properties is lingonberries.

- Leaves and fruits of lingonberries 20 gr.

— Water 200 ml.

Place the fruits and leaves of lingonberries in a thermos and pour boiling water over it. Infuse for 1 hour, take a tablespoon three times before lunch, dinner and breakfast. This decoction is choleretic and diuretic. folk medicine, which helps with kidney disease, with edema.

• A good natural diuretic drink is a mixture of cranberries and lingonberries.

— Cranberry fruits 50 gr

— Cowberry fruits 50 gr.

Grind the berries and pour into a glass hot water. You can add honey to taste and drink three times a day.

• Strawberries are one of the tastiest homemade diuretics. In season, you can regularly eat this berry. Strawberries are a vitamin product, as a diuretic, it fights edema and.
• Watermelon is a very useful and effective diuretic product. With the help of watermelon, you can clean the kidneys and liver. During the ripening period, watermelon should be eaten as often as possible.
• Sweet cherry is very tasty fragrant and also medicinal berry.

Cherry compotes are an excellent diuretic, they can be used for various edema in hypertensive patients and pregnant women without fear of side effects.

— Cherry 100 gr.

— Water 500 ml.

Place the berries in boiling water, boil for five minutes. Cool and drink in the morning, afternoon and evening.

The drink cleanses the kidneys, is used for hypertension, heart disease.

diuretic juices

Juices, which are used in various combinations, also do an excellent job of removing excess fluid from the body.

• Birch sap expels salts, fights edema, is harmless during pregnancy, you need to drink it three times a day, 150 ml each.

• Cranberry and beetroot juice

— Cranberry juice 150 ml.

— beetroot juice 100 ml.

Mix fresh ingredients, take 50 ml.

• Pumpkin

Raw pumpkin has an excellent diuretic effect without irritating the walls of the stomach. The easiest way to drink it is in the form of juice. Every day, the juice should always be fresh, drink in small sips throughout the day, but not more than a glass a day.

Safe Diuretic Fruits and Herbs

• Rose hip

Gourds melon and watermelon, contributes to good digestion, lower blood pressure, normalize water metabolism in the body.

Cucumbers remove excess fluid, cleanse the body of toxins, toxins and other harmful accumulations. Cucumber juice is used as a diuretic.

Diuretic fruits that are used to remove excess fluid and relieve swelling are apricots, mangoes, cherries, raspberries, cranberries, viburnum, apples.

diuretic lemon

Lemon contains a large amount of vitamin C, which helps to remove excess fluid.

• The first way - lemon zest

Wash, dry and grind the zest of one lemon. Take half a teaspoon three times a day with big amount plain clean water.

• Second recipe

In equal proportions, you need to mix carrot, lemon and cucumber juices. Each need to take 100 ml. Drink the remedy three times a day, diluting warm water in half.

• The third way is a lemon with horseradish.

- Three lemons with zest.

- One medium-sized horseradish root.

Wash and grind all products in a meat grinder. Take the mixture for 14 days in a teaspoon twice a day before meals.

In any case, before self-administration of folk diuretics, it is recommended to consult with your doctor.