Details

Autor(en) / Beteiligte

• SWANEPOEL, C. R

Titel

Which diuretic to use ?

Ist Teil von

• Cardiovascular drugs and therapy, 1994-02, Vol.8 (1), p.123-128

Ort / Verlag

Dordrecht: Springer

Erscheinungsjahr

1994

Quelle

SpringerLINK Contemporary (Konsortium Baden-Württemberg)

Beschreibungen/Notizen

• The choice of a diuretic depends on knowledge of its efficacy in different disease states as well as the complications associated with its use. However, efficacy of the various diuretic agents as determined in healthy subjects may not always be applicable to the sick patient. The thiazide group appears to be the main offender with regard to hypokalemia and metabolic upsets; these complications seem to stem from long-term use and high dosages. Interest has been expressed on the influence of diuretic induced hypokalemia (and intracellular potassium deficiency) in inducing insulin resistance. The lipid abnormalities may arise as a result of this resistance or may be consequent on hyperinsulinemia from other as yet undetermined mechanisms. In addition, hypertension per se may be associated with insulin resistance. It is interesting to speculate that diuretics, which are commonly used in the treatment of hypertension, may, in some way, perhaps via the induction of hypokalemia, unmask this resistance.