Oh Se Won, Han Sang Youb
Department of Internal Medicine, Inje University College of Medicine, Goyang, Korea.
Electrolyte Blood Press. 2015 Jun;13(1):17-21. doi: 10.5049/EBP.2015.13.1.17. Epub 2015 Jun 30.
Diuretics are commonly used to control edema across various clinical fields. Diuretics inhibit sodium reabsorption in specific renal tubules, resulting in increased urinary sodium and water excretion. Loop diuretics are the most potent diuretics. In this article, we review five important aspects of loop diuretics, in particular furosemide, which must be considered when prescribing this medicine: (1) oral versus intravenous treatment, (2) dosage, (3) continuous versus bolus infusion, (4) application in chronic kidney disease patients, and (5) side effects. The bioavailability of furosemide differs between oral and intravenous therapy. Additionally, the threshold and ceiling doses of furosemide differ according to the particular clinical condition of the patient, for example in patients with severe edema or chronic kidney disease. To maximize the efficiency of furosemide, a clear understanding of how the mode of delivery will impact bioavailability and the required dosage is necessary.
利尿剂在各个临床领域中普遍用于控制水肿。利尿剂抑制特定肾小管中的钠重吸收,从而导致尿钠和水排泄增加。袢利尿剂是最强效的利尿剂。在本文中,我们回顾了袢利尿剂(尤其是呋塞米)在开药时必须考虑的五个重要方面:(1)口服与静脉治疗,(2)剂量,(3)持续输注与大剂量推注,(4)在慢性肾脏病患者中的应用,以及(5)副作用。呋塞米的生物利用度在口服和静脉治疗之间有所不同。此外,呋塞米的阈剂量和最大剂量根据患者的具体临床情况而有所不同,例如重度水肿或慢性肾脏病患者。为了使呋塞米的疗效最大化,有必要清楚了解给药方式将如何影响生物利用度和所需剂量。