When you hear the words Alzheimer's disease, what do you think of? The truth is, the picture most of us have of the disease is incomplete. Alzheimer's disease doesn't start when someone starts to lose their memory. It actually starts years – sometimes decades – earlier. The Rethinking Alzheimer's Disease Podcast is an engaging, narrative-style podcast miniseries for those curious or motivated to learn about Alzheimer’s disease. Perhaps you have a family member with Alzheimer’s disease, or ca ...
…
continue reading
Content provided by Sean P. Kane, PharmD, BCPS, Sean P. Kane, and PharmD; Khyati Patel. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Sean P. Kane, PharmD, BCPS, Sean P. Kane, and PharmD; Khyati Patel or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://podcastplayer.com/legal.
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183 - The Ultimate Guide to Loop Diuretics: An In-Depth Drug Class Review
Manage episode 426075287 series 2391262
Content provided by Sean P. Kane, PharmD, BCPS, Sean P. Kane, and PharmD; Khyati Patel. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Sean P. Kane, PharmD, BCPS, Sean P. Kane, and PharmD; Khyati Patel or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://podcastplayer.com/legal.
In this episode, we review the pharmacology, pharmacokinetics, adverse effects, monitoring, medicinal chemistry, and more of loop diuretics.
Key Concepts
- Loop diuretics (furosemide, torsemide, bumetanide, ethacrynic acid) are the most potent type of diuretic and are used to relieve edema.
- Loop diuretics cause an increased loss of sodium, chloride, potassium, hydrogen, magnesium, and calcium ions into the urine. Excessive loss of these ions manifests as hypokalemia, hypomagnesemia, and metabolic alkalosis.
- Loop diuretics have an S-shaped dose response curve – a minimum dose is required for diuresis and a “ceiling” effect occurs at higher doses (leading to more ADRs). Doses should be individualized based on the clinical response of the patient.
- Ethacrynic acid is incorrectly used in patients with a “sulfa” allergy. The other loop diuretics contain a sulfa moiety but are safe for use in patients with “sulfa” allergy (e.g. allergy to sulfamethoxazole-trimethoprim).
- The TRANSFORM-HF trial strongly suggests that there is no clinical difference between furosemide and torsemide.
References
- Rachoin JS, Cerceo EA. Four nephrology myths debunked. J Hosp Med. 2011;6(5):E1-E5. doi:10.1002/jhm.703
- Strom BL, Schinnar R, Apter AJ, et al. Absence of cross-reactivity between sulfonamide antibiotics and sulfonamide nonantibiotics. N Engl J Med. 2003;349(17):1628-1635. doi:10.1056/NEJMoa022963
- Buggey J, Mentz RJ, Pitt B, et al. A reappraisal of loop diuretic choice in heart failure patients. Am Heart J. 2015;169(3):323-333. doi:10.1016/j.ahj.2014.12.009
- Mentz RJ, Anstrom KJ, Eisenstein EL, et al. Effect of Torsemide vs Furosemide After Discharge on All-Cause Mortality in Patients Hospitalized With Heart Failure: The TRANSFORM-HF Randomized Clinical Trial. JAMA. 2023;329(3):214-223. doi:10.1001/jama.2022.23924
207 episodes
183 - The Ultimate Guide to Loop Diuretics: An In-Depth Drug Class Review
HelixTalk - Rosalind Franklin University's College of Pharmacy Podcast
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Manage episode 426075287 series 2391262
Content provided by Sean P. Kane, PharmD, BCPS, Sean P. Kane, and PharmD; Khyati Patel. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Sean P. Kane, PharmD, BCPS, Sean P. Kane, and PharmD; Khyati Patel or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://podcastplayer.com/legal.
In this episode, we review the pharmacology, pharmacokinetics, adverse effects, monitoring, medicinal chemistry, and more of loop diuretics.
Key Concepts
- Loop diuretics (furosemide, torsemide, bumetanide, ethacrynic acid) are the most potent type of diuretic and are used to relieve edema.
- Loop diuretics cause an increased loss of sodium, chloride, potassium, hydrogen, magnesium, and calcium ions into the urine. Excessive loss of these ions manifests as hypokalemia, hypomagnesemia, and metabolic alkalosis.
- Loop diuretics have an S-shaped dose response curve – a minimum dose is required for diuresis and a “ceiling” effect occurs at higher doses (leading to more ADRs). Doses should be individualized based on the clinical response of the patient.
- Ethacrynic acid is incorrectly used in patients with a “sulfa” allergy. The other loop diuretics contain a sulfa moiety but are safe for use in patients with “sulfa” allergy (e.g. allergy to sulfamethoxazole-trimethoprim).
- The TRANSFORM-HF trial strongly suggests that there is no clinical difference between furosemide and torsemide.
References
- Rachoin JS, Cerceo EA. Four nephrology myths debunked. J Hosp Med. 2011;6(5):E1-E5. doi:10.1002/jhm.703
- Strom BL, Schinnar R, Apter AJ, et al. Absence of cross-reactivity between sulfonamide antibiotics and sulfonamide nonantibiotics. N Engl J Med. 2003;349(17):1628-1635. doi:10.1056/NEJMoa022963
- Buggey J, Mentz RJ, Pitt B, et al. A reappraisal of loop diuretic choice in heart failure patients. Am Heart J. 2015;169(3):323-333. doi:10.1016/j.ahj.2014.12.009
- Mentz RJ, Anstrom KJ, Eisenstein EL, et al. Effect of Torsemide vs Furosemide After Discharge on All-Cause Mortality in Patients Hospitalized With Heart Failure: The TRANSFORM-HF Randomized Clinical Trial. JAMA. 2023;329(3):214-223. doi:10.1001/jama.2022.23924
207 episodes
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Similar to HelixTalk - Rosalind Franklin University's College of Pharmacy Podcast
When you hear the words Alzheimer's disease, what do you think of? The truth is, the picture most of us have of the disease is incomplete. Alzheimer's disease doesn't start when someone starts to lose their memory. It actually starts years – sometimes decades – earlier. The Rethinking Alzheimer's Disease Podcast is an engaging, narrative-style podcast miniseries for those curious or motivated to learn about Alzheimer’s disease. Perhaps you have a family member with Alzheimer’s disease, or ca ...
…
continue reading
The BMJ brings you interviews with the people who are shaping medicine and science around the world.
…
continue reading
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…
continue reading
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continue reading
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…
continue reading
Concise summaries of everything published in the latest weekly issue of the New England Journal of Medicine (NEJM). NEJM publishes new medical research findings, review articles, and editorial opinion on topics of importance to biomedical science and clinical practice.
…
continue reading
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…
continue reading
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continue reading
Learn something new every day! Everything Everywhere Daily is a daily podcast for Intellectually Curious People. Host Gary Arndt tells the stories of interesting people, places, and things from around the world and throughout history. Gary is an accomplished world traveler, travel photographer, and polymath. Topics covered include history, science, mathematics, anthropology, archeology, geography, and culture. Past history episodes have dealt with ancient Rome, Phoenicia, Persia, Greece, Chi ...
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continue reading
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