Correction of Diuretic-Induced Hypokalemia and Hyperuricemia

Rj, Sperber; Fisch, Solomon; Ac, Degraff; Rr, Freudenthal

doi:10.1097/00000441-196503000-00003

Cited by 14 publications

(6 citation statements)

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“…In dogs insulin seems necessary for the transfer of excess infused potassium into intracellular fluid (Hiath et al, 1974). Potassium supplements are not needed when these drugs are used in combination with thiazide diuretics, but the serum potassium should still be checked since hypokalaemia may also occur (Sperber et al, 1965). Journal 41: 193-196 (1965).…”

Section: Amiloride and Triamterenementioning

confidence: 99%

Diuretics

Davies

Wilson

1975

Drugs

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Despite the bewildering number of diuretics available to the physician, these drugs can be divided into 4 main groups, characterised by their site of action on sodium reabsorption in the kidney. Drugs acting on the ascending limb of the loop of Henle have a powerful but short acting diuretic effect; they include frusemide, ethacrynic acid and bumetanide. The benzothiadiazines and related compounds have a moderate diuretic action spread over a longer period, whilst the potassium-sparing diuretics, triamterene, amiloride and spironolactone, have only a weak diuretic effect but a marked ability to diminish urinary potassium excretion. The fourth group is made up of miscellaneous substances which function as vasodilator or osmotic agents. The pathogenesis of oedema formation in heart failure is outlined and a logical approach to treatment suggested. Duiretics are being increasingly used in the treatment of non-oedematous states, in particular hypertension, diabetes insipidus and hypercalciuria; their exact role in pregnancy and acute renal failure remains controversial. Side-effects can be related to their effect on electrolyte excretion and include hypokalaemia, hyponatraemia, hyperkalaemia and hyperuricaemia. The incidence of disturbed carbohydrate tolerance in previously normal individuals is low. Other less common side-effects are also discussed.

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Section: Amiloride and Triamterenementioning

confidence: 99%

Diuretics

Davies

Wilson

1975

Drugs

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“…One reason for investigating a combination of triamterene and hydrochlorothiazide was the early observation in animal (13) and clinical (14) studies that the potassium‐conserving activity of triamterene decreased or eliminated the urinary potassium‐wasting and the hypokalemia associated with thiazide therapy (4). Further studies (15–17) confirmed these observations and showed that a better potassium balance is achieved when these two agents are employed together rather than singly. Clinical studies also showed that triamterene modifies other actions of hydrochlorothiazide; these include a reduction in urinary acidification, enhancement of the natruretic effect, and a decrease in the tendency toward hypochloremic alkalosis (15, 16).…”

mentioning

confidence: 76%

“…Gifford (18) reported that hypokalemia (>3.5 mEq/L) develops in 40 per cent of patients receiving hydrochlorothiazide or chlorothiazide alone with no potassium supplementation. Sperber et al (17) reported that the incidence of hypokalemia during treatment with hydrochlorothiazide alone was 25 per cent, whereas during treatment with a combination of triamterene (25 mg) and hydrochlorothiazide (25 mg) it was only 11 per cent. In the patients of the present report, 189 had normal pretreatment serum potassium levels.…”

Section: Discussionmentioning

confidence: 99%

Use of a Diuretic Combination of Triamterene and Hydrochlorothiazide in Elderly Patients

Bender¹,

Carter²,

Hansen³

1967

J American Geriatrics Society

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“…(13,14) Oral supplements of potassium chloride given with diuretics to counteract potassium loss have disadvantages (2,3). The difficulties associated with the use of potassium supplements in situations where there is a risk of hypokalemia can be overcome by giving potassium-sparing diuretics such as amiloride in combination with diuretics which cause kaliuresis.…”

mentioning

confidence: 99%

Effects of Hydrochlorothiazide and Amiloride on Potassium Distribution in Skeletal Muscle of the Rat

Jukes¹,

Goulding²,

Irvine³

1973

Pharmacology

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To study the effect of diuretics on K⁺ distribution in skeletal muscle, rats were fed hydrochlorothiazide (HC) 20 mg/kg/day, amiloride (AM) 5 mg/kg/day, or HC (10 mg/kg/day) and AM (5 mg/kg/day) combined, for 4 weeks. When compared with controls the rats fed HC showed a fall of K⁺ concentration in extracellular water and a rise in the K⁺ gradient across the skeletal muscle cell membrane. These changes were not seen in rats fed AM, and where the animals were given HC and AM together there was a rise in the intracellular concentration of K⁺ but no change in the K⁺ gradient. AM and HC in combination caused a greater natriuresis than either diuretic alone.

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Correction of Diuretic-Induced Hypokalemia and Hyperuricemia

Cited by 14 publications

References 0 publications

Diuretics

Diuretics

Use of a Diuretic Combination of Triamterene and Hydrochlorothiazide in Elderly Patients

Effects of Hydrochlorothiazide and Amiloride on Potassium Distribution in Skeletal Muscle of the Rat

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