Diuretic dose schedules: is twice daily more effective? [letter]

Elliott, HL; Campbell, BC; Lawrence, J. R.

doi:10.1111/j.1365-2125.1981.tb01209.x

Cited by 4 publications

(1 citation statement)

References 3 publications

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“…Cohen et al found that in patients with severe heart failure, the natriuretic and diuretic effects are similar whether oral furosemide in tablet or solution form is administered in a once or twice-daily schedule [37]. Elliott et al reported that the diuretic effect is probably governed by the total daily dosage of loop diuretic and the total amount reaching the tubular lumen, and is not significantly influenced by different schedules of dose administration [38]. Anisman et al found that loop diuretics respond in an all-or-none fashion.…”

Section: Deprescribing Case Studiesmentioning

confidence: 99%

Person-Centred Care Including Deprescribing for Older People

et al. 2019

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There is concern internationally that many older people are using an inappropriate number of medicines, and that complex combinations of medicines may cause more harm than good. This article discusses how person-centred medicines optimisation for older people can be conducted in clinical practice, including the process of deprescribing. The evidence supports that if clinicians actively include people in decision making, it leads to better outcomes. We share techniques, frameworks, and tools that can be used to deprescribe safely whilst placing the person’s views, values, and beliefs about their medicines at the heart of any deprescribing discussions. This includes the person-centred approach to deprescribing (seven steps), which incorporates the identification of the person’s priorities and the clinician’s priorities in relation to treatment with medication and promotes shared decision making, agreed goals, good communication, and follow up. The authors believe that delivering deprescribing consultations in this manner is effective, as the person is integral to the deprescribing decision-making process, and we illustrate how this approach can be applied in real-life case studies.

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Section: Deprescribing Case Studiesmentioning

confidence: 99%

Person-Centred Care Including Deprescribing for Older People

et al. 2019

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Piretanide: A Loop‐Active Diuretic

Marsh

Smith

1984

Pharmacotherapy

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Piretanide is a high-ceiling, loop-active diuretic that has been developed for treatment of congestive heart failure, hypertension and edematous states caused by renal and hepatic diseases. Piretanide is structurally related to furosemide and bumetanide; when administered orally, 6 mg of piretanide is as effective as 40 mg of furosemide, and when administered intravenously, 12 mg of piretanide is as effective as 40 mg of furosemide. Piretanide enhances water and sodium excretion in patients with congestive heart failure, with nephrotic syndrome and with cirrhosis and ascites. Adverse effects reported to date are limited to those attributable to excess loss of fluid and electrolytes. Under some conditions, piretanide appears to be less potassium wasting than thiazide diuretics or other loop-active diuretics.

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Diuretic induced hypokalaemia: relationship to dosage interval and plasma aldosterone.

McInnes¹,

Shelton²,

Harrison³

et al. 1982

Brit J Clinical Pharma

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Plasma potassium and aldosterone responses to 9 days treatment with hydrochlorothiazide (100 mg/ day) alone or in combination with spironolactone (100 mg/day), prescribed once daily or in doses 12 h apart, were examined in a double-blind, crossover study in twelve healthy subjects. Plasma potassium concentrations were lower when the drugs were administered 12 h apart (P < 0.01). Spironolactone attenuated significantly hydrochlorothiazide induced hypokalaemia-mean rise in plasma potassium, 0.36 mmol/l (P < 0.001). The increase in plasma aldosterone was greater following combination therapies (P < 0.001), but there were no significant differences between once daily and twice daily regimens. We conclude that plasma potassium concentration is better maintained when diuretics are given once daily and that this is not related closely to differences in plasma aldosterone responses.

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Diuretic dose schedules: is twice daily more effective? [letter]

Cited by 4 publications

References 3 publications

Person-Centred Care Including Deprescribing for Older People

Person-Centred Care Including Deprescribing for Older People

Piretanide: A Loop‐Active Diuretic

Diuretic induced hypokalaemia: relationship to dosage interval and plasma aldosterone.

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