Maria Cristina Constantinescu *
* Maria Cristina Constantinescu – asistent universitar, Catedra de Farmacologie, Facultatea de Medicină, UMF “Carol Davila”, București
Abstract
In most patients with renal, hepatic or cardiac disease using the appropriate diuretic therapy can attain an effective diuresis. The diuretic strategy is different according to the type of disease, because each type affects the metabolism and action of different diuretics in different ways. A patient with renal insufficiency should be given increasing doses of a loop diuretic until an effective dose is identified, and should be given as often as necessary to maintain the response. If the response is inadequate, a thiazide should be given. Spironolactone is the mainstay of diuretic therapy in patients with cirrhosis, associated with a thiazide diuretic and/or a loop diuretic. For the patients with congestive heart failure the loop diuretics are the mainstay,in moderate doses, given more often than in other patients. The addition of a thiazide or of an antialdosteronic diuretic may increase diuresis.