Study of the prevalence of sodium and potassium disturbances in the elderly

Background: Electrolyte disturbances establish a broad problem among old individuals. A medication adverse effect that in youngsters would deliver just a trifling change in the plasma sodium and potassium may cause a major serious effect in the older, mostly because of aging. This study was directed to assess the commonness of sodium and potassium disturbances in the old. Methods: A Cross-sectional study was completed among old patients who were regular visitors to Internal Medicine Department outpatient clinics of the Zagazig University from February 2018 to February 2019. This examination included 100 older patients. Results: Our examination revealed the predominance of hypokalemia was 17% and hyperkalemia was 25%. While hyponatremia was 32% and hypernatremia was 4%. Diuretics were the most affecting medication on potassium and sodium levels. No significant difference was found in age among potassium and sodium gatherings. Conclusion: In this study, we found that disturbances in the sodium and potassium are commonly found in the old and a few sorts of medications are assosciated with these disturbances however diuretics were the most commonly to be found. Different components, including polypharmacy , disabled organ work and numerous ailments, put them at a more serious danger of medication induced changes in electrolyte homeostasis. Specialists should know about this hazard and screen both medication records and sodium and potassium levels ,so as to counteract and deal with these disturbances that may some way or another further affect the health of these old and frail patients

Activite diuretique et salidiuretique d'une recette utilisee en medecine traditionnelle pour le traitement de l'hypertension arterielle

"Notre etude sur le traitement traditionnel de l'hypertension a porte sur la recette Nitrokoudang a base de Sclerocarya birrea et Vitex doniana. L'etude phytochimique par les reactions de caracterisation en tube et la chromatographie sur couche mince a permis de mettre en evidence des tanins; des flavonoides; des leucoanthocyanes; des oses et holosides. L'infuse a presente un grand nombre de substances anti-radical 1;1'diphenyl-2 picryhydrazyle (DPPH); ce qui presage un potentiel antioxydant de la recette; ceci est important dans la prise en charge de l'hypertension arterielle. Les extraits aqueux de la recette ont presente une activite diuretique dose dependante. L'infuse extemporane; prepare selon les indications du tradipraticien de sante; a presente le meilleur effet diuretique avec une excretion urinaire volumetrique de 170; le Furosemide a la dose de 20mg/kg; a presente 184. Chez les animaux traites par la recette; l'elimination du sodium a ete importante et le potassium a ete epargne. L'activite salidiuretique de l'infuse extemporanee a ete de 2 contre 2;62 pour le Furosemide et de 0;90 chez les souris traitees avec l'eau distillee. Ces proprietes de la recette ""Nitrokoudang"" justifient son utilisation dans la prise en charge de l'hypertension arterielle."

Pharmacotherapy for Chronic Heart Failure

Background : Heart failure is a chronic and progressive disorder which results due to inability of the heart to pump adequate blood to meet up the metabolic demands of the body. Detecting patients with heart failure could be simple but rather complex of clinical decisions as presentation could be classical or non-specific with minimal symptoms and or signs. Management is aimed at relieving symptoms; improving quality of life; preventing hospitalisation and arresting disease progression thus prolonging survival. In addition to pharmacologic measures; non-pharmacologic ones are also employed. Method : Relevant literature was reviewed using medical journals and also via internet. The key words employed were: Heart failure; Chronic heart failure; Diuretics; Vasodilators; Angiotensin receptor blockers (ARBS) and Angiotensin converting enzyme inhibitors (ACEI). The National Heart; Lung and Blood Institute; Canadian Cardiovascular Society; American College of Cardiology websites were also used in the course of this review. Results: This review was able to support the use of beta- blockers; ACEI; ARBS; digitalis; diuretics; vasodilators and aldosterone antagonists in the management of chronic heart failure. Conclusion : The objectives of drug therapy in heart failure includes the short-term goals of stabilising the patient; improving haemodynamic function and conferring symptomatic improvement; as well as the long-term goal of limiting disease progression; decreasing hospital re-admission rates and improving survival. The cause needs to be established and aggravating factors identified (and where possible treated). Most of the drugs; if not all; are used in combination with one another to achieve maximal therapeutic goal. Use of some drugs could be entertained as an add-on therapy depending on any co-existing medical condition.1

Mieux prescrire les diuretiques

Les diuretiques sont des medicaments couramment utilises en pratique clinique quotidienne. Bien que rarement utilises en automedication; une meilleure connaissance des risques et des benefices lies a ces medicaments peut permettre de mieux les utiliser en fonction de la situation clinique du patient

"Prevention and Treatment of Acute Renal Failure Using Diuretis and ? or Low (""renal"") Dose of Dopamine : a Critical Review"

The currently available evidence suggest that diuretics and/or low dose dopamine increases renal blood flow (RBF); glomerular filtration rate (GFR) and natriuresis in experimental animals; and limits ATP utilisation and oxygen needs in nephron segments at high risk of ischaemic injury; actions that could potentially limit renal injury and accelerate recovery in acute renal failure (ARF). These effects have indeed been confirmed in most experimental animals while using mannitol or low dose dopanime. Frusemide; however; for unknown reasons; has been effective in some animal models; but not others. In humans; it can be said that diurectics have a limited value to prevent; reverse or speed recovery from acute renal failure. Most clinical studies have failed to demonstrate convincingly that low dose dopamine either prevents ARF in high risk patients or improves renal function or outcome in patients with established ARF. This confusing scenario is further complicated by the fact that both diuretics and low dose dopamine can result in severe metabolic and cardiovascular complications in critically ill patients