Loop Diuretics in Clinical Practice

Diuretics are commonly used to control edema across various clinical fields. Diuretics inhibit sodium reabsorption in specific renal tubules, resulting in increased urinary sodium and water excretion. Loop diuretics are the most potent diuretics. In this article, we review five important aspects of loop diuretics, in particular furosemide, which must be considered when prescribing this medicine: (1) oral versus intravenous treatment, (2) dosage, (3) continuous versus bolus infusion, (4) application in chronic kidney disease patients, and (5) side effects. The bioavailability of furosemide differs between oral and intravenous therapy. Additionally, the threshold and ceiling doses of furosemide differ according to the particular clinical condition of the patient, for example in patients with severe edema or chronic kidney disease. To maximize the efficiency of furosemide, a clear understanding of how the mode of delivery will impact bioavailability and the required dosage is necessary.

Torsemide: A New Loop Diuretic.

Loop diuretics are often administered to hospitalized patients to augment urinary output. They play an essential role in the treatment of fluid overload in patients of congestive heart failure and chronic renal failure. Torsemide is a new loop diuretic that has revolutionized the therapy of fluid overload disorders. Torsemide has a higher bioavailability, greater potency and longer duration of action than frusemide. Torsemide causes significantly greater diuresis, natriuresis, lesser kaluresis, greater reduction in body weight and improvement in edema and ascites as compared to frusemide.