The use of diuretics in acute heart failure: Evidence based therapy?

Vazir, Ali; Cowie, Martin

doi:10.4236/wjcd.2013.32a004

Cited by 8 publications

(7 citation statements)

References 58 publications

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“…At present, while some advocate the use of higher dose aldosterone antagonist diuretics (12) and the use of phosphodiesterase type 5 inhibitors to augment diuresis (13), more work is needed to determine therapeutic targets and optimal strategies for these patients.…”

Section: Discussionmentioning

confidence: 99%

Unanswered Questions in Contemporary Heart Failure

Gilstrap

Snipelisky

AbouEzzeddine

et al. 2017

Journal of Cardiac Failure

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Background The epidemiology of heart failure (HF) is changing. This study aims to describe questions that arise during the routine care of heart failure (HF) patients that are unanswered by the current literature and describe how the type and focus of these questions has changed over time. Methods Investigators from the NHLBI-sponsored Heart Failure Apprentice Network collected and categorized questions from 5 academic hospitals over 12 months. A total of 174 unanswered questions were collected and analyzed. Results As compared to 2004, there were more unanswered questions about “whether” to use therapies and fewer about “how” to use therapies. There were fewer questions about what therapeutic targets, therapy adjustment and combination therapies. There were more questions about whether or how to stop therapies and how to add therapies back. Newly prominent topics, not observed in 2004, including novel therapeutics, refractory ventricular tachycardia, right heart failure and nutrition/frailty accounted for 24% of questions. Conclusions As compared to 2004, there are fewer unanswered questions about how to use, adjust and combine therapies. There were more unanswered questions about whether and how to stop therapies. Almost 25% of unanswered questions dealt with topics indicative of more advanced disease, not observed in 2004.

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Section: Discussionmentioning

confidence: 99%

Unanswered Questions in Contemporary Heart Failure

Gilstrap

Snipelisky

AbouEzzeddine

et al. 2017

Journal of Cardiac Failure

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“…Therefore, herbal medicines are employed to tackle edematous condition such as such as cardiac failure, cirrhosis, and nephritic syndrome that lead to fluid overload in the body. 3 With currently available conventional drugs, several adverse effects are associated. For example loop and thiazide diuretics cause electrolyte abnormalities (hypokalemia, hyperuricemia and hyponatremia), acid base balance, metabolic abnormalities and acute hypovolemia.…”

Section: Introductionmentioning

confidence: 99%

<p>Evaluation of the Diuretic Activity of the Aqueous and 80% Methanol Extracts of <em>Ficus sur</em> Forssk (Moraceae) Leaves in Saline-loaded Rats</p>

Ayele¹,

Makonnen²,

Ayele³

et al. 2020

JEP

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Background Although investigations on different pharmacological activities of the experimental plant, Ficus sur have been conducted, its folklore use for diuresis has not yet been validated. The current study, therefore, focused on the diuretic activity of aqueous and 80% methanol extracts of F. sur Forssk. leaves in rats. Methods Rats were randomly assigned into eight groups each consisting of six rats. Test groups received either 100 mg/kg, 200 mg/kg, or 400 mg/kg of aqueous or 80% methanol leaves extract. The negative control group and positive control were treated with 2 mL/100 g of distilled water and furosemide (10 mg/kg), respectively. Thereafter urine volume was recorded every hour until the end of the fifth hour, and cumulative urine volume of each rat was measured. Then, diuretic activity, diuretic index, saliuretic index, natriuretic index and carbonic anhydrase inhibition index in each group were calculated, and results were compared among the groups. Results The middle (200 mg/kg) and the highest (400 mg/kg) doses of both extracts significantly increased diuresis at the fifth hour ( p <0.001) compared to the negative control, although the diuretic activity was less than that of the positive control. Regarding electrolyte excretion, all dose levels of both extracts showed significant natriuresis ( p <0.001) and chloriuresis ( p <0.01) compared to the negative control. Aqueous extract displayed more significant diuretic effect than 80% methanol extract. The aqueous and 80% methanol extracts produced alkaline urine. Conclusion The crude leaves extracts of F. sur increased urinary excretion and concentration of urinary electrolytes in a dose-dependent manner. These findings are in agreement with the traditional claim for use of F. sur as diuretic agent.

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“…Therapeutic strategies to control fluid balance, and shift of fluid out of the interstitium, lead to significant symptomatic relief, and improved health-related with the quality of life [5]. Medicinal plants contain known and unknown important medicinal chemical substances.…”

Section: Introductionmentioning

confidence: 99%

DIURETIC ACTIVITY OF MATOA LEAVES EXTRACTS (Pometiapinnata) AND ITS INFLUENCE ON POTASSIUM AND SODIUM LEVELS

Purwidyaningrum

Sukandar

Fidrianny

2017

Asian J Pharm Clin Res

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Objective: The goal of this research were to determine diuretic activity of matoa leaves (Pometia pinnata J.R. Forster & J.G Forster) extracts and fractions and its influence on potassium and sodium levels.Methods: Matoa leaves were extracted by reflux method followed by evaporation using rotary evaporator. The subjects were male Wistar rats that were divided into 11 groups: Furosemide (3.6 mg/kg bw); control group carboxymethylcellulose 0.5%; matoa leaves extracts with doses of 50 mg/kg bw, 100 mg/kg bw, and 150 mg/kg bw; matoa leaves aqueous fraction with dose of 10.94 mg/kg bw, 21.88 mg/kg bw, and 32.82 mg/kg bw; matoa leaves ethyl acetate fraction (MEF) with dose of 4.35 mg/kg bw, 8.71 mg/kg bw, and 13.06 mg/kg bw. Rats were placed in metabolic cages during an observation study. Urine volume was measured for 5-24 hrs. Potassium and sodium levels in urine were determined using atomic absorption spectrophotometry. Results:The effective dose of matoa leaves extract and fractions for diuretic activity was matoa leaves MEF 8.71 mg/kg bw which could increase the excretion of sodium and potassium in the urine of the male Wistar rats. Conclusion:Matoa leaves extract and fractions could increase the excretion of sodium and potassium in the urine of the male Wistar rats.

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The use of diuretics in acute heart failure: Evidence based therapy?

Cited by 8 publications

References 58 publications

Unanswered Questions in Contemporary Heart Failure

Unanswered Questions in Contemporary Heart Failure

<p>Evaluation of the Diuretic Activity of the Aqueous and 80% Methanol Extracts of <em>Ficus sur</em> Forssk (Moraceae) Leaves in Saline-loaded Rats</p>

DIURETIC ACTIVITY OF MATOA LEAVES EXTRACTS (Pometiapinnata) AND ITS INFLUENCE ON POTASSIUM AND SODIUM LEVELS

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