Unable to load your collection due to an error Epub 2017 Sep 15. However, interesting alternatives and adjunctive therapies are now available, including:This article, the first in a 2-part series, discusses torsemide, while the second article will address spironolactone.Loop diuretics, in general, exemplify the phrase “double-edged sword”: They are typically necessary—often lifesaving—yet are invariably harmful in some respects, particularly with long-term use (Loop diuretics are pyridine-3-sulfonurea drugs that act on the thick portion of the nephron’s ascending loop of Henle, where they inhibit the sodium–potassium–chloride (Na+–K+–2Cl–) cotransporter, leaving sodium (and other ions) to be lost, with water, in the urine.For nearly 50 years, furosemide has been a workhorse for cardiologists and internists. Copyright Â© 2012. It also confers an anti-aldosterone effect, similar to spironolactone (potassium-sparing diuretic), which may reduce diuretic resistance and myocardial fibrosis. Be … However, negative effects are associated with any potent diuretic (FIGURE 1. Urinary furosemide levels, of course, depend on the plasma concentration delivered to, and filtered by, the glomerulus, which, in turn, is affected by furosemide bioavailability. Almost: Both these medications are loop diuretics. The loop diuretic torsemide has several characteristics that make it suitable for treatment of advanced heart failure including longer half-life, increased potency of diuretic action, and anti-aldosterone effects. The IV form is only given by a healthcare provider. 2009 Jun;53(6):435-7. doi: 10.1097/FJC.0b013e3181a71a78.Congest Heart Fail.
Stay connected and sign up for our newsletter. Please enable it to take advantage of the complete set of features! Thus, torsemide produces a longer-lasting, and more powerful diuretic action. She did not have any issues before the furosemide. 1 Of these, loop diuretics—furosemide, bumetanide, and torsemide—are the most potent and commonly used diuretics.
We tried reducing the dosage per our vet's recommendation but she's still urinating frequently in the house no matter how often we take her out. As shown in this figure, administering the same dosage 3 times triples the time in the effective range and avoids the risk for toxicity.FIGURE 6. A 39-year-old member asked: Does Lasix (furosemide) work the same as torsemide? She has been having urinary incontinence as a result of the furosemide.
Diuresis occurs when urine levels of furosemide are within the therapeutic range.
A better approach, although problematic in terms of owner compliance, is to administer multiple doses throughout the day. We are reluctant to speculate from the human dosage because of the apparent differences between species with regard to administration of oral torsemide.Currently, torsemide is used most often as a rescue agent when furosemide (usually with standard CHF drugs, including hydrochlorothiazide and spironolactone) no longer adequately controls signs of congestion (One author considers using torsemide when the furosemide response is inadequate at a furosemide dosage of 4 mg/kg Q 24 H or greater.Alternatively, with twice daily furosemide therapy, torsemide could be added as the third diuretic dose of the day. Torsemide advantages over Furosemide .
1995 Apr;29(4):396-402. doi: 10.1177/106002809502900411.Drugs.