Discussing Pharmacology Diuretics

Discussing Pharmacology Diuretics
The Chosen Article
Burnier, M., Bakris, G., & Williams, B. (2019). Redefining diuretics use in hypertension: why select a thiazide-like diuretic?. Journal of hypertension, 37(8), 1574–1586. https://doi.org/10.1097/HJH.0000000000002088

Brief Synopsis of the Article

Burnier et al. (2019) say that diuretics are one of the first-line treatments for high blood pressure in many recommendations. But there are big changes in how safe and effective the different diuretics are. Because of this, the non-thiazide diuretics and the thiazide-like diuretics are now being treated differently. The main goal of the study is to show that diuretics are still an important part of treating high blood pressure with drugs. It also talks about who can benefit from diuretics and what the main differences are between thiazide-like diuretics and thiazide diuretics.

Different groups of people are said to gain from diuretics in the article. For example, people with high blood pressure and type 2 diabetes may gain more from diuretics because they are more likely to get too much fluid in their bodies and have heart failure. Diuretics are also helpful for people who are over 65 years old. The known data support the use of diuretics, especially indapamide, to treat high blood pressure in older people. Indapamide has been shown to be very helpful in a number of clinical trials.When used together, indapamide and angiotensin-converting enzyme inhibitor are very helpful for people who have had a stroke in the past. This is based on tests that were done with just a fake. Burnier et al. shows that people of African and Caribbean descent and those with salt-sensitive high blood pressure also benefit from diuretics. (2019).

The piece also talks about why thiazide-like diuretics are better than thiazide diuretics. Several standards favored the use of diuretics that work like thiazides. This is mostly because of how well they drop blood pressure, how long they work, and the information we have about the cardiovascular endpoint. When it comes to lowering blood pressure, thiazide-like and thiazide diuretics have the same benefits. However, when potency and dose-response are taken into account, there are big differences. The piece also talks about how well the two types of diuretics are tolerated, as well as their clinical endpoints, mortality, end-organ damage, and vascular health. (Burnier et al., 2019).

Burnier et al. (2019) say that the risk-benefit ratio of thiazide-like diuretics is better than that of thiazide diuretics. When choosing a diuretic, the first thing to look at is how well it controls volume. Most of the time, thiazide-like diuretics are better for patients who need to control their blood pressure, fluid levels, and avoid heart disease and death.

Description of how the chosen diuretic works in the body

The diuretic that will be used is indapamide. This is a diuretic called a sulfonamide. It is thought to be a useful treatment for high blood pressure, and it also stops end-organ damage. It makes you lose water and salts and can make you pee a lot if you take more of it. A serious electrolyte imbalance, such as hypokalemia, can also be caused by the diuretic. Also, the kidneys can get rid of sodium, magnesium, and chloride, which can also throw off the balance of ions. (Macfarlane et al., 2019).

Liang et al. (2017) say that the drug works on the proximal part of the distal convoluted tubule. It stops the Na+/Cl- cotransporter from working and causes sodium to be reabsorbed. This keeps water and sodium in the lumen so they can be passed out. This then lowers blood pressure by decreasing the heart’s output, the veins’ return, and the amount of plasma. Also, it has been shown that indapamide and other thiazide-like diuretics lower blood pressure in ways other than making you pee. Indapamide also makes you pee out less calcium and makes your aldosterone and plasma renin levels go up.

References

Burnier, M., Bakris, G., & Williams, B. (2019). Redefining diuretics use in hypertension: why select a thiazide-like diuretic?. Journal of hypertension, 37(8), 1574–1586. https://doi.org/10.1097/HJH.0000000000002088

Liang, W., Ma, H., Cao, L., Yan, W., & Yang, J. (2017). Comparison of thiazide-like diuretics versus thiazide-type diuretics: a meta-analysis. Journal of cellular and molecular medicine, 21(11), 2634–2642. https://doi.org/10.1111/jcmm.13205

Macfarlane, T. V., Pigazzani, F., Flynn, R., & MacDonald, T. M. (2019). The effect of indapamide vs. bendroflumethiazide for primary hypertension: a systematic review. British journal of clinical pharmacology, 85(2), 285–303. https://doi.org/10.1111/bcp.13787

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