In: Anatomy and Physiology
pharmacology question
Explain briefly why the effectiveness of oral furosemide would be lowered in patients with severe chronic congestive heart failure.
In general, due to their greater effectiveness, loop diuretics, such as the furosemide, are the mainstay of diuretic therapy in HF. Indeed loop diuretics produce more intense and shorter diuresis than thiazides, which results in more gentle and prolonged diuresis.
Furosemide:
it is an loop diuretic and the mode of action is by blocking the absorption of sodium, chloride, and water from the filtered fluid in the kidney tubules, causing a profound increase in the output of urine
Most patients with chronic CHF who were clinically stabilized on high doses of furosemide remained stable on a maintenance dose equal to one-third of the dose needed for their stabilization. Patients unable to tolerate the dose
In chronic CHF, mean NYHA functional class increased from 1.8 +/- 0.4 to 2.4 +/- 0.6 (p = 0.07), accompanied by a significant increase of the right and left ventricular , respectively. These patients returned to a stable clinical status upon resumption of the prior doses of furosemide.