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PubMed · 15675332

[Diuretics; their characteristics and future development].

Enyu Imai·Yoshimasa Orita
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Abstract

We review the diuretics regarding the mechanism of action, way of clinical use and their adverse effects. Recent progress of molecular biology revealed the molecular target of diuretics and thereby, the molecular mechanism of diuretic action became clear to understand. Loop diuretics and thiazides are the most widely used diuretics and the physiologic adaptation to their prolonged use are mentioned. Carbonic anhydrase inhibitors are not used as diuretics but for correction of metabolic alkalosis and treatment of glaucoma. Potassium-sparing diuretics have modest natriuresis but the combination with loop diuretics or thiazides results in strong natriuresis. Adenosine type 1 receptor antagonist has been developed for treatment of edema in chronic heart failure. Vasopressin type 2 receptor antagonists are developed for a new type of diuretics to increase the free water clearance in cases of chronic heart failure and SIADH. The recombinant atrial natriuretic polypeptide is recently used as diuretics in acute heart failure. Knowledge of pharmacological action of diuretics could help the appropriately clinical use of diuretics, in particular the diuretics-resistant edema.

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Enyu Imai, Yoshimasa Orita. 2005. [Diuretics; their characteristics and future development].. https://pubmed.ncbi.nlm.nih.gov/15675332/

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PubMed2006

Diuretics for Ménière's disease or syndrome.

BACKGROUND: Ménière's disease is a disorder characterised by hearing loss, tinnitus and disabling vertigo. Diuretics are used to try and reduce the severity and frequency of episodes but there is little evidence behind this treatment. OBJECTIVES: To assess the effect of diuretic treatment in patients with Ménière's disease. SEARCH STRATEGY: We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 1 2005), MEDLINE (1966 to 2005), EMBASE (1974 to 2005), CINAHL and the metaRegister of Controlled Trials (mRCT) (up to 2005). SELECTION CRITERIA: Randomised controlled trials of diuretic versus placebo in Ménière's patients. DATA COLLECTION AND ANALYSIS: One author identified studies which loosely met the inclusion criteria and full texts were retrieved. Two authors independently applied the inclusion criteria. Seven studies were excluded from the review due to inappropriate study design or absence of randomisation. MAIN RESULTS: There were no trials of high enough quality to meet the standard set for this review. AUTHORS' CONCLUSIONS: There is insufficient good evidence of the effect of diuretics on vertigo, hearing loss, tinnitus or aural fullness in clearly defined Ménière's disease.

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