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PubMed · 8086322

Which diuretic to use?

C R Swanepoel
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Abstract

The choice of a diuretic depends on knowledge of its efficacy in different disease states as well as the complications associated with its use. However, efficacy of the various diuretic agents as determined in healthy subjects may not always be applicable to the sick patient. The thiazide group appears to be the main offender with regard to hypokalemia and metabolic upsets; these complications seem to stem from long-term use and high dosages. Interest has been expressed on the influence of diuretic induced hypokalemia (and intracellular potassium deficiency) in inducing insulin resistance. The lipid abnormalities may arise as a result of this resistance or may be consequent on hyperinsulinemia from other as yet undetermined mechanisms. In addition, hypertension per se may be associated with insulin resistance. It is interesting to speculate that diuretics, which are commonly used in the treatment of hypertension, may, in some way, perhaps via the induction of hypokalemia, unmask this resistance.

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DiureticsDrug InteractionsGlomerular Filtration RateGlucose IntoleranceHumansHyperglycemiaHypokalemiaHyponatremiaInsulin ResistanceEditorialReview

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BibTeXRIS

C R Swanepoel. 1994. Which diuretic to use?. https://doi.org/10.1007/bf00877100

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Diuretics↗
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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