Diuretika

  • Hartmut Oßwald
  • Bernd Mühlbauer
Chapter

Zusammenfassung

Von den Diuretika werden hauptsächlich Schleifendiuretika und Thiazide verordnet. Aldosteronantagonisten folgen mit deutlichem Abstand. Schleifendiuretika sind die dominierende Gruppe der Diuretika und machten 2014 über 60% der verordneten Tagesdosen dieser Gruppe aus. Ihre Verordnungen nahmen 2014 weiterhin leicht zu, während die Thiazidmonopräparate wenig Änderung zeigten und die Thiazidkombinationen ihren seit 10 Jahren zu beobachtenden Rückgang weiter fortsetzten. Der Einsatz von Spironolacton und Eplerenon nahm weiter zu, während Spironolacton-Furosemidkombinationen deutlich abnahmen.

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Literatur

  1. Buggey J, Mentz RJ, Pitt B, Eisenstein EI, Anstrom KJ, Velazquez EJ, O'Connor CM (2015): A reappraisal of loop diuretic choice in heart failure patients. Am Heart J 169: 323–333CrossRefPubMedGoogle Scholar
  2. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ (2003): The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report. JAMA 289: 2560–2571CrossRefPubMedGoogle Scholar
  3. Cosin J, Diez J, TORIC investigators (2002): Torasemide in chronic heart failure: results of the TORIC study. Eur J Heart Fail 4: 507–513CrossRefPubMedGoogle Scholar
  4. Düsing R, Piesche L (1990): Second line therapy of congestive heart failure with torasemide. Prog Pharmacol Clin Pharmacol 8: 105–120Google Scholar
  5. Gentilini P, Laffi G, La Villa G, Carloni V, Foschi M, Romanelli RG, Marra F (1993): Torasemide in the treatment of patients with cirrhosis and ascites. Cardiovasc Drugs Ther 7 (Suppl 1): 81–85CrossRefPubMedGoogle Scholar
  6. Jacob MS, Tang WH (2011): Aldosterone-receptor antagonists in heart failure: insights after EMPHASIS-HF. Curr Heart Fail Rep. 8: 7–13CrossRefPubMedGoogle Scholar
  7. Juurlink DN, Mamdani MM, Lee DS, Kopp A, Austin PC, Laupacis A, Redelmeier DA (2004): Rates of hyperkalemia after publication of the Randomized Aldactone Evaluation Study. N Engl J Med 351: 543–551CrossRefPubMedGoogle Scholar
  8. Lachaine J, Beauchemin C, Ramos E (2011): Use, tolerability and compliance of spironolactone in the treatment of heart failure. BMC Clin Pharmacol May 20; 11: 4. doi: 10.1186/1472- 6904-11-4Google Scholar
  9. Murray MD, Deer MM, Ferguson JA, Dexter PR, Bennett SJ, Perkins SM et al (2001): Open label randomized trial of torsemide compared with furosemide therapy for patients with heart failure. Am J Med 111: 513–520CrossRefPubMedGoogle Scholar
  10. Oßwald H, Vallon V, Luippold G, Gleiter CH (2004): Diuretika - Physiologie, Pharmakologie und klinische Anwendungen. Wissenschaftliche Verlagsgesellschaft, StuttgartGoogle Scholar
  11. Pitt B, Nicklas J (2009): Loop diuretics in patients with heart failure: time to change to torsemide? J Cardiovasc Pharmacol 53: 435–437CrossRefPubMedGoogle Scholar
  12. Pitt B, Remme W, Zannad F, Neaton J, Martinez F, Roniker B, Bittman R, Hurley S, Kleiman J, Gatlin M; Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study Investigators (2003): Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 348: 1309–1321Google Scholar
  13. Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A, Palensky J, Wittes J (1999): The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Rand- omized Aldactone Evaluation Study Investigators. N Engl J Med 341: 709–717CrossRefPubMedGoogle Scholar
  14. Psaty BM, Lumley T, Furberg CD, Schellenbaum G, Pahor M, Alderman MH, Weiss NS (2003): Health outcomes associated with various antihypertensive therapies used as first-line agents: a network meta-analysis. JAMA 289: 2534–2544CrossRefPubMedGoogle Scholar
  15. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group (2003): Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 288: 2981–2997CrossRefGoogle Scholar
  16. Wargo KA, Banta WM (2009): A comprehensive review of the loop diuretics: Should furosemide be first line? Ann Pharmacother 43: 1836–1847CrossRefPubMedGoogle Scholar
  17. Wilcox CS (2002): New insights into diuretic use in patients with chronic renal disease. J Am Soc Nephrol 13: 798–805PubMedGoogle Scholar
  18. Zillich AJ, Garg J, Basu S, Bakris GL, Carter BL (2006): Thiazide diuretics, potassium, and the development of diabetes: a quantitative review. Hypertension 48: 219–224CrossRefPubMedGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Hartmut Oßwald
  • Bernd Mühlbauer

There are no affiliations available

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