Diuretics: Get Rid of the Water
Apr 18, 2011
By Barret Procyshyn, Pharmacist at the Dauphin Clinic Pharmacy
After a long winter with lots of snow, there is again water lying everywhere. Creeks are overflowing and worst of all; it is ending up in peoples basements. Just like a farmer can have too much water in the fields, we can have too much water in our bodies. Fluid buildup in the body can contribute to hypertension or high blood pressure. Simply, if you have more water in the pipes you have a higher amount of pressure. Fluid buildup can also occur, most commonly in the feet. Complications can occur with circulatory problems or in diabetic patients. Fluids can even buildup in the pulmonary area, which can be very dangerous.
Diuretic medications, more commonly known as water pills, are a good treatment option for removing fluid from the body. Diuretic drugs are substances which increase the rate of urination and provide a means of forced diuresis. Simply they force excess fluid out of the body. Diuretics are a first line treatment option for uncomplicated hypertension or high blood pressure. They are inexpensive and very well tolerated. Most importantly they have good data supporting their effectiveness.
Diuretic medications work in the kidney, an organ in our body responsible for filtering our body fluid and forming urine. As blood flows through the kidney it filters water and electrolytes, such as sodium and potassium. Through a filtration process in various loops and tubes, the kidney determines how much water and sodium will be sent out of the body in the urine. A diuretic works by altering how the kidney handles the sodium in our body. If our kidney sends out more sodium into the urine, more water will follow as it is drawn to the sodium.
Several categories of diuretics exist, each with their own specific set of characteristics and a slightly different mechanism of action. However; they all work to increase the excretion of water from bodies, although different diuretics do it in their own distinct fashion.
Furosemide or Lasix belong to a group called loop diuretics. It is very effective in removing excess fluid in the body and does so rather quickly. This drug works by inhibiting the bodys ability to eliminate sodium. Once again, if we force the sodium to stay in the urine, more water will follow it. The sodium and water is removed from the body as urine. Loop diuretics are very powerful and can promote significant sodium loss. In an attempt to save sodium, your body trades potassium for the sodium. For this reason furosemide use often leads to potassium depletion, so patients are often also prescribed potassium supplements. Potassium levels will be monitored closely via blood tests.
Thiazide diuretics are the most common class of diuretics used because of their effectiveness and minimal side effects. Hydrochlorothiazide belongs to this class. Many people who have hypertension take this medication on its own or it is commonly combined with other high blood pressure medications in one pill. Indapamide is another medication found in this class. Thiazide diuretics also cause sodium and potassium loss, but not in the magnitude of loop diuretics.
The third main class of diuretics is potassium sparring diuretics. These diuretics do not cause sodium loss and therefore do not contribute in depleting sodium from the body. However, this does make them a weaker diuretic. Examples of a potassium sparring diuretic are spironolactone and amioloride.
When starting diuretics you may notice their effect are strong at the start and then they seem to weaken. This is normal. Whether you are using a diuretic to help decrease blood pressure or remove excess fluid from the body they all have the same effect; they make you pee. Therefore I recommend taking diuretics in the morning or at least during the early part of the day. No one wants to be up all night using the washroom.
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The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.