1st line diuretic for CHF and HTN? - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 06-07-2015
USMLE Forums Scout
 
Steps History: Step 1 Only
Posts: 69
Threads: 44
Thanked 8 Times in 6 Posts
Reputation: 18
Unhappy 1st line diuretic for CHF and HTN?

What is the best diuretic used for CHF?

Loop, Thiazide or Spironolactone? Can't determine which is the best answer....

Also for HTN?


Appreciate any input! Thanks in advance!
Reply With Quote Quick reply to this message



  #2  
Old 06-07-2015
CleverFOX's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 239
Threads: 4
Thanked 176 Times in 116 Posts
Reputation: 188
Send a message via Skype™ to CleverFOX
Default

It's Loop Diuretic(s)...

They are also called High Ceiling Diuretics....We prefer Loop over anything in CHF because Loops will prevent and will diminish any pulmonary edema that will occur due to CHF as it increases Prostaglandin Synthesis and Release will improve renal blood flow by dilating afferent arterioles and will also vasodialte systemic vessels thus moving the pulmonary edema fluid from pulmonary circulation to systemic circulation...not to mention the steep dose-response curve of loop diuretics

__________________
Hard work beats talent when talent doesn't work hard...
Step 1 Experience -
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
- 259

Last edited by CleverFOX; 06-08-2015 at 01:19 AM.
Reply With Quote Quick reply to this message
The above post was thanked by:
unn99 (06-08-2015), Virgo11 (06-07-2015)
  #3  
Old 06-07-2015
USMLE Forums Scout
 
Steps History: Not yet
Posts: 23
Threads: 1
Thanked 3 Times in 2 Posts
Reputation: 13
Default

Quote:
Originally Posted by CleverFOX View Post
It's Loop Diuretic(s)...

They are also called High Ceiling Diuretics....We prefer Loop over anything in CHF because Loops will prevent and will diminish any pulmonary edema that will occur due to CHF as it increases Prostaglandin Synthesis and Release will improve renal blood flow by dilating efferent arterioles and will also vasodialte systemic vessels thus moving the pulmonary edema fluid from pulmonary circulation to systemic circulation...not to mention the steep dose-response curve of loop diuretics

i think it dilate afferent to maintain GFR and i didn't hear about any systemic vasodilation induced by loop diuretics, nitrates is the one that do that
and as u know low dose thiaziads is much better in treatment of hypertension
Reply With Quote Quick reply to this message
The above post was thanked by:
Virgo11 (06-07-2015)
 
  #4  
Old 06-07-2015
USMLE Forums Scout
 
Steps History: Step 1 Only
Posts: 69
Threads: 44
Thanked 8 Times in 6 Posts
Reputation: 18
Default

Quote:
Originally Posted by CleverFOX View Post
It's Loop Diuretic(s)...

They are also called High Ceiling Diuretics....We prefer Loop over anything in CHF because Loops will prevent and will diminish any pulmonary edema that will occur due to CHF as it increases Prostaglandin Synthesis and Release will improve renal blood flow by dilating efferent arterioles and will also vasodialte systemic vessels thus moving the pulmonary edema fluid from pulmonary circulation to systemic circulation...not to mention the steep dose-response curve of loop diuretics


Thanks Cleverfox! And I think you mean "afferent" instead of "efferent" Gosh it is just so confusing!
Reply With Quote Quick reply to this message
  #5  
Old 06-08-2015
CleverFOX's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 239
Threads: 4
Thanked 176 Times in 116 Posts
Reputation: 188
Send a message via Skype™ to CleverFOX
Default

Quote:
Originally Posted by Virgo11 View Post
Thanks Cleverfox! And I think you mean "afferent" instead of "efferent" Gosh it is just so confusing!
yeah sorry for that typo now fixed...and just as elisha said Thiazides are best for HTN(mild - moderate) because of their long duration of action...

@mina try to search the mechanism - why loops are used in acute pulmonary edema you will understand what I meant by dialating systemic vasculature and shifting blood from pulmonary circuit to systemic circuit
__________________
Hard work beats talent when talent doesn't work hard...
Step 1 Experience -
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
- 259

Last edited by CleverFOX; 06-08-2015 at 01:29 AM.
Reply With Quote Quick reply to this message
  #6  
Old 06-08-2015
USMLE Forums Scout
 
Steps History: Not yet
Posts: 23
Threads: 1
Thanked 3 Times in 2 Posts
Reputation: 13
Default

@cleverfox
i will
Reply With Quote Quick reply to this message



Reply

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
decompensated CHF vs compensated CHF substancep1991 USMLE Step 1 Forum 0 10-26-2014 11:20 AM
HTN or DM F/U stepdoc1 USMLE Step 2 CS Forum 0 02-28-2013 12:57 PM
Pul htn q niborfernando USMLE Step 1 Forum 3 12-10-2012 10:30 PM
Which diuretic? Casandra USMLE Step 1 Forum 3 08-04-2012 02:40 AM
CCS: Primary HTN meduploader USMLE Step 3 Forum 0 06-25-2011 02:39 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)