Diuréticos
Autor: Lígia Martins | Publicado: 2011-10-05T17:50:00-07:00

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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Diuréticos de alça, como a furosemida e a bumetanida, são usados no tratamento do edema agudo de pulmão, insuficiência cardíaca crônica, síndrome nefrótica, cirrose hepática complicada por ascite, hipercalemia, insuficiência renal e hipertensão complicada por comprometimento renal. Os efeitos adversos incluem hipotensão, hipovolemia, hipocalemia, hipomagnesia, alcalose metabólica e hiperuricemia. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Os diuréticos tiazídicos, hidroclorotiazida e bendroflumetazina, possuem usos clínicos na hipertensão, insuficiência cardíaca leve, edema resistente grave, diabetes insípido nefrogênico e para prevenir a formação recorrente de cálculos na hipercalcinúria idiopática. E os efeitos adversos são ligeira poliúria, hipocalcinúria, hiponatremia, hipocalemia, disfunção erétil, hiperuricemia, hiperglicemia, rashes, pancreatite e edema pulmonar agudo.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; A espironolactona e a eplerenona são antagonistas da aldosterona, usadas com diuréticos de alça ou tiazídicos para prevenir perda de K+, insuficiência cardíaca, hiperaldosterismo primário, hipertensão essencial resistente, hiperaldosterismo secundário causado por cirrose hepática complicada por ascite.&nbsp; Podem gerar hipercalemia, desconforto gastrintestinal, ginecomastia, distúrbios menstruais, atrofia testicular e efeitos estrogênicos colaterais.&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; O manitol é um diurético osmótico, que aumenta a quantidade de soluto não-reabsorvivel no túbulo. É usado tratamento de emergência de hipertensão intracraniana aguda ou de elevação aguda da pressão intra-ocular e na insuficiência renal aguda. Mas pode gerar expansão transitória do volume de líquido extracelular, hiponatremia, cefaléia, náuseas e vômitos.