Roberts, Darren M. and Buckley, Nick A. (2012). Diuretics. In Jeffrey K. Aronson (Ed.), Side effects of drugs annual : a worldwide yearly survey of new data in adverse drug reactions (pp. 339-348) Oxford: Elsevier Science. doi:10.1016/B978-0-444-59499-0.00021-0

Author Roberts, Darren M.
Buckley, Nick A.
Title of chapter Diuretics
Title of book Side effects of drugs annual : a worldwide yearly survey of new data in adverse drug reactions
Place of Publication Oxford
Publisher Elsevier Science
Publication Year 2012
Sub-type Research book chapter (original research)
DOI 10.1016/B978-0-444-59499-0.00021-0
Year available 2012
Series Side Effects of Drugs Annual
ISBN 9780444594990
ISSN 0378-6080
Editor Jeffrey K. Aronson
Volume number 34
Chapter number 21
Start page 339
End page 348
Total pages 10
Total chapters 49
Collection year 2013
Language eng
Formatted Abstract/Summary
This review of the 2010 publications on diuretics covers carbonic anhydrase inhibitors (acetazolamide, dorzolamide, and methazolamide), thiazide and thiazide-like diuretics (chlortalidone, hydrochlorothiazide, and indapamide), loop diuretics (furosemide and torasemide), aldosterone receptor antagonists (eplerenone, potassium canrenoate, and spironolactone), and mannitol. The publications reflected increased use of aldosterone receptor antagonists and thiazides, and genotype-associated adverse reactions. Chlortalidone and hydrochlorothiazide monotherapy reduced the mean plasma potassium concentration by 0.3-0.5mmol/l and increased fasting mean plasma glucose concentration by 7-8%. Indapamide increases HbA1c and uric acid concentrations. In a Scottish population study were was no dramatic increase in the incidence of hyperkalemia after publication of the RALES study, in contrast to data from Canada published in 2004. Eplerenone, canrenoate, and spironolactone led to small mean increases in plasma potassium. In one study there were intermittent episodes of hyperkalemia in 12% of patients taking active therapy (versus 6% with placebo). Hyperkalemia necessitated withdrawal of treatment in some patients in all studies. Other susceptibility factors (e.g. genotype and renal or hepatic impairment) and the extent of clinical and biochemical monitoring may modify the risk. Life-threatening skin reactions with carbonic anhydrase inhibitors may be more common in patients of Asian descent. For example, in Korea there was a strong association between HLA*B5901 and Cw*0102 alleles and Stevens-Johnson syndrome from methazolamide. Women and patients with the drug transporter SLCO1B1c.521T>C polymorphism have lower clearance of torasemide, which may lead to an increased risk of adverse reactions
Keyword Stevens Johnson Syndrome
Heart failure
Double blind
Preterm Infants
Dose response
Risk Factor
Q-Index Code B1
Q-Index Status Provisional Code
Institutional Status UQ

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