Indications
Indications for prescribing diuretics include:
- acute left ventricular failure - parenteral route
- chronic heart failure - reduce symptoms but not mortality
- hypertension
- hepatic oedema and ascites - spironolactone preferred because of problems of secondary hyperaldosteronism
- nephrotic syndrome
They DO NOT include:
- right heart failure - may cause a dangerous drop in filling pressure and hypotension
- gravitational oedema
- obesity
- venous stasis
- lymphoedema
Diuretics are grossly over-prescribed both in individual dosage and number of patients treated.
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