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Vol. 7. Núm. F.
Enfoque traslacional de la insuficiencia cardiaca: del gen al paciente y a la población
Páginas 34F-44F (Octubre 2007)
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Vol. 7. Núm. F.
Enfoque traslacional de la insuficiencia cardiaca: del gen al paciente y a la población
Páginas 34F-44F (Octubre 2007)
Enfoque traslacional de la insuficiencia cardiaca
Acceso a texto completo
Tratamiento diurético de la insuficiencia cardiaca
Diuretic Treatment of Heart Failure
Visitas
16080
Eduardo de Teresa
Autor para correspondencia
edeteresa@secardiologia.es

Correspondencia: Dr. E. de Teresa. Servicio de Cardiología. Hospital Clínico Universitario Virgen de la Victoria. Campus de Teatinos. 29010 Málaga. España.
Servicio de Cardiología. Hospital Clínico Universitario de Málaga. Departamento de Medicina. Universidad de Málaga. España
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Los diuréticos constituyen una de las piedras angulares del tratamiento de la insuficiencia cardiaca. La correcta utilización de estos agentes exige conocer adecuadamente su farmacodinámica y farmacocinética, sus interacciones y las posibles causas de ineficacia, así como sus peligros potenciales. Para evitarlos deben mantenerse unas normas básicas que incluyen el empleo de las dosis más bajas que consigan mantener al paciente libre de edema, el control periódico de la función renal y los electrolitos séricos, y la utilización amplia de asociaciones entre diuréticos potentes (de asa) y antialdosterónicos. Actualmente no disponemos de datos sobre el impacto que estos fármacos pueden tener en la supervivencia de los pacientes con insuficiencia cardiaca. Posiblemente, pocos campos como éste se presten a ejercer en toda su amplitud la ars medicae.

Palabras clave:
Diuréticos
Insuficiencia cardiaca
Edema
Abreviaturas:
ATP
BNP
NYHA
IECA
AINE

Diuretics provide one of the cornerstones of heart failure treatment. Correct use of these agents depends on good understanding of their pharmacodynamics and pharmacokinetics, their interactions with other drugs, reasons why they may not be effective, and their potential harmful effects. To avoid harmful effects, it is essential that some basic rules be followed, such as administering the lowest possible dose that ensures the patient remains free from edema, regular monitoring of renal function and serum electrolyte levels, and using a combination of potent (loop) diuretics and antialdosterone agents as often as possible. Nowadays no specific data are available on the effect of these drugs on survival in heart failure patients. There may be few fields of medicine in which the ars medicae can be practiced to as full an extent as this.

Key words:
Diuretics
Heart failure
Edema
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