Diuretics digitalis

Hypomagnesemia is usually associated with disorders of the intestinal tract or kidneys. Drugs (e.g., aminoglycosides, amphotericin B, cyclosporine, diuretics, digitalis, cisplatin) or conditions that interfere with intestinal absorption or increase renal excretion of magnesium can cause hypomagnesemia. 

Drugs that may interact include ACE inhibitors, potassium-sparing diuretics, digitalis, and potassium-containing salt substitutes. 

Contraindications Concurrent use of potassium-sparing diuretics, digitalis toxicity, heat cramps, hyperkalemia, postoperative oliguria, severe burns, severe renal impairment, shock with dehydration or hemolytic reaction, untreated Addison s disease... 

William Withering, an English physician with a strong interest in botany, was the first to introduce the diuretic digitalis (from the foxglove plant Digitalis purpurea) into common medical practice for the treatment... 

Glomerulonephritis Pyelonephritis Nephrotic syndrome Drug-induced renal losses Aminoglycosides Amphotericin B Cyclosporine Diuretics Digitalis Cisplatin... 

Drugs diuretics, digitalis, aminoglycoside antibiotics, cisplatin, cyclosporin... 

V 1 1 IV. 6 hr half-life, partially metabolized in liver, low plasma protein binding. Hypersensitivity to amrinone. Amrinone increases diuresis in patients on diuretics. Digitalis inotropy and risk of toxicity increased (amrinone causes hypokalemia). Excessive hypotension with disopyramide. If cellular supplies of cAMP are depleted, amrinone will not be effective. Capable of increasing myocardial contraction even in the presence of p-adrenergic antagonists. 

Enaiapril (Vasotec) Converted to enaloprilic acid which acts like captopril. Mild to severe hypertension and renovascular hypertension, heart failure (with diuretics digitalis). (1 M... 

Siort-term management of HF in patients with no response to digitalis, diuretics, or vasodilators HF... 

Fhtients taking a diuretic and a digitalis glycoside must be monitored closely. Thiazide and loop diuretics (see Chap. 46) may increase the risk and effects of toxicity. 

CARD IAC ARRHYTH MI AS AN D DIZZIN ESS. Patients receiving a diuretic (particularly a loop or thiazide diuretic) and a digitalis glycoside concurrently require frequent monitoring of the pulse rate and rhythm because of the possibility of cardiac arrhythmias. Any significant changes in the pulse rate and rhythm are immediately reported to the primary health care provider. 

Calcium is contraindicated in patients with hypercalcemia or ventricular fibrillation and in patients taking digitalis. Calcium is used cautiously in patients with cardiac disease. Hypercalcemia may occur when calcium is administered with the thiazide diuretics. When calcium is administered with atenolol there is a decrease in Hie effect of atenolol, possibly resulting in decreased beta blockade. There is an increased risk of digitalis toxicity when digitalis preparations are administered with calcium. The clinical effect of verapamil may be decreased when the drug is administered with calcium. Concurrent ingestion of spinach or cereal may decrease file absorption of calcium supplements. 

Diaminopyrimidines, 19 (1982) 269 Digitalis recognition matrix, 30 (1993) 135 Diuretic drugs, 1 (1961) 132 DNA-binding drugs, 16 (1979) 151 Dopamine D2 receptor agonists,... 

Oral Treatment of hypokalemia in the following conditions With or without metabolic alkalosis digitalis intoxication familial periodic paralysis diabetic acidosis diarrhea and vomiting surgical conditions accompanied by nitrogen loss, vomiting, suction drainage, diarrhea, and increased urinary excretion of potassium certain cases of uremia hyperadrenalism starvation and debilitation corticosteroid or diuretic therapy. 

Prevention of potassium depletion when dietary intake is inadequate in the following conditions Patients receiving digitalis and diuretics for CHF significant cardiac arrhythmias hepatic cirrhosis with ascites states of aldosterone excess with normal renal function potassium-losing nephropathy certain diarrheal states. 

Oral verapamil may precipitate heart failure. Control patients with milder ventricular dysfunction with digitalis or diuretics before verapamil, if possible. 

Congestive heart failure (CHF) For the treatment of mild to severe heart failure of ischemic or cardiomyopathic origin, in conjunction with digitalis, diuretics, and ACE inhibitors, to reduce the progression of disease. 

Heart failure - Usual initial dosage is 25 mg 3 times daily. After 50 mg 3 times daily is reached, delay further dosage increases, where possible, for at least 2 weeks to determine if a satisfactory response occurs. Most patients have had a satisfactory clinical improvement at 50 or 100 mg 3 times daily. Do not exceed a daily dose of 450 mg. Captopril should generally be used in conjunction with a diuretic and digitalis. 

Heart failure As adjunctive therapy with diuretics and digitalis, the recommended starting dose is 2.5 mg twice daily. The usual therapeutic dosing range for the treatment of heart failure is 2.5 to 20 mg/day given in 2 divided doses. The maximum daily dose is 40 mg. 

Initial dose 5 mg once daily with diuretics and digitalis. Usual effective dosage range is 5 to 20 mg/day as a single dose. In patients with hyponatremia (serum sodium less than 130 mEq/L), initiate dose at 2.5 mg once daily. If used with diuretics, initial dose is 5 mg/day. 

Fluid overload occurs commonly in patients with renal failure, often in the absence of associated heart disease. If salt and water intake is not controlled in the patient who is oliguric or anaemic, plasma volume and symptoms of congestive heart failure ensue. Hypertension and coronary heart disease with increasing age contributes to the congestive heart failure. Diuretics like loop-diuretics or metolazone may be of value. Digitalis should be used with caution in patients on dialysis as cardiac arrhythmias may ensue in patients receiving dialysis in the presence of hypokalemia. 

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