Chloride regulatory mechanisms and their influence on neuronal excitability
The chloride concentration in neurons is in general established by the precise functional expression of the sodium-potassium-chloride cotransporter one (NKCC1) and the potassium-chloride cotransporter two (KCC2). NKCC1 raises the intracellular chloride concentration, while KCC2 extrudes chloride. The intracellular chloride concentration determines the strength and direction of γ-aminobutyric acid (GABA) receptor-mediated transmission. In general, the intracellular chloride concentration in neurons is low and causes GABA-mediated inhibition. However, the intracellular chloride concentration in immature neurons is high leading to GABAergic depolarization, which can cause excitation. The effects of excitatory GABA signaling in early development is still unclear. It has been speculated that excitatory GABA, causing general ...https://edoc.ub.uni-muenchen.de/12513/
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Side Effects of Loop Diuretics
Loop diuretics are drugs which treat edema and hypertension resulting from heart disease and kidney failure. The side effects of loop diuretics include low blood volume and electrolyte depletion. The target of loop diuretics is the Loop of Henle region of the nephron.http://www.brighthub.com/science/medical/articles/70011.aspx
NKCC1 Antagonist Reduces Seizures in Rodent Models. Volodymyr I. Dzhala, Kishore V. Kuchibhotla, Joseph C. Glykys, Kristopher T. Kahle, Waldemar B. Swiercz, et al.. (see pages 11745-11761). During development, GABA is excitatory because relatively high expression of the neuronal sodium-potassium-chloride cotransporter (NKCC1) raises intracellular chloride concentrations, making the reversal potential for GABA receptors (EGABA) more depolarized than resting membrane potential (Vm). Although EGABA is normally hyperpolarized relative to Vm in mature neurons, seizures can depolarize EGABA, thus reducing or reversing inhibitory currents and increasing the likelihood of future seizures. Dzhala et al. found that kainic acid, GABA receptor antagonists, or reduced extracellular magnesium concentration caused recurrent seizures that progressively increased in frequency in intact neonatal rodent hippocampi. Although GABA agonist had a net inhibitory ...http://www.jneurosci.org/content/30/35/i
Effects of High- Versus Moderate-Intensity Training on Neuroplasticity and Functional Recovery After Focal Ischemia | Stroke
Methods-Rats were randomized as follows: control (n=15), SHAM (n=9), middle cerebral artery occlusion (n=13), middle cerebral artery occlusion at day 1 (n=7), MOD (n=13), and HIT (n=13). Incremental tests were performed at day 1 (D1) and 14 (D14) to identify the running speed associated with the lactate threshold (SLT) and the maximal speed (Smax). Functional tests were performed at D1, D7, and D14. Microglia form, cytokines, p75NTR (pan-neurotrophin receptor p75), potassium-chloride cotransporter type 2, and sodium-potassium-chloride cotransporter type 1 expression were made at D15. ...http://stroke.ahajournals.org/content/early/2017/09/13/STROKEAHA.117.017962
High Blood Pressure Medications: Loop Diuretics | HubPages
Loop diuretics are a commonly prescribed class of drug used for several indications, including high blood pressure. This introduction to loop diuretics, authored by a physician, explains how they work and what the phrase 'loop diuretic' means.https://hubpages.com/health/High-Blood-Pressure-Medications-Loop-Diuretics
Intravenous or enteral loop diuretics for preterm infants with (or developing) chronic lung disease | Cochrane
There is no strong evidence of benefit from routine use of loop diuretics in preterm babies at risk of, or with, chronic lung disease. Lung disease in babies born early (preterm) is often complicated with excess of water. Medications that reduce body water (diuretics) might help the baby recover from lung disease. The review analysed the effects of diuretics working on the deep part of the small kidney tubes (loop diuretics). The review of trials found that diuretics, given from a single dose to one week's treatment, inconsistently improved lung function and oxygen levels in the blood. There was not enough evidence to show any improvement in long-term outcome.. ...http://www.cochrane.org/CD001453/NEONATAL_intravenous-or-enteral-loop-diuretics-for-preterm-infants-with-or-developing-chronic-lung-disease
Blood Urea Nitrogen | JACC: Journal of the American College of Cardiology
Loop diuretics are used in patients with heart failure (HF) to relieve symptoms of systemic and pulmonary venous congestion. Despite their nearly universal use for this indication, loop diuretics have not been shown to improve survival-indeed, a number of recent studies suggest an adverse relationship between the use of loop diuretics and survival (1-3). This is plausible because loop diuretics block sodium chloride absorption at the macula densa in the thick ascending limb of the loop of Henle, activating the renin-angiotensin-aldosterone system (RAAS) and potentially exacerbating HF (4). Few data exist to inform providers how to use loop diuretics to provide the greatest symptomatic benefit with the least adverse effect. In this issue of the Journal, Testani et al. (5) have provided insight into this difficult therapeutic dilemma. They analyzed data from the BEST (Beta-Blocker Evaluation of Survival Trial) to determine whether the blood urea nitrogen (BUN), used as a ...http://www.onlinejacc.org/content/58/4/383
BestBets: The use of loop diuretics in acute renal failure in critically ill patients to reduce mortality, maintain renal...
About one fifth of the cardiac output is directed to the kidneys. This exceeds the oxygen supply to other vital organs, such as the brain, heart, or liver. A very low fraction of oxygen delivered is extracted by the kidney, suggesting ample oxygen reserve. Paradoxically, the kidney is the organ which is most sensitive to hypoperfusion and hypoxia, with acute renal failure being one of the most frequent complications of hypotension. This is because of the physiological gradient of intrarenal oxygenation, which means that under normal physiological conditions the renal medulla functions at very low oxygen tensions. Many therapeutic interventions in the prevention or management of patients with acute renal failure have been investigated in clinical studies. Interventions to enhance renal blood flow and decrease tubular reabsorption seem to be a logical approach for the prevention of outer medullary hypoxic injury. Loop diuretics block the active ...http://bestbets.org/bets/bet.php?id=297
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Heart failure, chronic diuretic use, and increase in mortality and hospitalization: an observational study using propensity...
Non-potassium-sparing diuretics are commonly used in heart failure (HF). They activate the neurohormonal system, and are potentially harmful. Yet, the long-term effects of chronic diuretic use in HF are largely unknown. We retrospectively analysed thhttp://www.biomedsearch.com/nih/Heart-failure-chronic-diuretic-use/16709595.html
Loop Diuretics | Blake Medical Center | Bradenton, FL
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British Cardiovascular Society
Regimens for iv loop diuretics vary. An initial bolus of 40-80 mg of furosemide given over 5-10 minutes followed by either regular boluses every 12 h or continuous infusion is a usual approach. If infusion is chosen, initiating rate is usually 5 mg/h with a further bolus and increase in the rate to 10 mg/h if diuresis is suboptimal. In patients with eGFR ,30 ml/min, the respective rates are 20 40 mg/h, but with increasing risk of ototoxicity and other side effects.The effects of mode of iv loop diuretic administration (boluses vs continuous infusion) has been addressed in several trials. In the systematic review16 of 8 RCTs (n=254), when compared to iv boluses, equivalent cumulative dose of continuous infusion of loop diuretics was shown to be associated with reduced ototoxicity and statistically non-significant better diuresis (mean 271 ml in 24 h) in patients with ADHF. However, in the more recent DOSE trial17, 308 patients with ADHF were randomly assigned to a) iv boluses of furosemide every ...https://www.bcs.com/pages/news_full.asp?NewsID=19792495
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Bumetanide (Injection Route) Description and Brand Names - Mayo Clinic
Bumetanide belongs to a group of medicines called loop diuretics or "water pills." Bumetanide is given to help treat fluid retention (edema) and swelling that is caused by congestive heart failure, liver disease, kidney disease, or other medical conditions. It works by acting on the kidneys to increase the flow of urine . ...http://www.mayoclinic.org/drugs-supplements/bumetanide-injection-route/description/DRG-20071268
USPharmacist | Weekly News Update
Most patients with HF received a loop diuretic. However, torsemide, a new agent with potentially superior clinical effectiveness, was rarely used," the authors write. "Given the common usage of loop diuretics in HF and their potential non-equivalence in HF outcomes and safety endpoints, perhaps it is time for well-designed randomized controlled trials, powered for clinical endpoints such as mortality, readmission, and quality of life, to determine whether there are differences in the safety and effectiveness of these agents both for management of chronic HF and for episodes of acute decompensation ...https://www.uspharmacist.com/weekly_news_update/nl/40100/
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Drugs That Interact With Other Drugs: Combinations That Should Be Avoided In Older Adults > Resources > Health...
Drugs and Categories of DrugsInteracting Drugs and Categories of DrugsWhat Happens When these Drugs InteractRecommendations Peripheral Alpha-1 blockers Used to treat the prostate, also sometimes prescribed for high blood pressure. Loop diuretics Used to treat high blood pressure or fluidhttp://www.healthinaging.org/resources/resource:drugs-that-interact-with-other-drugs-combinations-that-should-be-avoided-in-older-adults/
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