Use of Modern Diuretics

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Abstract
The status of current diuretic therapy is reviewed in the light of the prospective availability of 2 powerful new diuretic agents, ethacrynic acid and fursemide. The physiologic basis of the action of diuretics is reviewed with regard to the possible mechanisms of action, the maximum effect produced by drugs of various groups, and the production of K+ depletion. The inherent limitations in the relation of salt loss to volume output are considered in the light of the concentrating and diluting processes in the kidney and the effects of diuretics on these processes. Some of the factors to be considered in the choice of specific diuretics are briefly reviewed and users are cautioned against the substitution of highly powerful diuretics in patients who are adequately managed through the use of drugs of the thiazide group.