Why Are Loop Diuretics Called High Ceiling

September 15, 2020

Compared to other diuretics furosemide has high ceiling effect. This is a new term for me.

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This is apparently considered a low bioavailability as far as loop diuretics go.

Why are loop diuretics called high ceiling. Furosemide is a loop diuretic that inhibits the na k 2cl cotransporter in the ascending thick loop of henle. The group of high ceiling diuretics consists of a variety of chemically different potent diuretic and saluretic substances. So if you go above the ceiling dose no extra effect will be achieved.

Diuretics are used. Furosemide decreases the sodium chloride and potassium reabsorption from the tubule. This is my interpretation of the ceiling dose of furosemide.

Loop diuretics are the most powerful of all diuretics they termed high ceiling the loop diuretics drugs act primary on the thick segment of the ascending loop of henle inhibiting the transport of sodium chloride out of the tubule into the interstitial tissue by inhibiting the na k 2cl carrier in the luminal membrane. Loop diuretics act at the ascending thick limb. Where dose is on x axis while na excretion is on y axis.

Why not ask whoever gave you that terminology. This is called the ceiling effect. It is often called a high ceiling diuretic because it is more effective than other diuretics.

Types include loop diuretics osmotic diuretics potassium sparing diuretics and thiazide diuretics with the most frequently prescribed being the thiazides. Schlatter e greger r weidtke c. Furosemide s avalability in the body when taken orally varies greatly from 30 90.

Loop diuretics may also precipitate kidney failure in patients concurrently taking an nsaid and an ace inhibitor the so called triple whammy effect. In circumstances that result in hypercalcemia calcium excretion can be enhanced by administration of loop diuretics with saline infusion. Loop diuretics are also known as high ceiling diuretics or na k 2cl cotransporter inhibitors.

Maximum response is called ceiling. The ascending thick limb has the greatest capacity to reabsorb nacl. An agent that does this such as common substances like tea coffee and water as well as medications.

Increasing diuresis urine excretion. Correlation of chemical structure and inhibitory potency. Why called high ceiling diuretics.

Since a significant percentage of filtered nacl is absorbed by the thick ascending limb of loop of henle diuretics acting at this site are highly effective. Who calls thiazides low ceiling diuretics. 14 because furosemide torsemide and bumetanide are technically sulfa drugs there is a theoretical risk that patients sensitive to sulfonamides may be sensitive to these loop diuretics.

Effect of high ceiling diuretics on active salt transport in the cortical thick ascending limb of henle s loop of rabbit kidney. Increasing the dose above the threshold will ellicit a dose dependant increase in diuresis until they reach maximum effectiveness. Diuretics must acheive what is called a threshold concentration to have a therapeutic effect ie to start working.

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