The Pharmacology of Newer Diuretics

Diuretics continue to be among the commonest of all prescribed items. Until recently, the physician needed to have little concern about the dose of the agent he was choosing because firstly, the dose-response curve tended to be startlingly flat, and secondly, there was little chance of inducing an excessive diuresis, regardless of dose. Now that furosemide (Lasix) and ethacrynic acid (Edecrin) have become available, we find that one must indeed titrate the dose to the particular patient, and must appreciate for the first time the complications which can result from an excessive diuresis. Finally, with the availability of triamterene and MK870 ( Colectril, not yet available), one must appreciate the importance of the distal tubular mechanism for potassium for sodium exchange. The additive effect of these exchange inhibitors can be of considerable clinical usefulness .