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Flowchart to diuretic use in acute heart failure.

(A) Congestion with volume overload. 

(B) Treatment algorithm after
(B) Treatment algorithm ... Total loop diuretic ... intravenous; SGLT2‐I, sodium–glucose ... following a single loop ... #CHF #Algorithm
Mechanisms of Loop Diuretic Action and Resistance. Panel A, loop diuretics circulate bound to protein. As
Mechanisms of Loop ... Diuretic Action ... Panel A, loop diuretics ... for binding to sodium–potassium–chloride ... #Pathophysiology
Ascites Management Principles
Low Salt Diet - 2000 Mg Sodium
Fluid Restriction - Never
Work-horse Diuretic - Aldosterone Antagonist
Combination
Management Principles Low ... Diet - 2000 Mg Sodium ... Never Work-horse Diuretic ... Antagonist Combination Diuretics ... - Add-on Loop Diuretics
Nephron Remodeling as a Mechanism of Diuretic Resistance. When high doses of loop diuretics are used
a Mechanism of Diuretic ... high doses of loop ... diuretics are used ... the epithelial sodium ... #Pathophysiology
Diuretics - Pharmacology

Thiazides diuretics:
 • Inhibit Na+ Cl- cotransporter in distal tubule
 • Chlorothiazide, Chlorthalidone, Indapamide,
Diuretics - Pharmacology ... Metolazone Loop ... as no effect on sodium ... Pharmacology #nephrology #conversion ... #loop #thiazide
Metabolic Alkalosis - Differential Diagnosis Algorithm - Urinary Chloride
 • Cl- responsive metabolic alkalosis
Differential Diagnosis Algorithm ... Remote use of loop ... - Normal/low ... pressure: Active diuretic ... Differential #Diagnosis #Algorithm
Metabolic Alkalosis - Urinary Chloride Algorithm
Cl- responsive metabolic alkalosis
 • Kidney loss of Cl-
Urinary Chloride Algorithm ... Remote use of loop ... or thiazide diuretics ... alkalosis • Normal/low ... pressure: Active diuretic
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Diagnosis Workup Algorithm ... • Euvolemic (Low ... • Hypovolemic: Diuretics ... osmotic (solute) diuresis ... #nephrology #sodium
Hypokalemia - Differential Diagnosis Algorithm
Extra-renal Losses:
 • Normal Acid-Base: Low intake
 • Metabolic acidosis: Gl tract
Differential Diagnosis Algorithm ... Normal Acid-Base: Low ... • HTN Absent: Loop ... and thiazide diuretics ... Differential #Diagnosis #Algorithm
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
normal volume-based algorithm ... : SIADH, Renal Sodium ... can be high or low ... Primary polydipsia), Low ... diagnosis #table #sodium