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DIURETICI: In gravidanza vanno somministrati solo per brevi periodi e sotto controllo medico; sconsigliati in allattamento perchè possono inibire la lattazione.
Furosemide: fa parte (assieme a bumetanide, muzolimina ed ac. etacrinico) della categoria dei diuretici dell’ansa (agiscono a livello del tratto ascendente dell’ansa di Henle), dove inibiscono il riassorbimento di Na, K+ e Cl–.. Poiché questo tratto del nefrone è responsabile del riassorbimento (quindi del risparmio) del 30-40% del cloruro di sodio filtrato dal glomerulo renale, i diuretici dell’ansa sono i più efficaci in assoluto consentendo un effetto diuretico massimale. A differenza dei diuretici tiazidici , essi aumentano il contenuto di Ca+ nell’urina. La furosemide passa nel latte materno ed è quindi necessario evitare l’allattamento durante la terapia.
Diuretici risparmiatori di potassio: la somministrazione in gravidanza e allattamento è permessa se non per brevissimi periodi e sotto controllo medico.
- Diuretici tiazidici: Agiscono soprattutto a livello del tubulo distale renale (primo tratto convoluto), inibendo il riassorbimento di NaCl. In gravidanza si possono utilizzare solo in caso di fallimento con altri diuretici perché riducono la volemia materna e possono compromettere l’ossigenazione e la nutrizione fetale. Essi possono, inoltre, causare iponatremia, ipokaliemia e trombocitopenia nel neonato.
|Tab. 22 – DIURETICI||
Lasix, Salf, Furosemide
Edecrin (Ac. Etacrinico)
diuretici risparmiatori di potassio
Ctg C della FDA;
+ diuretico tiazidico)
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