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Torasemide – Effect, Application & Risks

Torasemide

The drug torasemide belongs to the loop diuretics and is mainly used for drainage. In addition to water retention , possible indications include high blood pressure and cardiac insufficiency .

What is torasemide?

Torasemide is a loop diuretic. This group of water-inducing drugs (diuretics) unfolds its effect directly in the urinary system of the kidneys .

Due to their fairly linear effect-concentration relationship, loop diuretics such as torasemide are classified as high-ceiling diuretics. Depending on the fluid intake, the loop diuretic can be used to urinate up to 45 liters per day.

Pharmacological action

The kidneys filter metabolic waste products from the blood and excrete them. To do this, it initially produces up to 200 liters of primary urine every day. This is concentrated in a complex system of so-called tubules, the loop of Henle and collecting tubes. For this purpose, water is reabsorbed so that ultimately between one and one and a half liters of secondary urine remain.

The ascending part of the loop of Henle is the site of action of torasemide. Up to 25 percent of the initially filtered sodium gets back into the blood here. A transport protein is required for the reabsorption of sodium. Torasemide inhibits this protein . The sodium can then no longer be reabsorbed. This also increases water excretion.

At the same time, the so-called glomerular filtration rate increases. This means that the kidney corpuscles filter and produce more urine.

Medical Application & Use

Loop diuretics such as torasemide are mainly used in the treatment of acute pulmonary edema . Here, as a result of heart disease, fluid collects in the air sacs of the lungs or in the lung tissue The consequences are life-threatening respiratory disorders. Torasemide can help eliminate excess fluid from the body.

Fluid retention in other organs , such as the abdomen or extremities, is also treated with torasemide. Such edema can develop in the context of heart, liver or kidney failure and severely impair organ activity. In acute kidney failure, torasemide can help control water balance, at least for a period of time.

Since the loop diuretic not only causes increased water but also electrolytes to be excreted, torasemide can also be used to treat hypercalcemia . Hypercalcaemia is when there is too much calcium in the blood. Typical causes are malignant tumors or diseases of the hormone system . In addition to calcium, loop diuretics also leach out potassium . Another area of ​​application is therefore hyperkalemia , as can occur, for example, in diseases of the kidneys or the adrenal glands .

In the past, torasemide was also used for forced excretion in poisoning with bromide, fluoride and iodide and in rhabdomyolysis , a breakdown of striated muscle fibers . In order to prevent disturbances in the electrolyte balance, however, a simultaneous supply of sodium, water and chloride is necessary.

Risks & side effects

Loop diuretics such as torasemide are highly effective and must therefore be used with caution. In patients with a disturbed electrolyte or acid-base balance in particular , close monitoring of the water balance and appropriate substitution of electrolytes are essential.

Due to the increased excretion of electrolytes, torasemide must not be used in the case of sodium and potassium deficiency . Use is also contraindicated in the case of complete urinary retention . Likewise, the drug must not be used during breastfeeding . If the use of the drug is vital, breastfeeding must be stopped beforehand.

Long-term use can lead to so-called hypovolemia due to excessive dehydration . In hypovolemia, the circulating blood volume is reduced. This is manifested by symptoms such as dizziness , headaches and hypotension . In severe cases, patients can become dehydrated.

The increased excretion of potassium and protons can lead to hypokalemic hyperacidity . In rare cases, patients may also have reduced levels of sodium in their blood.

Increased absorption of uric acid can also lead to hyperuricemia , which can lead to gout attacks . During treatment with torasemide, some patients develop hearing damage in the high frequencies up to complete deafness . However, this effect usually only occurs during treatment, permanent damage is very rare.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.