Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

1.1K
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
1.1K
Antihypertensive Drugs: Action of Diuretics01:16

Antihypertensive Drugs: Action of Diuretics

2.7K
Diuretics are antihypertensive drugs used to treat hypertension resulting from sodium and water retention. Sodium, vital for fluid balance and nerve or muscle function, is regulated by the kidneys through millions of nephrons. Blood enters nephrons via afferent arterioles, which branch into capillaries called glomeruli. These filter blood plasma, allowing water and solutes, like sodium ions, to pass through capillary walls into Bowman's capsule. The filtrate then flows through various...
2.7K
Antihypertensive Drugs: Thiazide-Class Diuretics01:15

Antihypertensive Drugs: Thiazide-Class Diuretics

2.2K
Thiazide diuretics are sulfonamide derivatives featuring a benzothiadiazine ring system in their molecular structure. Based on this structure, thiazide diuretics can be categorized into two groups: thiazide-type and thiazide-like diuretics. Thiazide-type diuretics, including hydrochlorothiazide and chlorothiazide, consist of a benzothiadiazine backbone with an attached sulfonamide group. Thiazide-like diuretics, such as chlorthalidone and indapamide, lack the thiazide ring but demonstrate...
2.2K
Antihypertensive Drugs: Potassium-Sparing Diuretics01:28

Antihypertensive Drugs: Potassium-Sparing Diuretics

2.6K
Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
2.6K
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

1.4K
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
1.4K
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

470
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
470

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

New Mexico P5 (Physician-Pharmacist-Patient-Payor Partnerships) Summit.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists·2025
Same author

Utilization rate and predictors of sodium-glucose cotransporter 2 inhibitor use in patients with heart failure: A continuing review.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists·2025
Same author

Community Pharmacists Identification of Gaps in Care - Statin Utilization for Primary Prevention.

Journal of pharmacy practice·2024
Same author

The Need for Competency-Based Education.

American journal of pharmaceutical education·2024
Same author

Retooling the Remediation Process: An Overview of One School's Process Overhaul.

American journal of pharmaceutical education·2023
Same author

Utilization rates and predictors of sodium glucose cotransporter 2 inhibitor use in patients with heart failure with or without type 2 diabetes.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists·2023

Related Experiment Video

Updated: Mar 17, 2026

Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol
07:59

Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol

Published on: July 28, 2018

11.8K

Treating Diuretic Resistance: An Overview.

Brandi N Bowman1, James J Nawarskas, Joe R Anderson

  • 1From the *Department of Pharmacy, University of New Mexico Hospital, Albuquerque, NM; and †College of Pharmacy, University of New Mexico, Albuquerque, NM.

Cardiology in Review
|July 29, 2016
PubMed
Summary

Diuretic resistance in acute decompensated heart failure impacts patient outcomes. Strategies to overcome this diminished loop diuretic response are crucial but lack robust clinical trial evidence.

More Related Videos

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
08:35

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

Published on: May 26, 2022

4.4K
Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
04:37

Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension

Published on: June 6, 2025

844

Related Experiment Videos

Last Updated: Mar 17, 2026

Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol
07:59

Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol

Published on: July 28, 2018

11.8K
Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
08:35

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

Published on: May 26, 2022

4.4K
Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
04:37

Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension

Published on: June 6, 2025

844

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Loop diuretics are essential for managing fluid overload in acute decompensated heart failure (ADHF).
  • Diminished response to loop diuretics is a significant clinical issue, negatively impacting patient outcomes.
  • Factors contributing to diuretic resistance include impaired oral absorption, postdiuretic sodium retention, reduced renal perfusion, and altered sodium handling in advanced heart failure.

Purpose of the Study:

  • To review the factors contributing to diuretic resistance in ADHF.
  • To discuss pharmacologic interventions aimed at improving diuretic response.
  • To highlight the lack of clinical trial evidence guiding therapy for diuretic resistance.

Main Methods:

  • Literature review of factors contributing to diuretic resistance.
  • Summary of pharmacologic interventions used to enhance diuretic efficacy.
  • Analysis of the current evidence base for managing diuretic resistance in ADHF.

Main Results:

  • Diuretic resistance is multifactorial, involving pharmacokinetic and pharmacodynamic alterations.
  • Interventions like IV diuretics, dose adjustments, agent changes, combination therapy, dopamine, and hypertonic saline have been employed.
  • There is a notable scarcity of high-quality clinical trial data to guide therapeutic decisions.

Conclusions:

  • Diuretic resistance is a complex problem in ADHF with significant clinical implications.
  • While several strategies exist to overcome resistance, evidence-based guidelines are lacking.
  • Further clinical trials are needed to establish optimal therapeutic approaches for diuretic resistance in ADHF.