A rapid reduction of ascites is often accomplished simply with the addition of low-dose oral diuretics in the outpatient setting. First-line diuretic therapy for cirrhotic ascites is the combined use of spironolactone (Aldactone) and furosemide (Lasix) - Clevland Clinic
redvelvetPatients with hepatic ascites have hyperaldosteronism; because the intravascular volume is escaped to third space(ascites). So adding spironolactone is a good choice. +3
champagnesupernova3Always combine a K+ losing diuretic with a K+ sparing diuretic+16
bryno20My rational was a bit different. The patient likely has hepatorenal syndrome leading to a the ascites and decreased GFR. All diuretics, except for the steroids (eg, spironolactone), require secretion into the PCT in a GFR-dependent manner; for this reason, patient's with renal impairment show best success the steroid diuretics since their action is independent of renal function and GFR. +
utap2001RAAS system is increased in hepatic disease and HF, ACEI or ARB are good choices in diuresis therapy. +
kcyanide101I got this question wrong... My mind set was that in cirrhotic cases they have hyper estrenism which accounts for the spider angioma etc.... As such adding spironolactone which is a potent blocker of testosterone will make their condition worse :(+2
epiglotitties@kcyanide101 glad i'm not the only one who went about it that way+
submitted by โsweetmed(157)
A rapid reduction of ascites is often accomplished simply with the addition of low-dose oral diuretics in the outpatient setting. First-line diuretic therapy for cirrhotic ascites is the combined use of spironolactone (Aldactone) and furosemide (Lasix) - Clevland Clinic