A patient with chronic heart failure and edema, with normal liver and kidney function, is prescribed a diuretic to relieve fluid retention. Which diuretic is commonly used?

A patient with chronic heart failure and edema, with normal liver and kidney function, is prescribed a diuretic to relieve fluid retention. Which diuretic is commonly used?

• A. Spironolactone
• B. Furosemide
• C. Hydrochlorothiazide
• D. Acetazolamide

Answer: (B)

In heart failure with fluid overload, you want rapid and strong removal of excess water. Loop diuretics fit that need best because they cause substantial natriuresis and diuresis by blocking the Na-K-2Cl transporter in the thick ascending limb of the loop of Henle. This makes them the go-to choice for relieving edema in chronic heart failure, especially when kidney function is relatively preserved. Furosemide, a loop diuretic, is the standard pick here for fast relief of fluid retention. Spironolactone, while helpful in heart failure for reducing mortality and for its potassium-sparing effect, provides milder diuresis and is typically used as an add-on rather than the primary agent for rapid edema relief. Hydrochlorothiazide is a weaker diuretic and less effective for significant edema, particularly in heart failure. Acetazolamide isn’t used for edema management; it serves other indications and doesn’t provide the needed diuresis.

In heart failure with fluid overload, you want rapid and strong removal of excess water. Loop diuretics fit that need best because they cause substantial natriuresis and diuresis by blocking the Na-K-2Cl transporter in the thick ascending limb of the loop of Henle. This makes them the go-to choice for relieving edema in chronic heart failure, especially when kidney function is relatively preserved.

Furosemide, a loop diuretic, is the standard pick here for fast relief of fluid retention. Spironolactone, while helpful in heart failure for reducing mortality and for its potassium-sparing effect, provides milder diuresis and is typically used as an add-on rather than the primary agent for rapid edema relief. Hydrochlorothiazide is a weaker diuretic and less effective for significant edema, particularly in heart failure. Acetazolamide isn’t used for edema management; it serves other indications and doesn’t provide the needed diuresis.