medicina59巻12号

2022年11月発行

特集 避けて通れない心不全診療—総合内科力・循環器力を鍛えよう！ 急性心不全

利尿薬：フロセミドで十分な利尿効果が得られない急性心不全では何をしたらよいですか？

著者： 河越美佳¹ 谷亀元香¹ 河原崎宏雄¹

所属機関： ¹帝京大学医学部附属溝口病院腎臓内科

ページ範囲：P.2146 - P.2151

Point
◎利尿薬抵抗性とは，十分量の利尿薬を投与してもなお求められる利尿効果が得られない状態を指す．
◎十分量の利尿薬，利尿薬の種類，利尿効果の程度，評価タイミングなどには厳密な定義はない．
◎利尿薬抵抗性のときは病態の把握とともに，ループ利尿薬の増量，投与回数増加，効果の異なる利尿薬の併用をまず考える．
◎外来では内服アドヒアランス，食塩摂取量，非ステロイド性抗炎症薬（NSAIDs）の内服などについても注意する．

参考文献

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