Bartter syndrome medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
*Prostaglandin synthetase inhibitors suppress the production of [[prostaglandin]]. This corrects all the chemical features of the syndrome except the urinary loss of [[potassium]].<ref name="pmid820194">{{cite journal| author=Gill JR, Frölich JC, Bowden RE, Taylor AA, Keiser HR, Seyberth HW | display-authors=etal| title=Bartter's syndrome: a disorder characterized by high urinary prostaglandins and dependence of hyperreninemia on prostaglandin synthesis. | journal=Am J Med | year= 1976 | volume= 61 | issue= 1 | pages= 43-51 | pmid=820194 | doi=10.1016/0002-9343(76)90029-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=820194 }} </ref> | *Prostaglandin synthetase inhibitors suppress the production of [[prostaglandin]]. This corrects all the chemical features of the syndrome except the urinary loss of [[potassium]].<ref name="pmid820194">{{cite journal| author=Gill JR, Frölich JC, Bowden RE, Taylor AA, Keiser HR, Seyberth HW | display-authors=etal| title=Bartter's syndrome: a disorder characterized by high urinary prostaglandins and dependence of hyperreninemia on prostaglandin synthesis. | journal=Am J Med | year= 1976 | volume= 61 | issue= 1 | pages= 43-51 | pmid=820194 | doi=10.1016/0002-9343(76)90029-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=820194 }} </ref> | ||
*[[Hypokalemia]] should be treated. [[Potassium chloride]] supplements are preferred salt because of the coexisting [[chloride]] deficiencies in these patients.<ref name="pmid26140272">{{cite journal| author=Al Shibli A, Narchi H| title=Bartter and Gitelman syndromes: Spectrum of clinical manifestations caused by different mutations. | journal=World J Methodol | year= 2015 | volume= 5 | issue= 2 | pages= 55-61 | pmid=26140272 | doi=10.5662/wjm.v5.i2.55 | pmc=4482822 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26140272 }} </ref> | *[[Hypokalemia]] should be treated. [[Potassium chloride]] supplements are preferred salt because of the coexisting [[chloride]] deficiencies in these patients. | ||
*[[Spironolactone]], aldosterone antagonist. | |||
*Amiloride reduces potassium and hydrogen excretion, by inhibiting epithelial sodium channels (ENaC). | |||
*[[Triamterene]] decreases [[calcium]] excretion and increases [[magnesium]] loss. | |||
*[[Angiotensin-converting enzyme (ACE) inhibitors]], such as [[captopril]], [[enalapril]] and [[lisinopril]]. | |||
*Nonsteroidal drug anti-inflammatory drugs (NSAID) such as [[indomethacin]] and [[naproxen]] which decrease the activity of the enzyme [[cyclo-oxygenase]] (COX) which increases [[prostaglandin]] synthesis. | |||
*[[Growth hormone]] (GH) for growth retardation. | |||
*Calcium or magnesium supplements in the presence of muscle spasm and tetany.<ref name="pmid26140272">{{cite journal| author=Al Shibli A, Narchi H| title=Bartter and Gitelman syndromes: Spectrum of clinical manifestations caused by different mutations. | journal=World J Methodol | year= 2015 | volume= 5 | issue= 2 | pages= 55-61 | pmid=26140272 | doi=10.5662/wjm.v5.i2.55 | pmc=4482822 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26140272 }} </ref> | |||
==References== | ==References== | ||
Revision as of 19:53, 4 August 2020
Main article: Bartter syndrome
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Tayyaba Ali, M.D.[2]
Overview
Medical Therapy
- Prostaglandin synthetase inhibitors suppress the production of prostaglandin. This corrects all the chemical features of the syndrome except the urinary loss of potassium.[1]
- Hypokalemia should be treated. Potassium chloride supplements are preferred salt because of the coexisting chloride deficiencies in these patients.
- Spironolactone, aldosterone antagonist.
- Amiloride reduces potassium and hydrogen excretion, by inhibiting epithelial sodium channels (ENaC).
- Triamterene decreases calcium excretion and increases magnesium loss.
- Angiotensin-converting enzyme (ACE) inhibitors, such as captopril, enalapril and lisinopril.
- Nonsteroidal drug anti-inflammatory drugs (NSAID) such as indomethacin and naproxen which decrease the activity of the enzyme cyclo-oxygenase (COX) which increases prostaglandin synthesis.
- Growth hormone (GH) for growth retardation.
- Calcium or magnesium supplements in the presence of muscle spasm and tetany.[2]
References
- ↑ Gill JR, Frölich JC, Bowden RE, Taylor AA, Keiser HR, Seyberth HW; et al. (1976). "Bartter's syndrome: a disorder characterized by high urinary prostaglandins and dependence of hyperreninemia on prostaglandin synthesis". Am J Med. 61 (1): 43–51. doi:10.1016/0002-9343(76)90029-2. PMID 820194.
- ↑ Al Shibli A, Narchi H (2015). "Bartter and Gitelman syndromes: Spectrum of clinical manifestations caused by different mutations". World J Methodol. 5 (2): 55–61. doi:10.5662/wjm.v5.i2.55. PMC 4482822. PMID 26140272.