In this This Is Why with Dr. Busti pharmacology review, Dr. Busti breaks down the science and clinical application of loop diuretics—a cornerstone drug class for managing fluid overload and edema. Drawing on his experience as a nurse, pharmacist, physician, and educator, he explains how these agents work at the loop of Henle, their pharmacokinetic differences, and why understanding their mechanism helps prevent common pitfalls like electrolyte disturbances, diuretic resistance, and hemodynamic instability.

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This session translates complex renal physiology into clear, clinically relevant knowledge—connecting the why behind loop diuretics’ powerful therapeutic effects and potential risks in both inpatient and outpatient care.

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Disclaimer: This content is for educational purposes only and is not intended to provide medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have heard in this content.

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Chapter Table of Contents

00:00 – Intro & Why Loops Matter
06:30 – Drug Lineup: Furosemide, Bumetanide, Torsemide (+ Ethacrynic Acid)
12:00 – Indications: Edema, HF, Ascites (BP secondary)
18:00 – Renal Perfusion 101: Getting Drug to Site of Action
24:00 – Nephron Tour → Thick Ascending Limb Focus
30:00 – MOA: NKCC2 Blockade & Rapid Diuresis
36:00 – Electrolytes: K⁺/Mg²⁺/Ca²⁺ Loss, QT Risk, Contraction Alkalosis
44:00 – PK & Dosing: PO vs IV, Potency, Ceiling Doses, Conversions
51:30 – Adverse Effects & Interactions: Ototoxicity, NSAIDs, Digoxin, Lithium
58:30 – Monitoring: Vitals, Daily Weights, BMP/CMP, Renal Function
01:05:00 – Counseling & Clinical Pearls; Wrap-Up

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