A patient is diagnosed with hypertension.
What is the initial recommendation for this patient likely to be?

This is because potassium sparing diuretics do not lower potassium levels in the blood, unlike other types of diuretics.Potassium is an essential electrolyte that serves nerve and muscular functions and is regulated by the kidneys.Low potassium levels can cause irregular heartbeats and other problems. Therefore, patients taking potassium sparing diuretics should avoid food sources that are high in potassium, such as bananas, avocados, spinach, and potatoes.

Choice A is wrong because thiazide diuretics, such as hydrochlorothiazide, can cause low potassium levels in the blood.

Patients taking thiazide diuretics may need to take potassium supplements or eat more potassium-rich foods to prevent hypokalemia.

Choice B is wrong because osmotic diuretics, such as mannitol, do not affect potassium levels in the blood.

They work by increasing the amount of water in the urine, but do not alter the electrolyte balance.

Osmotic diuretics are mainly used to treat cerebral edema and glaucoma.

Choice D is wrong because loop diuretics, such as furosemide, can also cause low potassium levels in the blood.

They work by inhibiting the reabsorption of sodium and water in the loop of Henle, a part of the kidney.

Loop diuretics are used to treat edema and heart failure.

Normal ranges for potassium in the blood are 3.5 to 5.0 millimoles per liter (mmol/L).

Diuretics are drugs that increase the amount of urine and salt (sodium) excreted by the kidneys. They are used to treat high blood pressure, heart failure, and edema (fluid retention). However, some diuretics can cause low levels of potassium in the blood (hypokalemia), which can lead to muscle weakness, cramps, and arrhythmias. To prevent this, a combination of diuretics acting on different parts of the kidney (such as a loop diuretic and a thiazide diuretic) may be prescribed.This way, the potassium-sparing effect of one diuretic can balance the potassium-wasting effect of the other, while still achieving a net sodium loss.

Choice A is wrong because they are not a part of the initial diuretic therapy.Combination diuretic therapy is usually reserved for patients who are resistant to or intolerant of monotherapy.

Choice C is wrong because little follow up is not needed after the initial treatment.Patients on combination diuretic therapy require close monitoring of their blood pressure, electrolytes, renal function, and weight to avoid adverse effects such as dehydration, hyponatremia, hypotension, and worsening renal function.

Choice D is wrong because they do not increase the risk of hypokalemia.As explained above, combination diuretic therapy aims to reduce the risk of hypokalemia by using a potassium-sparing diuretic along with a potassium-wasting diuretic.