[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"menu":3,"$fIB8ELIYumH_4QStbbxAQ1j8R8LgepSMVE2le0wN6A98":210},{"main":4,"mainTranslated":17,"footer":45,"footerTranslated":109},[5,8,11,14],{"title":6,"url":7},"Course library","https:\u002F\u002Fwww.medmastery.com\u002Fcourse-library",{"title":9,"url":10},"Pricing","https:\u002F\u002Fwww.medmastery.com\u002Fpricing",{"title":12,"url":13},"Earn credits","https:\u002F\u002Fwww.medmastery.com\u002Fcme-credits",{"title":15,"url":16},"Institutions","https:\u002F\u002Fwww.medmastery.com\u002Finstitutions",{"de":18,"es":27,"fr":36},[19,21,23,25],{"title":20,"url":7},"Kurse",{"title":22,"url":10},"Preise",{"title":24,"url":13},"CME-Punkte",{"title":26,"url":16},"Organisationen",[28,30,32,34],{"title":29,"url":7},"Biblioteca de cursos",{"title":31,"url":10},"Precios",{"title":33,"url":13},"Gana créditos",{"title":35,"url":16},"Instituciones",[37,39,41,43],{"title":38,"url":7},"Cours",{"title":40,"url":10},"Tarifs",{"title":42,"url":13},"Obtenir des crédits",{"title":44,"url":16},"Établissements",[46,59,79,97],{"title":47,"group":48,"menu":49},"Company",true,[50,53,56],{"title":51,"url":52},"Our teachers","https:\u002F\u002Fwww.medmastery.com\u002Fteachers",{"title":54,"url":55},"About us","https:\u002F\u002Fwww.medmastery.com\u002Fabout-us",{"title":57,"url":58},"Work with us","https:\u002F\u002Fwww.medmastery.com\u002Fwork-with-us",{"title":60,"group":48,"menu":61},"Product",[62,64,67,70,73,76,78],{"title":63,"url":7},"Courses",{"title":65,"url":66},"Magazine","https:\u002F\u002Fwww.medmastery.com\u002Fmagazine",{"title":68,"url":69},"Podcast","https:\u002F\u002Fwww.medmastery.com\u002Fpodcasts",{"title":71,"url":72},"Webinars","https:\u002F\u002Fwww.medmastery.com\u002Fwebinars",{"title":74,"url":75},"Guides","https:\u002F\u002Fwww.medmastery.com\u002Fguides",{"title":15,"url":77},"https:\u002F\u002Fwww.medmastery.com\u002Finstitutions\u002F",{"title":9,"url":10},{"title":80,"group":48,"menu":81},"Legal",[82,85,88,91,94],{"title":83,"url":84},"Imprint","https:\u002F\u002Fwww.medmastery.com\u002Fimprint",{"title":86,"url":87},"Newsletter policy","https:\u002F\u002Fwww.medmastery.com\u002Fnewsletter-privacy-policy",{"title":89,"url":90},"Privacy policy","https:\u002F\u002Fwww.medmastery.com\u002Fprivacy-policy",{"title":92,"url":93},"Cookie Policy","https:\u002F\u002Fwww.medmastery.com\u002Fcookie-policy",{"title":95,"url":96},"Terms","https:\u002F\u002Fwww.medmastery.com\u002Fterms",{"title":98,"group":48,"menu":99},"Customer support",[100,103,106],{"title":101,"url":102},"FAQs","https:\u002F\u002Fwww.medmastery.com\u002Ffaqs",{"title":104,"url":105},"Contact","https:\u002F\u002Fwww.medmastery.com\u002Fcontact",{"title":107,"url":108},"support@medmastery.com","mailto:support@medmastery.com",{"de":110,"es":143,"fr":177},[111,118,128,137],{"title":112,"group":48,"menu":113},"Unternehmen",[114,116,117],{"title":115,"url":52},"Unsere Dozentinnen und Dozenten",{"title":54,"url":55},{"title":57,"url":58},{"title":119,"group":48,"menu":120},"Produkt",[121,122,123,124,125,126,127],{"title":20,"url":7},{"title":65,"url":66},{"title":68,"url":69},{"title":71,"url":72},{"title":74,"url":75},{"title":26,"url":77},{"title":22,"url":10},{"title":129,"group":48,"menu":130},"Rechtliches",[131,133,134,135,136],{"title":132,"url":84},"Impressum",{"title":86,"url":87},{"title":89,"url":90},{"title":92,"url":93},{"title":95,"url":96},{"title":138,"group":48,"menu":139},"Kundenservice",[140,141,142],{"title":101,"url":102},{"title":104,"url":105},{"title":107,"url":108},[144,151,162,171],{"title":145,"group":48,"menu":146},"Empresa",[147,149,150],{"title":148,"url":52},"Nuestros profesores",{"title":54,"url":55},{"title":57,"url":58},{"title":152,"group":48,"menu":153},"Producto",[154,156,157,158,159,160,161],{"title":155,"url":7},"Cursos",{"title":65,"url":66},{"title":68,"url":69},{"title":71,"url":72},{"title":74,"url":75},{"title":35,"url":77},{"title":31,"url":10},{"title":163,"group":48,"menu":164},"Información legal",[165,167,168,169,170],{"title":166,"url":84},"Aviso legal",{"title":86,"url":87},{"title":89,"url":90},{"title":92,"url":93},{"title":95,"url":96},{"title":172,"group":48,"menu":173},"Atención al cliente",[174,175,176],{"title":101,"url":102},{"title":104,"url":105},{"title":107,"url":108},[178,185,196,204],{"title":179,"group":48,"menu":180},"Entreprise",[181,183,184],{"title":182,"url":52},"Nos enseignants",{"title":54,"url":55},{"title":57,"url":58},{"title":186,"group":48,"menu":187},"Produit",[188,189,190,191,192,193,194],{"title":38,"url":7},{"title":65,"url":66},{"title":68,"url":69},{"title":71,"url":72},{"title":74,"url":75},{"title":15,"url":77},{"title":195,"url":10},"Tarification",{"title":197,"group":48,"menu":198},"Mentions légales",[199,200,201,202,203],{"title":197,"url":84},{"title":86,"url":87},{"title":89,"url":90},{"title":92,"url":93},{"title":95,"url":96},{"title":205,"group":48,"menu":206},"Service client",[207,208,209],{"title":101,"url":102},{"title":104,"url":105},{"title":107,"url":108},{"content":211,"related":283,"meta":355,"internal":365},{"title":212,"leadIn":213,"category":214,"elements":217,"becomeAnExpert":251,"author":273,"readDuration":281,"readDurationFormatted":282},"The philosophy of diuretics","You probably agree that every clinician should understand how to handle diuretics, but do you know what to do when diuresis is not sufficient? Do you know what the ideal diuretic is in each patient? Our upcoming course, Fluids and Electrolytes Masterclass, will teach you all you need to know about diuretics, sodium, potassium, and much, much more.",{"id":215,"name":216},1,"Course previews",[218,229,234,239,246],{"type":219,"data":220},"video",{"readDurationInSeconds":221,"video":222},195,{"platform":223,"name":224,"url":225,"size":226},"YouTube","Philosophy of diuretics","https:\u002F\u002Fwww.youtube.com\u002Fwatch?v=0pDLwmMTFmM",{"width":227,"height":228},200,113,{"type":230,"data":231},"free_text",{"readDurationInSeconds":232,"text":233},11.466666666666667,"\u003Cp>Every clinician should understand how to handle diuretics (and most do), but do you know what to do when diuresis is not sufficient? Or how to choose the ideal diuretic for each patient? In this video from our Fluids and Electrolytes Masterclass, you'll go through important principles about diuretic therapy and managing diuresis.\u003C\u002Fp>",{"type":230,"data":235},{"readDurationInSeconds":236,"title":237,"text":238},17.066666666666666,"Join our Fluids and Electrolytes Masterclass Today!","\u003Cp>If you're a clinician working in internal medicine, you are likely taking care of patients with fluid and electrolyte problems on a daily basis. The \u003Ca href=\"https:\u002F\u002Fwww.medmastery.com\u002Fcourse\u002Ffluids-and-electrolytes-masterclass\">\u003Cstrong>Fluids and Electrolytes Masterclass\u003C\u002Fstrong>\u003C\u002Fa> teaches you the nuts and bolts of fluid and electrolyte management. You'll discover what it really means when sodium or potassium levels are abnormal, learn how to diagnose and treat imbalances, and get expert tips for prescribing diuretics.\u003C\u002Fp>",{"type":240,"data":241},"cta",{"readDurationInSeconds":242,"text":243,"buttonText":244,"buttonUrl":245},3.466666666666667,"Become a great clinician with our video courses and workshops","Start learning for free","https:\u002F\u002Fwww.medmastery.com\u002Fuser\u002Fregister",{"type":230,"data":247},{"readDurationInSeconds":248,"title":249,"text":250},101.06666666666666,"Video Transcript","\u003Cp dir=\"ltr\">\u003Cstrong>[00:00:00]\u003C\u002Fstrong> If the patient isn't volume depleted, they will be volume overloaded. It is the law of the hospital. So every doctor is endlessly prescribing diuretics. These drugs are the cornerstone of hypertension, heart failure, and nephrology. In these lessons, we'll go over the four classes of diuretics and the optimal use of each one. We'll discuss some of the variables that distinguish the different loop and thiazide diuretics from each other. One of the most important things we will go over, however, is how to adapt when a diuretic isn't working. Knowing how to turn around \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:00:30]\u003C\u002Fstrong> a failed diuresis is an awesome skill to have in your back pocket. Humans normally live in sodium equilibrium. The kidney excretes exactly as much sodium as the body absorbs. You can think of the kidneys as perfectly accurate atomic balancing machines. Sodium in equal sodium out and if not, you get pathologic conditions. For example, \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:01:00]\u003C\u002Fstrong> if sodium intake exceeds sodium excretion, the patient will develop edema. This is what happens regardless if the edema is due to cirrhosis or heart failure or nephrotic syndrome. In all those situations, sodium intake is exceeding sodium excretion. If sodium excretion exceeds sodium intake, the patient becomes volume depleted. This is what happens in diarrhea, \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:01:30] \u003C\u002Fstrong>vomiting, and with diuretics. In fact, that's the whole point of diuretics. Diuretics poison normal kidney function such that renal sodium excretion exceeds sodium intake. Diuretics lower total body sodium but they don't do that forever. Eventually, patients reach a new steady state where, once again, sodium intake equals sodium excretion. \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:02:00]\u003C\u002Fstrong> It just exists at a lower level of total body sodium than they did without the diuretics. Once they stopped the diuretics, their sodium balance returns to normal. Let's take a little closer look at renal sodium handling. Normal GFR is 100 mL \u002F min, normal sodium concentration is 140 and you've got 1440 minutes in a day. Multiply those together and you get 20,160 mmol of sodium that are filtered every \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:02:30] \u003C\u002Fstrong>day. How much sodium is excreted? Well, it's equivalent to the dietary intake. Call it at roughly 100 mmol per day though often quite a bit more. Take that 20 160, subtract that 100 and that leaves you 20 060 mmol of sodium that needs to be reabsorbed, 99.5% of the sodium filtered is reabsorbed by the nephron. That is the job of the nephros, it needs to reabsorb all that sodium so you can remain in sodium \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:03:00]\u003C\u002Fstrong> balance. Every segment of the nephron is involved in sodium reabsorption—the proximal tubule, the thick ascending limb of the loop of Henle, the distal convoluted tubule, and the cortical collecting duct. And each one of these is targeted by a unique class of diuretics. See one of these types in the next chapters bearing diuretics. We're going to go over each one of these types in the next chapters.\u003C\u002Fp>",{"courses":252,"showAwardsBelow":48},[253],{"id":254,"isFreeCmeCourse":255,"title":256,"type":257,"specialization":258,"teachers":260,"cmeCredits":262,"teacherIllustration":263,"backgroundImage":264,"relativeUrl":265,"lastChanged":266,"created":267,"description":268,"relativeURL":265,"meta":269},2026,false,"Fluids and Electrolytes Masterclass","course",[259],"Nephrology",[261],"Joel Topf, MD",5,"https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55eb7-10af-4c65-8174-3df202658892","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55eb7-dae2-4c71-baf3-9333ed8f1a6b","\u002Fcourses\u002Ffluids-and-electrolytes-masterclass","1769957860","1414606544","If you are a clinician working in internal medicine, you are likely taking care of patients with fluid and electrolyte problems on a daily basis. This course teaches you the nuts and bolts of fluid and electrolyte management. You'll discover what it really means when sodium or potassium levels are abnormal, learn how to diagnose and treat imbalances, and get expert tips for prescribing diuretics.",{"duration":270,"quizzes":271,"lessons":272},12323,9,54,{"id":274,"name":261,"image":275,"profession":276,"relativeUrl":279,"specializations":280},2118,"https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cefc-8e10-40f7-ba94-3b1be2090eaa",{"name":277,"description":278},"Nephrologist","Board certified nephrologist. Author of several medical textbooks. Social media aficionado.","\u002Fteachers\u002Fjoel-topf-md",[259],147,"3m",[284,311,330],{"id":285,"title":286,"text":287,"image":288,"author":296,"path":305,"readDuration":306,"readDurationFormatted":282,"internal":307},1350,"How to recognize INOCA (ANOCA) on an exercise stress test ","Angina, abnormal stress test, clean coronaries—that's INOCA (or ANOCA), and it carries real risk. Learn to recognize and report it with exercise stress ECG.",{"alt":289,"title":290,"size":291,"location":293},"Illustration of the heart's coronary vasculature showing large coronary arteries and the extensive network of smaller vessels affected in INOCA (ischemia with nonobstructive coronary arteries).","",{"width":292,"height":292},1200,{"bucket":294,"key":295},"public-drupal-medmastery-assets-production","\u002F2026-05\u002FC17(1)_magazine image_0.png",{"id":297,"title":298,"relativeURL":299,"image":300,"professionLong":301,"profession":302,"weight":304},1563,"Franz Wiesbauer, MD MPH","\u002Fteachers\u002Ffranz-wiesbauer-md-mph","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cef0-41ee-4005-9e4a-d8711c816401","Franz is the founder and CEO of Medmastery. He is an internist with a specialization in cardiology and a master’s in public health from Johns Hopkins University.",{"name":303},"Internist",4,"\u002Fmagazine\u002Fexercise-stress-ecg-inoca",141,{"created":308,"updated":309,"published":310},1778115738,1778799792,1778118255,{"id":312,"title":313,"text":314,"image":315,"author":321,"path":323,"readDuration":324,"readDurationFormatted":325,"internal":326},1348,"Hyperlipidemia screening: who, when, & what to measure","Testing for hyperlipidemia can help you mitigate your patients' cardiovascular risk. Learn who to screen and when, which measures to request, and how to stratify risk.",{"alt":316,"title":290,"size":317,"location":319},"Lipid panel blood sample tubes used to test for hyperlipidemia in a laboratory setting",{"width":318,"height":318},600,{"bucket":294,"key":320},"\u002F2026-04\u002FC121_magazine image.png",{"id":297,"title":298,"relativeURL":299,"image":300,"professionLong":301,"profession":322,"weight":304},{"name":303},"\u002Fmagazine\u002Ftest-for-hyperlipidemia",246,"5m",{"created":327,"updated":328,"published":329},1777403036,1777572381,1777412421,{"id":331,"title":332,"text":333,"image":334,"author":339,"path":348,"readDuration":349,"readDurationFormatted":350,"internal":351},1347,"Outpatient care for COPD exacerbations","Most acute COPD exacerbations can be managed with outpatient treatment. Learn how to treat mild and moderate COPD exacerbations—and when to escalate care.",{"alt":335,"title":290,"size":336,"location":337},"Older patient using a handheld nebulizer to inhale bronchodilator medication during an acute COPD exacerbation",{"width":318,"height":318},{"bucket":294,"key":338},"\u002F2026-04\u002FC133(4)_ exacerbations_magazine image.png",{"id":340,"title":341,"relativeURL":342,"image":343,"professionLong":344,"profession":345,"weight":347},5365,"Siamak Moayedi, MD","\u002Fteachers\u002Fsiamak-moayedi-md","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cf02-1064-4074-817b-0eb5de6ded74","Professor and Director of Medical Student Education, University of Maryland and Course Director, Essential and Critical Procedures, Emergency Medicine.",{"name":346},"Emergency medicine physician",1533,"\u002Fmagazine\u002Facute-copd-exacerbation-treatment",191,"4m",{"created":352,"updated":353,"published":354},1776705362,1776710540,1776710541,{"seo":356,"og":358},{"title":357,"description":213},"The philosophy of diuretics | Medmastery",{"title":357,"description":213,"image":359},{"alt":290,"title":290,"size":360,"location":363},{"width":361,"height":362},302,201,{"bucket":294,"key":364},"\u002Fmigrated-images\u002Fmagazine_150810.jpg",{"id":366,"created":367,"updated":368,"published":367},58,1439194074,1731351818]