Clinical selection of diuretic drugs in the management of cardiac edema ∗

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Mild cardiac edema can usually be controlled with a thiazide diuretic or a related sulfonamide compound. Successful treatment of moderate or severe heart failure generally requires (1) more potent diuretic drugs used alone, or (2) a combination of diuretic agents, such as ethacrynic acid or furosemide combined with a potassium-sparing drug or thiazide diuretic, or both. Regardless of the regimen employed, the efficient use of these various diuretic agents requires an intimate familiarity with their clinical pharmacology.