Clinical and Pharmacological Characteristics of Loop Diuretics and Current Approaches to Their Rational Use

Introduction. This issue is relevant because it is necessary to integrate theoretical and clinical understanding of loop diuretics with the challenges of modern medicine. The prescription of drugs such as furosemide, torasemide, and bumetanide is often based on stereotypes rather than on individual patient characteristics, despite the fact that they have been widely used for decades. This leads to widespread diuretic resistance, frequent hospitalizations due to exacerbations of chronic heart failure, and the emergence of predictable complications such as severe hypokalemia or renal dysfunction. In light of the epidemic of cardiovascular and metabolic diseases, optimizing the most common therapeutic interventions is a key priority for improving patients’ quality of life and the efficient use of healthcare resources. New data are challenging traditional approaches, highlighting the current relevance of this issue. According to recent studies, pharmacokinetic variability (e.g., unpredictable bioavailability of furosemide) and pathophysiologically grounded approaches to overcoming resistance (e.g., sequential nephron blockade) are vital. To achieve this, it is necessary to move away from standard regimens and instead use individualized strategies that take into account the specific diagnosis, renal status, hypoalbuminemia, and other factors. Thus, systematizing this knowledge through comprehensive work not only bridges the gap between cutting-edge science and clinical practice but also serves as the foundation for developing local clinical protocols and educational programs aimed at enhancing the professional competence of physicians and pharmacists. The aim of this theoretical study is to examine the clinical and pharmacological properties of loop diuretics, as well as to develop, based on current data, evidence-based strategies for their rational use in various clinical situations. Materials and мethods. An analytical review of current scientific publications, pharmacological studies, and clinical guidelines regarding the use of furosemide, bumetanide, and torasemide was conducted. The literature search was performed in the PubMed, Scopus, and Web of Science databases using relevant keywords. The obtained data were synthesized using methods of comparative and systematic analysis. Results. The human body functions as a complex system, and maintaining water and electrolyte balance is crucial for the normal functioning of all organs. The kidneys play a key role in regulating fluid volume and electrolyte levels, ensuring a stable internal environment.