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bnf 2021 > 2. Oedema > Flashcards

2. Oedema Flashcards

1
Q

What is oedema

A

Oedema is the build-up of fluid in the body’s tissues making them puffy and swollen. Oedema can affect any part of the body, but because gravity makes fluid fall downwards, the feet and ankles are most frequently affected

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2
Q

When is best to take meds for oedema

A

Morning

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3
Q

Oedema

Tx

A

Loop diuretic

Bumetanide (most potent) BD

Furosemide (Can cause gout, hyperuricemia) OD

Torsemide (SE mucscle pain) BD

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4
Q

Loop diuretics

Treat which oedema best?

A

Pulmonary oedema

In HF & LVEF

OR
Resistant hypertension

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5
Q

What has to checked before meds started in oedema patients

A

Urine output

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6
Q

When is best to take dose ?

Looo diuretics?

A

4 pm

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7
Q

Loop diuretic CI

In men

A

Benign prostatic hyperplasia

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8
Q

Loop diuretics

And acute urinary retention

A

Most common men usually sue to enlarged prostrates

Urologic emergency ! 🔴

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9
Q

Loop diuretic

SE

A

🔴Ototoxicity ( tinnitus, deafness)

Dizziness; electrolyte imbalance; fatigue; headache; metabolic alkalosis; muscle spasms; nausea

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10
Q

Diuretics

Caution

A

Anuria; comatose and precomatose states associated with liver cirrhosis; renal failure due to nephrotoxic or hepatotoxic drugs; severe hypokalaemia; severe hyponatraemia

Hypotension, dehydration

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11
Q

Loop diuretics

Direction

A

1 hr onset & 6 hrs duration

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12
Q

Avoid these
Meds In renal impairment

DAMN

A

D diuretics

A Ace/ARB

M metformin

N NSAIDs

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13
Q

Thiazides

Indicated for

A

Hypertension
Mild heart failure
Oedema

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14
Q

List

thiazides diuretics

A 
Chlorothiazide 
Chlorthalidone 
Hydrochlorothiazide 
Indapamide.
Metolazone.
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15
Q

Which 2
THIAZIDE diuretics Are only given on alternate days

Why?

A

Chlortalidone 40-60hrs

Indapramide 16hrs

Due to long half-life

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16
Q

Thiazides not given in
Severe renal failure

What reading?

Except from 1 that can be given …? Which one is that

A

eGFR<30ml/min

METOLAZONE

Thiazides and related diuretics are ineffective if eGFR is less than 30 mL/minute/1.73 m2 and should be avoided.

Metolazone remains effective if eGFR is less than 30 mL/minute/1.73 m2 but is associated with a risk of excessive diuresis.

17
Q

Thiazides

SE

A 
Alkalosis hypochloraemic; 
constipation; 
diarrhoea; 
dizziness; 
dry mouth; 
electrolyte imbalance; 
erectile dysfunction; 
fatigue; 
headache;

Raised LDL & Triglycerides
hyperglycaemia;
hyperuricaemia;
Hypokalaemia

nausea;
postural hypotension;
Impotence
skin reactions

18
Q

Best thiazides to take by diabetic

A

Indapramide

least aggregator to diabetes

19
Q

Thiazides

Start acting in body

How long do they stay in body

A

Start 1-2 hrs

Remain 12-24hrs

20
Q

Potassium sparing diuretics

Triamterene

Amiloride

CI

A

Addison’s disease; anuria; hyperkalaemia

21
Q

Potassium sparing diuretics

Which one causes blue urine

A

Triamterene

22
Q

Potassium sparing diuretics

Are used for oedema, HF, hypertension and ….?

A

Instead of a K+ supplement

They work better than supplements

23
Q

Potassium sparing diuretic

List 2

A

Triamterene

Amiloride

24
Q

Aldosterone antagonist

Such as

spironolactone

Eplerenone

Are also…?

A

Potassium sparing

25
Q

SE

Of spironolactone

Many in men

A

Gynecomastia (breasts in men)

Hypertrichosis (hairy)

26
Q

List 2

Aldosterone antagonists

A

Spironolactone

Eplerenone

27
Q

Ascites

is the medical term used to describe the abnormal build-up of fluid in the abdominal cavity. Over 7 in 10 cases of ascites is caused by cirrhosis (scarring) of the liver

Which Aldosterone antagonist is used?

A

Spironolactone

28
Q

Hyperkalaemia

symptoms

A 
Abdominal (belly) pain and diarrhea.
Chest pain.
Heart palpitations or arrhythmia (irregular, fast or fluttering heartbeat).
Muscle weakness or numbness in limbs.
Nausea and vomiting
29
Q

Factors causing :

Hyperkalaemia

A

Addison’s disease (adrenal insufficiency)

Angiotensin II receptor blockers.ARB

Angiotensin-converting enzyme (ACE) inhibitors.

Beta blockers. BB

Dehydration.

Destruction of red blood cells due to severe injury or burns.

Excessive use of potassium supplements.

Aldosterone antagonist: spironolactone/eplerenone
Type 1 diabetes

30
Q

Hyperkalaemia

Can cause

A

life-threatening heart rhythm changes,

Cardiac arrhythmias

paralysis and weakness

Numbness

Hepatic encephalopathy

31
Q

Aldosterone antagonist

Spironolactone
Eplerenone

CI which which drugs
(3)

A

ACE/ARB

Potassium supplements

Other potassium sparing drugs : triamterene/ amiloride

32
Q

Osmotic diuretics

Name one

A

glycerin (Glycerol)
Isosorbide.
Mannitol IV.
Urea.

33
Q

Osmotic diuretic

Mannitol IV

Indicated in

A

Cerebral oedema

High Intracranial pressure

34
Q

Osmotic diuretics

Such as mannitol

SE

A

Cough; headache; vomiting

35
Q

Simple gravitational oedema

Tx

A

1 compression stocking

2 not routinely treated with diuretics but IF given only for a short time

bnf 2021 (20 decks)

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