38. Diuretics Flashcards
1
Q
Common reasons to give patients diuretics?
A
- lower BP
- decrease edema (HF)
2
Q
5 classes of diuretics
A
- thiazides: hydrochlorothiazide
- loop: furosemide
- osmotic: mannitol
- carbonic anhydrase inhibitor: acetazolamide
- K-sparing: spironolactone
3
Q
MOA of hydrochlorothiazide (HCTZ)
A
- acts on renal distal tubules
- Na, K, and H2O excretion
- decreases preload and cardiac output
- dilates arterioles
4
Q
uses of HCTZ
A
- increase urine output
- HTN
- edema/heart failure
- nephrotic syndrome
- ascities
5
Q
side effects of HCTZ
A
- dizziness
- headache
- hyperglycemia
- hyperuricemia
- hypercalcemia
- hypomagnesemia
- muscle cramps
6
Q
adverse reactions to HCTZ
A
- orthostatic hypotension
- hyponatremia
- gout
- hypokalemia
- hyperglycemia
- SJS
- aplastic anemia and hemolytic anemia
- thrombocytopenia
- agranulocytosis
- photosensitivity
- renal failure
7
Q
contraindications for HCTZ
A
renal failure and hypersensitivity
8
Q
What is a drug interaction that occurs w/ HCTZ
A
increased risk of Digoxin toxicity if hypokalemia occurs
9
Q
patient teaching for HCTZ
A
- take in the morning
- slow positional changes
- K rich diet
10
Q
What to monitor in patients taking HCTZ
A
- BP
- electrolytes
- glucose (want baseline)
- uric acid
- daily weights
- urine output
11
Q
MOA of furosemide
A
- inhibits reabsorption of NaCl in the loop of Henle and proximal tubule (water follows salt)
- more potent than thiazides
12
Q
uses of furosemide
A
- CHF
- renal dysfunction
- HTN (not main use)
- nephrotic syndrome
- acute pulmonary edema
13
Q
side effects of furosemide
A
- headache (from decreased BP)
- muscle cramps
- dizziness
- weakness
14
Q
adverse effects
A
- dehydration
- hyponatremia
- hypochloremia
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hypotension
- ototoxicity (IV given slowly to prevent hearing loss)
- hyperglycemia
- renal failure
- increased LDL and decreased HDL
- SJS
15
Q
what to monitor in patients taking furosemide
A
- daily weights
- if K is below 3.5 -> monitor ECG (pt usually on K supplement)
- take in am to prevent nocturia
- monitor BP
- monitor I&Os