Cardiovascular Drugs: Diuretics Flashcards
4 major classes of diuretics
loop
thiazide
K+ sparing
osmotic
which diuretic class results in the MOST diuresis?
osmotic
which diuretic class THAT IS USED FOR HTN results in the most diuresis?
loop
do diuretics work in ESRD
no (they require filtrate to be produced)
which diuretic class results in the greatest hypokalemia risk
loop
Why is spironolactone prescribed for HTN?
very minimal diuresis, but can be used in combination with a loop or thiazide diuretic to avoid hypokalemia
adverse effects of loop diuretics?
hypokalemia, hyponatremia, hypochloridemia
hypotension, hypovolemia
ototoxicity
what are the s/s of ototoxicity?
hearing loss
tinnitus
balance issues
which diuretic class is first line for hypertension?
thiazide
list a few loop diuretics
furosemide
ethancrynic acid
torsemide
list a few thiazide diuretics
chlorothiazide
hydrochlorothiazide
methylchlothiazide
in a patient with low GFR, which diuretic class needs to be used?
loop
name the major potassium sparing diuretic
spironolactone
others - triamterene, amiloride
what is another positive effect of spironolactone besides those that involve the kidney?
decreased cardiovascular remodeling
adverse effects of spironolactone
hyperkalemia (if used alone)
gynecomastia, menstrual irregularities
how do osmotic diuretics work?
filtered by glomerulus, remain in filtrate - water is thus pulled out into the filtrate along osmotic gradient
immediately after administration of mannitol, what is a risk?
fluid overload (heart failure exacerbation & pulmonary edema)
electrolyte changes that can occur with mannitol
hyperNa+/K+
electrolyte changes that can occur with loop diuretics
hypoNa+, Cl-, K+
electrolyte changes that can occur with thiazide diuretics
hypoK+
electrolyte changes that can occur with K+ sparing diuretics
hyperK+
