Ch. 41: Diuretics

Question 1

Furosemide (lasix)

Answer 1

• most frequently prescribed loop diuretic
• acts on ascending loop to block reabsorption
• for pulmonary edema, edematous states, and hypertension
• adverse effects: dehydration, hypokalemia, ototoxicity, hyperglycemia, hyperuricemia, impact lipids/calcium, and magnesium metabolism
• interactions: digoxin, ototxic drugs, K+ sparing diuretics, lithium, antihypertensive agents, and NSAIDs

Question 2

Thiazides

Answer 2

• increase renal excretion of sodium, cholride, K+ and water
• elevate levels of uric acid and glucose
• max diuresis is considerably lower than with loop diurettics
• not effective when urine flow is scant (unlike loop)

Question 3

Hydrochlorothiazide (HydroDIURIL)

Answer 3

• early segment DVT
• for hypertension and edema, diabetes insipidus
• adverse effects: dehydration, hypokalemia, hyperglycemia, and hyperuricemia, impacts lipid, calcium and magnesium
• interactions: digoxin, augments effect of hypertensive meds; reduce renal excretion of lithium; NSAIDs may blunt diuretic effect

Question 4

K+-Sparing Diuretics

Answer 4

• modest increase in urine production and substantial decrease in K+ excretion
• rarely used alone
• aldosterone anatagonist: Spironolactone
• Nonaldosterone anatgonist: Triameterene

Question 5

Spironolactone (Aldactone)

Answer 5

• blocks aldosterone in distal nephron, retention of K+ and increased excretion of Na+
• uses: hypertension, edematous states, heart failure, primary hyperaldosteronism, PMS syndrmoe, acne
• adverse: hyperkalemia, benign and malignant tumors, and edocrine effects
• interactions: thiazide and loop diuretics; agents that raise K+ levels

Question 6

Osmotic Diuretic: Mannitol

Answer 6

• promotes diuresis by creating osmotic force within lumen of the nephron
• drug must be given parenterally
• uses: prophalyaxis of renal failure, reduction of intracranial pressure and intraocular pressure
• adverse effects: edema, headache, N/V, fluid and electrolyte imbalance