Chapter 26 Diuretic Drugs Flashcards
1
Q
Loop Diuretics
A
- furosemide (Lasix)
- Act in the ascending limb of the loop of Henle to inhibit CL- and NA+ resorption.
- Increases urinary MG2+ and CA2+ secretion
- Dilates blood vessels in the kidneys and lungs
- Potent diuretics and subsequent loss of fluids (only a single daily dose is needed because of potency)
- Rapid diuresis because of rapid onset
- Adverse effects: dizziness, headache, nausea, vomiting, diarrhea, electrolyte disturbances (decreased CA2+ = bone loss), changes in insulin and glucose
- Interactions: NSAIDS decrease effect and Thiazide increase effect
2
Q
Potassium Sparing Diuretics
A
- Work in the collecting ducts and distal convoluted tubules
- Competitively bind to aldosterone receptors (antagonist) and they block the resorption of NA+ and water usually induced by aldosterone. Prevents the renin aldosterone system.
- spironolactone
- weaker effect then loop diuretics (may be used in a combo to reverse the K+ loss in loop diuretics)
- Contraindications: hyperkalemia (great then 5.5 mmol/L) and severe kidney failure and hormonal disruptions
- Adverse effects: dizziness, headache, nausea, vomiting, diarrhea, hyperkalemia
3
Q
Thiazide and like diuretics
A
- Inhibit tubular resorption of NA+, CL-, and K+ ions (osmotic water loss)
- Acts primarily in the distal convoluted tubule
- Dilates the arteriloes by direct relaxation. Used for edematous states and heart failure.
- Should not be used if creatinine clearance is less than 30 to 50 mL/min (normal is 125)
- Cheapest
- Known for hyperkalemia (muscle weakness, cramping)
- Adverse effects: headache, decreased libido, impotence, NVD, elevated CA2+, lipids, glucose, and uric acid
- Interactions: digoxin toxicity, decreased antidiabetic effect, corticosteriods cause hypokalemia
