Chapter 28-Diuretic Drugs Flashcards
These drugs accelerate the rate of urine formation
Diuretic drugs
These drugs result in the removal of sodium and water from the body
Diuretic drugs
These drugs are used in the treatment of hypertension, heart failure, and renal failure
Diuretic drugs
Which location in the kidney is the area where the highest percentage of sodium and water are reabsorbed back into the bloodstream?
Ascending loop of Henle
Which location in the kidney is the greatest percentage of sodium and water returned to the bloodstream?
The proximal tubule
Carbonic anhydride inhibitors, loop, osmotic, potassium-sparring, and Thiazide and Thiazide-like are all types of ______
Diuretics
What is the most commonly used carbonic anhydrase inhibitor?
Acetazolamide (Diamox)
The enzyme carbonic anhydrase helps to make H+ ions available for exchange with sodium and water in the proximal tubules. These drugs block the action of carbonic anhydrase, preventing the exchange of H+ ions with sodium and water
Carbonic anhydrase inhibitors
These are adjunct drugs in the long-term management of open-angle glaucoma. They lower intraocular pressure prior to ocular surgery.
Carbonic anhydrase inhibitors
The strokes are useful in the treatment of edema and high-altitude sickness
Carbonic anhydrase inhibitors
These drugs are considered a less potent diuretic than loop diuretics or thiazides
Carbonic anhydrase inhibitors
Metabolic acidosis, anorexia, hematuria, photosensitivity, hypokalemia, drowsiness, urticaria, Paresthesia, and glycosuria in diabetics are all adverse affects of what type of drug?
Carbonic anhydrase inhibitors
What is the drug classification for Bumetanide (Bumex), ethacrynic (Edecrin), furosemide (Lasix), and torsemide (Demadex) ?
Loop diuretics
These drugs act directly on the ascending limb of the loop of Henle to inhibit chloride and sodium reabsorption. They increased renal prostaglandins, resulting in the dilation of blood vessels and reduced peripheral vascular resistance. They are useful in the treatment of edema and possess renal, cardiovascular, and metabolic effects.
Loop diuretics
These drugs cause a depletion in potassium and sodium
Loop diuretics
A reduction in blood pressure, pulmonary vascular resistance, systemic vascular resistance, central venous pressure, and left ventricular end-diastolic pressure are the result of ______ _____ _____
Decreased fluid volume
Edema associated with heart failure or heart disease, to control hypertension, increased renal excretion of calcium and faces with hypercalcemia, in cases of heart failure resulting from diastolic dysfunction are all indications of ______ ______
Loop Diuretics
What are the adverse affects of a loop diuretics?
Dizziness, headache, tinnitus, blurred vision, nausea, vomiting, diarrhea, Stevens-Johnson syndrome, agranulocytosis, neutropenia, thrombocytopenia, hypokalemia, hyperglycemia, hyperuricemia
When administering a loop diuretic to a patient, it is most important for the nurse to determine if the patient is also taking which drug?
Lithium (Eskalith)
What is the most common osmotic diuretic?
Mannitol (Osmitrol)
Which area of the kidney do osmotic diuretics effect?
Proximal tubule
The mechanism of action for this classification of drug is to inhibit tubular resorption of water and solutes, producing rapid diuresis. It pulls water into the renal tubules from the surrounding tissues and increases glomerular filtration rate and renal plasma flow, Which helps to prevent kidney damage during acute renal failure. It reduces intercranial pressure or cerebral edema associated with head trauma and also reduces excessive intraocular pressure.
Osmotic diuretics
Convulsions, thrombophlebitis, pulmonary congestion, headache, chest pain, tachycardia, blurred vision, chills, and fever are all adverse affects of this drug classification.
Osmotic diuretics
This osmotic diuretic can only be infused intravenously. It may crystallize when exposed to low temperatures and use of a filter is required.
Mannitol (Osmitrol)
What is the drug classification for amiloride (Midamor), spironololactone (Aldactone), triamterene (Dyrenium)?
Potassium sparing diuretics or aldosterone inhibiting diuretics
The mechanism of action for this classification of drug is interfering with sodium-potassium exchange, competitively binding to aldosterone receptors usually induced by aldosterone. This action takes place in the collecting ducts and distal convoluted tubules.
Potassium-sparing diuretics or aldosterone-inhibiting diuretics
The effects of this drug classification are to prevent potassium from being pumped into the tubules, preventing it’s secretion. It competitively blocks aldosterone receptors and inhibits their action, promoting the excretion of sodium and water while sparing potassium excretion.
Potassium-sparing diuretics or aldosterone-inhibiting diuretics
Hyperaldosteronism, hypertension, reversing potassium loss caused by potassium – losing drugs, and certain cases of heart failure are indications for which drugs?
Potassium-sparing diuretics or aldosterone-inhibiting diuretics
Spironolactone (Aldactone) & triamterene (Dyrenium)
Which potassium-sparing diuretic is used for the treatment of heart failure?
Amiloride (Midamor)
Dizziness, headache, cramps, nausea, vomiting, diarrhea, urinary frequency, weakness, and hyperkalemia, are all adverse effects of which drug classification?
Potassium-bearings diuretics for aldosterone-inhibiting diuretics
Gynecomastia, amenorrhea, irregular menses, and postmenopausal bleeding are all adverse affects of this specific potassium-sparing diuretic?
Spironolactone (Aldactone)
What is the drug classification for Hydrochlorothiazide (Esidrix, HydroDIURIL) and chlorothiazide (Diuril) ?
Thiazide diuretics
What is the drug classification for Metolazone (Mykrox, Zaroxolyn), chlorothalidone (Hydone, Thalitone), indapamide (Lozol)?
Thiazide-Like diuretics
These drugs inhibit tubular resorption of sodium, chloride, and potassium ions. They act primarily in the distal convoluted tubule of the kidney. They cause the excretion of water, sodium, chloride and lesser volumes of potassium and dilate the arterioles by direct relaxation.
Thiazide and thiazide-like diuretics
This drugs in this classification lower peripheral vascular resistance and deplete sodium, water, and potassium
Thiazide and Thiazide-like diuretics
Thiazides should not be used if the creatinine clearance is less than ______ to ______ mL/min (normal is 125 mLmin)
30 to 50
Thiazide and thiazide-like diuretics are one of the most prescribed group of drugs for this condition?
Hypertension
Hypertension, edematous states, idiopathic hypercalcuria, diabetes insipidus, and heart failure due to diastolic dysfunction are indications for this drug classification.
Thiazide and Thiazide-like diuretics
This drug classifications serves as adjunct drugs in treatment of edema related to heart failure, hepatic cirrhosis, or corticosteroid/estrogen therapy
Thiazide and Thiazide-like diuretics
Dizziness, headache, blurred vision, anorexia, nausea, vomiting, diarrhea, impotence, jaundice, Leukopenia, photosensitivity, hypokalemia, hypoglycemia, hyperuricemia, hypochloremic alkalosis are adverse effects for this drug classification?
Loop diuretics
What are the therapeutic effects of diuretics?
Reduction of the edema, reduction of fluid volume overload, improvement of manifestations of heart failure, reduction of hypertension, return to normal intraocular pressure
A patient with creatinine clearance of 20 mL/min is admitted to the medical surgical unit. The patient is in need of rapid diuresis. Which class of diuretic does the nurse anticipate administering?
Thiazide
Metolazone (Zaroxolyn)
Furosemide (Lasix) is ordered for a patient. Before administering the drug it is important for the nurse to assess the patient for allergies to which drug class?
Sulfonamides
Two days after admission, the nurse is reviewing the laboratory results of a patient. Which is the most common electrolyte finding resulting from administration of furosemide (Lasix)?
Hypokalemia
