Chapter 41 diuretics Flashcards
What is diuretics?
It results in the removal of what?
A drug that accelerates the rate of urine formation
Sodium and water
Diuretic drugs are used in the treatment of what 3 things?
Hypertension
Heart failure
Renal failure
2.2 pounds is equal to how much fluid loss?
1L
Diuretics may increase what and it isn’t good for what??(2)
Uric acid levels
Not great choice for a patient with gout or renal stones
What are the 5 types of diuretics?
Thiazide
Loop
Osmotic
Carbonic Anhydrase inhibitor
Potassium sparing
What are the 3 purposes of diuretics?
Reduce hypertension
Decrease edema
Work by decreasing plasma volume
What’s the function of thiazide?
Where does it act on?
Promote sodium, chloride, and water excretion
Act on distal convoluted renal tubule
Thiazide typically is the what type of treatment for many patients with hypertension and peripheral edema??
First line of treatment
Does thiazide have an immediate effect on diuresis?
No
What are the 3 biggest side effects of thiazide?
Sodium and potassium loss
Elevated uric acid
Hyperglycemia
Thiazide contraindications are like?
Why?
Renal failure
- because it’s cause too much stress on peeing when your renal is already struggling on
Thiazide decreased effect on ___
Increase risk of ____
Decrease effectiveness with ___
Usage with corticosteroid will increase ___
Anticoagulants & diabetes meds
Renal toxicity
NSAIDS
Digoxin toxicity
Extra notes
- not dose dependent !!
What is loop diuretics?
Where does it act on?
Excrete sodium, water, potassium, calcium and magnesium
Ascending Loop of henle
Example of loop diuretic?
Is it on dose dependent?
Lasix
Yes!!
What are the 3 biggest side effects of loop diuretics?
Hypokalemia
Neurotoxic
Nephrotoxic
If you need to make someone pee faster what do you give loop or thiazide?
Loop
Normally patients on loop diuretics are on what___?
Thiszide we just tell them ???
Potassium supplement
Education to eat more potassium
( orange juice, banana )
A lot of patients think, oh this pill gets rid of this water, so I’ll just stop drinking water!!
DONT DO THIS!!
Concurrent NSAID will cause what?
Decrease effect on systemic vascular resistance
When do you take a diuretic??
Morning!!
Patient who is taking a nephrotoxic medications they may complain about ?
Hearing or ringing in there ears
Blood pressure might be higher tho!
Patients who are on steroids
And diuretics
And also on digoxin
You want to pay attention what?
Digoxin toxics!!
And potassium loss
How do you weight someone?
Same scale
Same time
Same amount of clothing
Patients who take lithium and on a loop diuretic, we should look for what and what happens?
( mental health medication )
Low excretion of lithium and risk of toxicity
What is osmotic diuretics?
Acts where?
Excrete sodium, chloride, potassium, water
Increase sodium reabsorption in the proximal tubule and loop of henle
The only 2 reason we use osmotic diuretics?
Decrease intracranial and intraocular pressure
Is osmotic diuretics a rapid diuresis?
Yes
Example of osmotic diuretics?
Mannitol
Osmotic diuretics biggest side effects?
Fluid and electrolyte imbalance
And blurred vision
Notes
Contraindications
Heart disease
Heart failure
Peripheral edema
Renal failure
What is carbonic anhydrase inhibitors used for?
Primarily to decrease intraocular pressure in patients with open angel chronic glaucoma
What is potassium sparing diuretics?
Block the effects of aldosterone
So you don’t lose your potassium
POTASSOUM RENTEION!!
What’s the biggest consideration of potassium sparing diuretics??
Potassium retention
Ace inhibitors and arbs and if you’re patient is on potassium sparing diuretics
Now they have two reason why there potassium is?
Elevated !!
