Chapter 44: Diuretics Flashcards
what is the mechanism of action for most diuretics
blockage of sodium and chloride reabsorption
what are the general adverse effects on ECF
- hypovolemia
- acid base imbalances
- electrolyte imbalances
Loop Diuretics example
Furosemide [Lasix]
Furosemide [Lasix] acts on
ascending loop of Henle
Furosemide [Lasix] is
most potent diuretic avaliable
loop diuretics therapeutic uses
- pulmonary edema
- edematous states
- hypertension
furosemide [lasix] adverse effects
- hyponatremia, hypochloremia, hypokalemia
- dehydration
- hypotension
- ototoxicity
- hyperglycemia
- hyperuricemia
- photosensativity
can you use loop diuretics in renal failure
yes
Furosemide [Lasix] drug interactions
- Digoxin
- ototoxic drugs
- potassium sparing diuretics
- lithium
- antihypertensive agents
- non-steroidal anti-inflammatory drugs (NSAIDS)
what are other loop diuretics
ethacrynic acid
torsemide
bumetanide
Thiazides general effects
- increase renal excretion of sodium, chloride, potassium, and water
- elevate adn uric and glucose
Thiazides are different than loop diuretics
- maximum diuresis is considerably lower
- not effective when urine is scant
thiazides are not effective when
urine flow is scant
thiazides are often called
potassium depleting diuretics
Hydrochlorothiazide [hydroDIURIL] acts on
early segment of distal convoluted tubule
Hydrochlorothiazide [hydroDIURIL] therapeutic uses
- essential hypertension
- edema
- diabetes insipidus
Hydrochlorothiazide [hydroDIURIL] adverse effects
- hyponatremia, hypochloremia, and hypokalemia
- dehydration
- hyperglycemia
- hyperuricemia
- impacts lipids, calcium, and magnesium
- photosensitivity
Hydrochlorothiazide [hydroDIURIL] dru interactions
- Digoxin
- Augments effects of hypertensice medications
- NSAIDS
- can reduce renal excretion of lithium (leading to accumulation and toxicity)
Hydrochlorothiazide [hydroDIURIL] can be compined with
ototoxic agents without increased risk of hearing loss
- unlike loop diuretics
other thiazide diuretics
- Chlorthalidone (hygroton)
- Indapamide (lozide)
- Metolazone (Zaroxolyn)
potassium sparing diuretics use can result in
- modest increase in urine production
- substantial decrease in potassium excretion
Potassium Sparing Diuretics examples
Aldosterone antagonist
- Spironolactone [Aldactone]
Nonaldosterone antagonist
- Triamterene
- Amiloride
Spironolactone [Aldactone] MOA
- blocks aldosterone in the distal nephron
- retention of potassium
- increased excretion of sodium
Spironolactone [Aldactone] therapeutic uses
- hypertension
- edema
- Heart Failure
- Primary hyperaldosteronism (polycystic ovary syndrome)
Spironolactone [Aldactone] adverse effects
- hyperkalemia
- Endocrine: gynecomastia, impotence, hirsutism, menstrual irregularities, deepening of the voice
Mannitol [Osmitrol] therapeutic uses
- prophylaxis of renal failure
Mannitol [Osmitrol] adverse effects
edema, headache, nausea and vomiting, fluid and electrolyte imbalances
example of osmotic diuretic
Mannitol [Osmitrol]
