Chapter 44: Diuretics

Question 1

what is the mechanism of action for most diuretics

Answer 1

blockage of sodium and chloride reabsorption

Question 2

what are the general adverse effects on ECF

Answer 2

• hypovolemia
• acid base imbalances
• electrolyte imbalances

Question 3

Loop Diuretics example

Answer 3

Furosemide [Lasix]

Question 4

Furosemide [Lasix] acts on

Answer 4

ascending loop of Henle

Question 5

Furosemide [Lasix] is

Answer 5

most potent diuretic avaliable

Question 6

loop diuretics therapeutic uses

Answer 6

• pulmonary edema
• edematous states
• hypertension

Question 7

furosemide [lasix] adverse effects

Answer 7

• hyponatremia, hypochloremia, hypokalemia
• dehydration
• hypotension
• ototoxicity
• hyperglycemia
• hyperuricemia
• photosensativity

Question 8

can you use loop diuretics in renal failure

Answer 8

yes

Question 9

Furosemide [Lasix] drug interactions

Answer 9

• Digoxin
• ototoxic drugs
• potassium sparing diuretics
• lithium
• antihypertensive agents
• non-steroidal anti-inflammatory drugs (NSAIDS)

Question 10

what are other loop diuretics

Answer 10

ethacrynic acid
torsemide
bumetanide

Question 11

Thiazides general effects

Answer 11

• increase renal excretion of sodium, chloride, potassium, and water
• elevate adn uric and glucose

Question 12

Thiazides are different than loop diuretics

Answer 12

• maximum diuresis is considerably lower
• not effective when urine is scant

Question 13

thiazides are not effective when

Answer 13

urine flow is scant

Question 14

thiazides are often called

Answer 14

potassium depleting diuretics

Question 15

Hydrochlorothiazide [hydroDIURIL] acts on

Answer 15

early segment of distal convoluted tubule

Question 16

Hydrochlorothiazide [hydroDIURIL] therapeutic uses

Answer 16

• essential hypertension
• edema
• diabetes insipidus

Question 17

Hydrochlorothiazide [hydroDIURIL] adverse effects

Answer 17

• hyponatremia, hypochloremia, and hypokalemia
• dehydration
• hyperglycemia
• hyperuricemia
• impacts lipids, calcium, and magnesium
• photosensitivity

Question 18

Hydrochlorothiazide [hydroDIURIL] dru interactions

Answer 18

• Digoxin
• Augments effects of hypertensice medications
• NSAIDS
• can reduce renal excretion of lithium (leading to accumulation and toxicity)

Question 19

Hydrochlorothiazide [hydroDIURIL] can be compined with

Answer 19

ototoxic agents without increased risk of hearing loss
- unlike loop diuretics

Question 20

other thiazide diuretics

Answer 20

• Chlorthalidone (hygroton)
• Indapamide (lozide)
• Metolazone (Zaroxolyn)

Question 21

potassium sparing diuretics use can result in

Answer 21

• modest increase in urine production
• substantial decrease in potassium excretion

Question 22

Potassium Sparing Diuretics examples

Answer 22

Aldosterone antagonist
- Spironolactone [Aldactone]
Nonaldosterone antagonist
- Triamterene
- Amiloride

Question 23

Spironolactone [Aldactone] MOA

Answer 23

• blocks aldosterone in the distal nephron
• retention of potassium
• increased excretion of sodium

Question 24

Spironolactone [Aldactone] therapeutic uses

Answer 24

• hypertension
• edema
• Heart Failure
• Primary hyperaldosteronism (polycystic ovary syndrome)

Question 25

Spironolactone [Aldactone] adverse effects

Answer 25

• hyperkalemia
• Endocrine: gynecomastia, impotence, hirsutism, menstrual irregularities, deepening of the voice

Question 26

Mannitol [Osmitrol] therapeutic uses

Answer 26

• prophylaxis of renal failure

Question 27

Mannitol [Osmitrol] adverse effects

Answer 27

edema, headache, nausea and vomiting, fluid and electrolyte imbalances

Question 28

example of osmotic diuretic

Answer 28

Mannitol [Osmitrol]