Diuretic Drugs Flashcards
What are the two primary indications of diuretic drugs?
-Reduce blood pressure
-Treat edema associated with HF and renal/liver conditions
What are the 3 most common diuretics?
-Loop
-Thiazide
-Potassium-sparing
What are the two most common Loop Diuretic?
-Furosemide
-Torsemide
What are the 2 most common Thiazide Diuretics?
-Hydrochlorothiazide
-Metolazone
What are three of the most common Potassium-Sparing Diuretic?
Spironolactone
Amiloride
Triamterene
Describe the mechanism of action of Loop Diuretics
They prevent the reabsorption of sodium in the loop of Henle
What effect does Furosemide have on the vessels
Vasodilating effect which causes more blood flow to the kidneys
How long does it take for Loop Diuretics to start working?
1 hour PO
30 min IM
5 min IV
Describe the mechanism of action of Thiazide Diuretics
Promotes sodium, chloride, and water excretion in the distal convoluted renal tubule
Which diuretic will make you pee the most?
Loop Diuretics
What effect do Thiazide Diuretics have on the vessels?
Vasodilate
Describe the mechanism of action of Potassium-Sparing Diuretics
-Promote sodium and water excretion and potassium retention in the collecting tubules of the kidney
-Spironolactone prevents Aldosterone’s action
Which diuretic will make you pee the least?
Potassium-Sparing
Why is Spironolactone often prescribed with other diuretics?
To counter-act potassium-wasting effects of the other diuretics
Which electrolyte will you want to monitor when giving a loop and thiazide diuretic?
Potassium; can cause hypokalemia
What condition will you want to monitor in the patient before administering a loop diuretic?
Gout; can cause an increase in uric acid
What are 2 herbal drug supplements that can cause a drug reaction?
Gingko
Licorice
What electrolyte will you want to monitor before administering Potassium-Sparing Diuretics?
-Potassium but because it can cause HYPERkalemia instead
What are the contraindications of Loop Diuretics?
-Hepatic Coma
-Hypovolemia
-Anuria
-Sulfa drugs
What are the contraindications of Thiazide Diuretics?
-Hepatic Coma
-Anuria
-Renal failure
-Chronic Kidney Disease
What are symptoms of severe kidney impairment that would might hint that you probably shouldn’t administer a diuretic?
-Oliguria
-BUN
-High serum creatinine
What are the contraindications of Potassium-Sparing Diuretics?
-Hyperkalemia
-Severe Renal Failure
-Anuria
-Pregnancy
Why can Loop Diuretics be used in patients with Renal Failure but other diuretics can’t?
Because Loop Diuretics maintain their effectiveness even when kidney function is impaired. But the other depend on good kidney function
What drug interactions are there with Loop Diuretics?
-Digoxin
-Aminoglycosides
-Vancomycin
-Corticosteroids
-Lithium
-NSAIDs
-Antidiabetic drugs
What drug interactions are there with Thiazide Diuretics?
-Digoxin
-Lithium
-Antidiabetic drugs
-Antihypertensive drugs
What drug interactions are there with Potassium-Sparing Diuretics?
-ACE Inhibitors
-Lithium
-NSAIDs
Why should Furosemide be administered slowly via IV? At what rate?
Rapid admin can cause ototoxicity; 20mg/min
At what time of day should diuretics be given?
During the day; if taken at night, can make you get up to pee a lot
What are side effects of Loop Diuretics?
-Hearing loss
-Rash
-Pruiritus
-Nausea
-Diarrhea
-Hyperuricemia
What are adverse effects of Loops Diuretics?
-Hypokalemia
-Severe dehydration
-Hyponatremia
-Hypochloremia
-Hypotension
-Hyperglycemia
-Renal failure
-Circulatory collapse
What are side effects of Thiazide Diuretics?
-Hyperuricemia
-GI
-Anorexia
-Rash
-Orthostatic hypotension
What are adverse effects of Thiazide Diuretics?
Same as Loop
What are side effects of Potassium-Sparing Diuretics?
-Menstrual Irregularities
-Hirsutism
-Impotence
-Gynecomastia
What is the adverse effect of Potassium-Sparing Diuretic?
Hyperkalemia
What is a normal volume for urine output?
30mL/hr or 600mL/24hr
Why should Furosemide be taken with food?
It can cause nausea if taken on an empty stomach
What foods are good sources of potassium?
-Bananas
-Honeydew
-Cantaloupe
-Sweet potatoes
-Spinach
-Lima beans
-Tomato Juice
In what part of the kidney is sodium, potassium, and chloride transported into the bloodstream?
Loop of Henle
What part of the kidney is responsible for the majority of water and sodium resorption back into the bloodstream?
Proximal tubule
In what part of the kidney does antidiuretic hormone increase water and prevent excess water from being lost in the urine?
Collecting duct
What happens when Furosemide is taken with NSAID? How would the provider adjust?
Furosemide activity is decreased; increase dose of furosemide
Which diuretic can treat idiopathic hypercalciuria?
Metolazone
Which class of diuretics is used to treat increased intracranial pressure?
Osmotic diuretics
What class of diuretics acts on the Descending Loop of Henle?
Osmotic
Name an osmotic diuretic drug?
Mannitol
What is a normal serum potassium level?
3.5 - 5.2
What is a normal serum chloride level?
95 - 107
What is a normal serum sodium level?
135 - 147
What is a normal serum creatinine level?
0.59 - 1.35
What is a normal BUN level?
7-20
What is the contraindication for Mannitol?
Fluid in the lungs
