Diuretic Drugs

Question 1

a. Drugs that accelerate the rate of urine formation

b. Result in the removal of sodium and water

Answer 1

Diuretic drugs

Question 2

Used in the treatment of

Answer 2

i. Hypertension
ii. Heart failure (HF)
iii. Renal failure

Question 3

Diuretics classified according to their sites of action within the

Answer 3

nephron

Question 4

Normal Na+
Normal K+
Normal Cr

Answer 4

1. 132-144
2. 3.5-5.0
3. 0.6-1.3

Question 5

5 type of diuretic Drugs

Answer 5

a. Carbonic anhydrase inhibitors (CAIs) - Eyes
b. Loop diuretics
c. Osmotic diuretics- MS II
d. Potassium-sparing diuretics
e. Thiazide and thiazide-like diuretics

Question 6

Intended responses

Answer 6

a. Decrease in BP
b. Decrease in pulmonary or peripheral edema
c. Increase urine output
d. Reduce urine output in “diabetes insipidus”
e. Preserved bone integrity in postmenopausal women
f. Weight loss
g. Decrease in serum calcium levels

Question 7

Loop Diuretics examples

Answer 7

FUROSEMIDE (LASIX)

a. Bumetanide (Bumex)
b. Ethacrynic acid (Edecrin)

Question 8

Loop Diuretics: Interactions

Answer 8

a. Neurotoxic
b. Nephrotoxic
c. Thiazide (metolazone): sequential nephron blockade
d. Nonsteroidal anti-inflammatory drugs (NSAIDs)
e. Lithium- Needs normal sodium levels for proper functioning.

Question 9

Osmotic Diuretics

Answer 9

Mannitol (Osmitrol) most used osmotic diuretic

Question 10

b. Reduces intracranial pressure or cerebral edema associated with head trauma
c. Reduces excessive intraocular pressure
d. Intravenous (IV) infusion only

Answer 10

Mannitol (Osmitrol) osmotic diuretics

Question 11

Examples of Thiazide Diuretics

Answer 11

i. Chlorothiazide

ii. Hydrochlorothiazide (treating hypertension) KNOW THIS ONE

Question 12

Intended responses (Thiazide diuretics)

Answer 12

i. Increase urine output
ii. Lower blood pressure
iii. Urine lighter in color

Question 13

e. First choice med in essential hypertension
f. Promotes diuresis when renal function is not impaired
g. Treating cirrhosis

Answer 13

Thiazide diuretics

Question 14

Loop & thiazide diuretics contraindicated for clients with

Answer 14

anuria 
cardiovascular disease
DM 
dehydration
Electrolyte depletion
Gout

Question 15

Use caution in clients taking

Answer 15

NSAIDs, digoxin, lithium, ototoxic medications, or antihypertensives

Question 16

Digoxin toxicity (ventricular dysrhythmia’s) monitor what?

Answer 16

cardiac status, K+ levels, dig levels

ii. Potassium sparing used with loops to dec hypokalemia.

Question 17

Interactions with loop & thiazide

Answer 17

Digioxin toxicity
Concurrent use with antihypertensives
Lithium carbonate
NSAIDS

Question 18

Block the action of aldosterone receptors which cause sodium and water retention

Answer 18

Potassium-Sparing Diuretics

Conserve potassium!

Question 19

Drug example of Potassium-Sparing

Answer 19

Spironolactone

Question 20

Intended responses of Potassium-Sparing Diuretics

Answer 20

i. Increase urine output
ii. Lighten urine color
iii. Lower blood pressure
iv. Serum potassium level stays normal

Question 21

Spironolactone indications

Answer 21

i. Hyperaldosteronism
ii. Hypertension
iii. Reversing potassium loss caused by potassium-losing drugs
iv. Certain cases of HF: prevention of remodeling

Question 22

Side effects & adverse effects from potassium-sparing diuretics

Answer 22

b. Side effects: Postural hypotension, hyponatremia

c. Adverse effects: Fainting or falling, hyperkalemia

Question 23

Symptoms of Potassium Deficiency Hypokalemia

Answer 23

i. Weakness, fatigue
ii. Decrease in Muscle tone, leg cramps
iii. Hypoactive bowel sounds and distention, N, V
iv. Weak, irregular, pulse
v. Paresthesia’s
vi. Cardiac function

Question 24

Causes of Potassium Deficiency Hypokalemia

Answer 24

i. Diuretics that waste potassium
ii. D, V, gastric suction
iii. Increase in aldosterone secretion
iv. Polyuria, sweating

Question 25

Potassium Excess Hyperkalemia MACHINE

Answer 25

iii. M: Medications: ACE inhibitors & NSAIDs iv. A: Acidosis-Metabolic & Respiratory v. C: Cellular destruction-Burns, traumatic injury vi. H: Hypoaldosteronism, hemolysis vii. I: Intake: Excessive viii. N: Nephrons, renal failure ix. E: Excretion-Impaired

Question 26

Potassium Excess Hyperkalemia Symptoms: Murder

Answer 26

ii. M: Muscle cramps iii. U: Urine abnormalities iv. R: respiratory distress v. D: decreased cardiac contractility vi. E: EKG changes vii. R: Reflexes

Question 27

Hypernatremia (HIGH SALT) causes

Answer 27

i. H-yper cortisolism (Cushings’) ii. I-nc sodium intake iii. G-I feeding wo enough fluid intake iv. H-ypertonic solutions v. S-odium excretion decreased vi. A-ldosterone problems vii. L- oss of fluids (sweating, diarrhea, vomiting) viii. T- hirst impairment ix. “HIGH SALT”

Question 28

Hypernatremia symptoms (FRIED)

Answer 28

i. F-ever, flushed skin ii. R- estless, really agitated iii. I-creased fluid retention iv. E-dema, extremely confused v. D-decreased urine output, dry mouth and skin vi. No FRIED food for you!!