diuretic drugs: chapter 29 Flashcards
what is the desired action when using diuretics
accelerate the rate of urine formation to increase the removal of sodium and water from the body
what are the 5 classes of diuretic drugs
carbonic anhydrase inhibitors, loop diuretics, osmotic diuretics, potassium sparing diuretics, thiazide and thiazide-like diuretics
mechanism of action of carbonic anhydrase inhibitors
inhibit carbonic anhydrase
how does the inhibition of carbonic anhydrase have an effect on the body
it causes less sodium and water to be reabsorbed leading to them being eliminated from the body
what is another effect of carbonic anhydrase inhibitors secondary to the increased excretion of sodium and water
elevation of blood glucose levels due to increased potassium loss
4 indications for the use of carbonic anhydrase inhibitors
open angle glaucoma, edema due to heart failure, prevent and treat altitude sickness, epilepsy
4 contraindications for carbonic anhydrase inhibitors
hyponatremia, hypokalemia, severe liver or kidney dysfunction, adrenal gland insufficiency
5 adverse effects of carbonic anhydrase inhibitors
hypokalemia, dizziness, photosensitivity, hematuria, blood in the stool
2 interactions of carbonic anhydrase inhibitors
digoxin, corticosteroids
what is a key carbonic anhydrase inhibitor
acetazolamide
mechanism of action of loop diuretics
block chloride and sodium reabsorption
what are 5 effects that loop diuretics have on the body
dilate blood vessels, reduce preload and central venous pressures, decrease bp, loss of sodium and potassium, changes to insulin levels
3 indications for loop diuretics
edema due to heart failure, hypertension, increase kidney excretion of calcium in cases of hypercalcemia
2 contraindications for loop diuretics
severe electrolyte loss, hepatic coma
4 adverse effects of loop diuretics
hypokalemia, erythema, photosensitivity, anemia
key loop diuretic drug
furosemide
mechanism of action of osmotic diuretics (2)
pull water into tubules by increasing osmotic pressure, inhibit reabsorption of water and solutes
how do osmotic diuretics have an effect on the body (2)
reduce cellular edema, vasodilation
in what case would osmotic diuretics be used when the desired effect is vasodilation, why
to prevent kidney damage in acute kidney injury as filtration rate is increased
3 contraindications for osmotic diuretics
severe kidney disease, pulmonary edema, active intracranial bleeding
4 adverse effects of osmotic diuretics
convulsions, chest pain, tachycardia, blurred vision
key osmotic diuretic drug
mannitol
mechanism of action of potassium sparing diuretics
block reabsorption of sodium and water due to aldosterone secretion
3 indications for potassium sparing diuretics
hyperaldosteronism, hypertension, reverse potassium loss
2 contraindications for potassium sparing diuretics
hyperkalemia, severe kidney failure
4 adverse effects of potassium sparing diuretics
gynecomastia, amenorrhea, irregular menses, post menopausal bleeding
key potassium sparing diuretic drug
spironolactone
what is the most common use of spironolactone
children in heart failure
what condition can spirolactone be used to treat in terms of the liver
ascites due to liver cirrhosis
mechanism of action of thiazide and thiazide-like diuretics
inhibit reabsorption of sodium, potassium, and chloride
how do thiazide and thiazide-like diuretics have an effect on the body (2)
relax arterioles which reduces peripheral vascular resistance, decrease preload and afterload
2 contraindications for thiazide and thiazide-like diuretics
anuria, severe kidney failure
4 adverse effects of thiazide and thiazide-like diuretics
- hypokalemia
- increased calcium, lipid, glucose, and uric acid
- photosensitivity
- increased risk of non-melanoma skin cancer
what are 4 symptoms of hypokalemia
muscle weakness, hypotension, nausea, confusion
what is a key thiazide and thiazide-like diuretic drug
hydrochlorothiazide
what is a key pharmacological principle of hydrochlorothiazide in terms of therapeutic effects
hydrochlorothiazide has a ceiling effect meaning that increasing the dose will not increase therapeutic effects and it will only increase occurence of toxicity
since diuretics cause increased water excretion, what must the nurse be aware of when a patient is taking this medication. what are 2 things that can be done for prevention
constipation. increase fluids and fibre
when should diuretics ideally be taken. why
in the morning to decrease nocturia and loss of sleep
what changes should be made to the patients diet while on diuretics
eat potassium rich foods except when taking potassium sparing diuretics
what are 6 examples of potassium rich foods
banana, oranges, raisins, broccoli, green beans, potatoes, meat, whole wheat bread
