diuretic drugs: chapter 29

Question 1

what is the desired action when using diuretics

Answer 1

accelerate the rate of urine formation to increase the removal of sodium and water from the body

Question 2

what are the 5 classes of diuretic drugs

Answer 2

carbonic anhydrase inhibitors, loop diuretics, osmotic diuretics, potassium sparing diuretics, thiazide and thiazide-like diuretics

Question 3

mechanism of action of carbonic anhydrase inhibitors

Answer 3

inhibit carbonic anhydrase

Question 4

how does the inhibition of carbonic anhydrase have an effect on the body

Answer 4

it causes less sodium and water to be reabsorbed leading to them being eliminated from the body

Question 5

what is another effect of carbonic anhydrase inhibitors secondary to the increased excretion of sodium and water

Answer 5

elevation of blood glucose levels due to increased potassium loss

Question 6

4 indications for the use of carbonic anhydrase inhibitors

Answer 6

open angle glaucoma, edema due to heart failure, prevent and treat altitude sickness, epilepsy

Question 7

4 contraindications for carbonic anhydrase inhibitors

Answer 7

hyponatremia, hypokalemia, severe liver or kidney dysfunction, adrenal gland insufficiency

Question 8

5 adverse effects of carbonic anhydrase inhibitors

Answer 8

hypokalemia, dizziness, photosensitivity, hematuria, blood in the stool

Question 9

2 interactions of carbonic anhydrase inhibitors

Answer 9

digoxin, corticosteroids

Question 10

what is a key carbonic anhydrase inhibitor

Answer 10

acetazolamide

Question 11

mechanism of action of loop diuretics

Answer 11

block chloride and sodium reabsorption

Question 12

what are 5 effects that loop diuretics have on the body

Answer 12

dilate blood vessels, reduce preload and central venous pressures, decrease bp, loss of sodium and potassium, changes to insulin levels

Question 13

3 indications for loop diuretics

Answer 13

edema due to heart failure, hypertension, increase kidney excretion of calcium in cases of hypercalcemia

Question 14

2 contraindications for loop diuretics

Answer 14

severe electrolyte loss, hepatic coma

Question 15

4 adverse effects of loop diuretics

Answer 15

hypokalemia, erythema, photosensitivity, anemia

Question 16

key loop diuretic drug

Answer 16

furosemide

Question 17

mechanism of action of osmotic diuretics (2)

Answer 17

pull water into tubules by increasing osmotic pressure, inhibit reabsorption of water and solutes

Question 18

how do osmotic diuretics have an effect on the body (2)

Answer 18

reduce cellular edema, vasodilation

Question 19

in what case would osmotic diuretics be used when the desired effect is vasodilation, why

Answer 19

to prevent kidney damage in acute kidney injury as filtration rate is increased

Question 20

3 contraindications for osmotic diuretics

Answer 20

severe kidney disease, pulmonary edema, active intracranial bleeding

Question 21

4 adverse effects of osmotic diuretics

Answer 21

convulsions, chest pain, tachycardia, blurred vision

Question 22

key osmotic diuretic drug

Answer 22

mannitol

Question 23

mechanism of action of potassium sparing diuretics

Answer 23

block reabsorption of sodium and water due to aldosterone secretion

Question 24

3 indications for potassium sparing diuretics

Answer 24

hyperaldosteronism, hypertension, reverse potassium loss

Question 25

2 contraindications for potassium sparing diuretics

Answer 25

hyperkalemia, severe kidney failure

Question 26

4 adverse effects of potassium sparing diuretics

Answer 26

gynecomastia, amenorrhea, irregular menses, post menopausal bleeding

Question 27

key potassium sparing diuretic drug

Answer 27

spironolactone

Question 28

what is the most common use of spironolactone

Answer 28

children in heart failure

Question 29

what condition can spirolactone be used to treat in terms of the liver

Answer 29

ascites due to liver cirrhosis

Question 30

mechanism of action of thiazide and thiazide-like diuretics

Answer 30

inhibit reabsorption of sodium, potassium, and chloride

Question 31

how do thiazide and thiazide-like diuretics have an effect on the body (2)

Answer 31

relax arterioles which reduces peripheral vascular resistance, decrease preload and afterload

Question 32

2 contraindications for thiazide and thiazide-like diuretics

Answer 32

anuria, severe kidney failure

Question 33

4 adverse effects of thiazide and thiazide-like diuretics

Answer 33

• hypokalemia
• increased calcium, lipid, glucose, and uric acid
• photosensitivity
• increased risk of non-melanoma skin cancer

Question 34

what are 4 symptoms of hypokalemia

Answer 34

muscle weakness, hypotension, nausea, confusion

Question 35

what is a key thiazide and thiazide-like diuretic drug

Answer 35

hydrochlorothiazide

Question 36

what is a key pharmacological principle of hydrochlorothiazide in terms of therapeutic effects

Answer 36

hydrochlorothiazide has a ceiling effect meaning that increasing the dose will not increase therapeutic effects and it will only increase occurence of toxicity

Question 37

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

Answer 37

constipation. increase fluids and fibre

Question 38

when should diuretics ideally be taken. why

Answer 38

in the morning to decrease nocturia and loss of sleep

Question 39

what changes should be made to the patients diet while on diuretics

Answer 39

eat potassium rich foods except when taking potassium sparing diuretics

Question 40

what are 6 examples of potassium rich foods

Answer 40

banana, oranges, raisins, broccoli, green beans, potatoes, meat, whole wheat bread