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Pharm > Diuretic Meds > Flashcards

Diuretic Meds Flashcards

1
Q

Types of Diuretics

A

Loop
thiazide
potassium sparing
osmotic (not HTN med)

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2
Q

Diuretics Treat

A

pulmonary edema, HF, renal failure, cirrhosis,

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3
Q

Loop Diuretic example

A

Furosemide (Lasix)

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4
Q

Loop Diuretics act on

A

the ascending loop of Henle

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5
Q

Loop Diuretic UOP

A

large

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6
Q

Loop Diuretic potassium effect

A

potassium wasting

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7
Q

Loop Diuretics: GFR function

A

work despite GFR function

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8
Q

Loop Diuretic indictaion

A

rapid continuous mobilization of fluid
Emergent
used in cirrhosis, pulmonary edema in HF, renal disease, fluid overload or HTN when thiazides are not enough

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9
Q

loop IV onset

A

5 mins, peak in 1-2

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10
Q

Loop ADR

A

hyponatremia, dehydration, hypotension, hypokalemia, ototoxicity, hyperglycemia (DM pts!), high LDL, low HDL, increase uric acid (GOUT!)

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11
Q

loop in pregnancy

A

can use in pregnancy

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12
Q

other loop diuretics

A

ethacrynic acid
bumetanide
torsemide

(all can cause ototoxicity, hypovolemia, hypotension, hypokalemia, hyperuricemia, hyperglycemia, disrupt lipid metabolism

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13
Q

loop drug interactions

A

Furosemide can drop BP too much with other drugs

Ototoxic with ahminoglycosides (antibiotics)

lithium toxicity (bipolar)

digoxin (toxicity with decreased K+)

Nsaids - blunt effects of diuretics

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14
Q

Loop patient education

A

about hyponatremia, hypocalcemia, dehydration, postural hypertension, hypokalemia and dietary counseling, ototoxicity (hearing and balance), NSAIDS

Take daily weights, daily BP monitoring, avoid late dosing, assess skin

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15
Q

Thiazides act on

A

early distal tubule (inhibit na and cl reabsorption) (reduce plasma and extracellular fluid)

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16
Q

Thiazides GFR

A

need adaquate GFR for effects

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17
Q

Thiazides UOP

A

moderate

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18
Q

Thiazides indication

A

HTN, edema (from HF or cirrhosis)

Protective effects in postmenopausal osteoporosis (tubular reabsorption of Ca2+)

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19
Q

Thiazides ADR

A

hyponatremia, hypochloremia, dehydration, hypokalemia (cardiac dysrythmias, increased risk of digitalis toxicity), hyperglycemia

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20
Q

thiazides contraindications

A

hypersensitivity in stevens johnson syndrome

use with caution in renal disease (GFR function)

caution in gout, unstable diabetes hyperlipidemia, pregnancy and lactation

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21
Q

Thiazides drug interactions

A

can be combined with other HTN meds

Nsaids blunt effects

digoxin and lithium toxicity

careful with anything that affects electrolytes

22
Q

Thiazides pt education

A

baseline monitoring (weight, BP, electrolytes, edema, lipids)

Hypokalemia

time of administration

may make pt tired

23
Q

Thiazide drug example

A

hydrochlorothiazide (HCTZ)

24
Q

Furosemide (Lasix) is what type of drug

A

loop diuretic

25
Q

Hydrochlorothiazide (HCTZ) is what type of drug

A

thiazide diuretic

26
Q

Potassium sparing diuretics

A

increase urine output with less excretion of K+

27
Q

K sparing UOP

A

small increase (weak diuretic)

28
Q

K sparing indications

A

HTN, edema
while limiting K+ excretion

29
Q

K sparing spironolactone mechanism

A

block action of aldosterone in distal tubule

interferes with Na/K pump controlled by aldosterone

promotes Na and water excretion while reducing K excretion compared to other diuretics

30
Q

Types of k sparing diuretics

A

aldosterone antagonist : Spironolactone

non aldosterone antagonist: triamterene and amiloride

31
Q

Spirinolactone indication

A

used to counteract loss of K+ caused by thiazides and loop diuretics

HTN, Edema, HF

Primary hyperaldosteronism, hormonal acne in women, polycystic ovary syndrome

prevention and treatment of hypokalemia

can be used in combo with thiazides and loops

32
Q

K Sparing ADR’s

A

hyperkalemia

endocrine effects - steroid derivative - gynecomastia, menstrual irregularities, impotence, hirsutism, voice changes

33
Q

K sparing drug interactions

A

yes with thiazides and loops

don’t use with other K increasing supplements, ACEi, ARBs, or transplant drugs

Don’t use salt substitutes

NSAIds block action

digoxin toxicity if K+ too low

Hypotension (when used with ETOH, antiHTN, or nitrates)

34
Q

Overuse of K sparing

A

hypovolemia
hypotension

35
Q

k sparing pt education

A

monitor K+ levels
no suplemental K+ foods (bananas)
No salt substitutes (unlike other diuretics)

36
Q

Osmotic diuretic example

A

Manitol (IV admin)

37
Q

Manitol site of action

A

drug stays in nephron (filtered by glomerulus)

38
Q

Mannitol action

A

promotes diuresis by creating osmotic force within lumen of the nephron

UOP increase

Degree of UOP is dose dependant

39
Q

Mannitol indication

A

Relieves intracranial pressure, reduce acute intraocular pressure (glaucoma if not responsive to other drugs)

Prevents renal failure in acute states

not used in HTN

40
Q

Mannitol ADR

A

edema
HA N/V
F&E imbalances
dry mouth, polyuria, weakness
rash, vision disturbances
rebound ICP (intracranial pressure)

41
Q

how mannitol causes edema

A

can leave capillary beds everywhere except brain, drawing water with it

extreme caution with heart disease pts, stop if signs of HF or pulmonary congestion

42
Q

mannitol contraindications

A

dehydration
renal or cardiac dysfunction
active intracranial bleeding
severe pulmonary edema

43
Q

mannitol nursing implications

A

monitor vital signs, UOP, biomarkers for hemodynamics
monitor dehydration, neuro status, intraocular pressures,

Always check renal function before administering
do not give if osmolarity over 310

44
Q

Other mannitol oddities

A

will crystalize in low temps

use filter needles
use indwelling catheter with promoter to measure hourly urine output

effects last 6-8hrs

45
Q

Loop and thiazide adverse effects

A

dehydration, hypovolemia, hypotension, hyperuricemia, hyperglycemia, hypokalemia, ototoxicity, hyperlipidemia, sleep disturbance

46
Q

aldosterone antagonist ADRs

A

hyperkalemia
gi effects
endocrine effects : gynecomastia

47
Q

signs of hypovolemia

A

dizziness, confusion, insaziabile thirst, salt craving

48
Q

signs of hypokalemia

A

thirst
muscle weakness
lethargy
depression
muscle cramping
vomiting

49
Q

control K+ levels

A

oral agents
KCL in liquids
powders
effervescent tablets
potassium sparing diuretics
IV potassium suplement

50
Q

Diuretic nursing considerations

A

first line for mild to moderate HTN

increase in urine may only last a few weeks, but continue the medication (pts may stop or self increase their dose)

tailor schedule to lifestyle

Do not administer late in the day

51
Q

Diuretic therapy diet

A

low salt intake
ensure adequate water intake

Pharm (9 decks)

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