Diuretics Flashcards
What are diuretics?
= increase the volume and output of urine –> diuresis
- loop diuretics
- thiazide diuretics
- potassium sparing diuretics
Define Natriuresis
= excretion of sodium in the urine
MOA of diuretics
= inhibit the reabsorption of sodium at different sites in the renal tubules (cause more sodium to be excreted)
- increase osmotic pressure in renal tubers and reduce passive reabsorption of water
- amount of diuresis produced depends on amount of sodium resorption inhibited
MOA loop diuretics and example
- inhibits sodium potassium chloride pump in the ascending loop of Henle
e. g. frusemide
Side effects of loop diuretics?
- potential electrolyte disturbances e.g. hypokalaemia, hyponatraemia
- may increase blood uric acid and precipitate gout
- may increase BGL
- May produce urinary frequency and urgency
Indications of loop diuretics?
- oedema associated with Heart failure
- renal impairment
Contradictions of loop diuretics
- hyperglycaemia - increase BGL
Interactions with loop diuretics
- adrenaline
- K depleating agents (laxatives)
Nursing practice points for loop diuretics
- start low dose
- monitor renal function
- monitor weight and electrolytes
MOA for Spironolactone (potassium sparing diuretics)
= copetes with aldosterone and inhibits stimulant effects of aldosterone on sodium potassium exchange (late distal)
- aldosterone pulls sodium and water in and pumps potassium out
Adverse reactions of Thiazide?
- Hypokalaemia/natremia
- increased blood uric and
- hyperglycaemia
- urinary urge and frequency increase
Adverse reactions of potassium sparing diurtics?
- hyperkalaemia
- hypotraemia
- hepototoxicity
Interactions with potassium sparing diurectics
- ACE inhibitors
- antihypertensives
Nursing practice points of potassium sparing diuretics
- weak diuretic
- check renal function and potassium levels
Effects of diuretics on sodium excretion?
= all may produce hyponatremia
