Diuretics Flashcards
Where are they metabolized and excreted?
metabolized in kidney; excreted in urine
Who to NOT give diuretics to
ppl who don’t make urine/ who are on dialysis
Also ppl with really bad edema (fluid isn’t in peeable area)
If someone’s kidneys are starting to fail, what kind of a dose of diuretics should ya givem?
higher!
List some issues that require diuretics
Cerebral edema
Pulmonary edema –> CHF, cancer, sepsis
Hear failure –> diuretics reduce preload
Cirrhosis –> ascites
Potential adverse effects of daily diuretic use
alkalosis
hypokalemia
hypovolemia
How diuretics effect reabsorption
99% of water, electrolytes, and nutrients are reabsorped
Diuretics stop this
How diuretics work
block Na and Cl reabsorption –> water follows
At proximal tubules
signs of too much diuretic
dizzy, headache, lightheaded, tachycardic, hypotensive, nauseous
Loop diuretics:
-common ones
-rate of onset
-where is it used
furomeside and bumetanide
really fast (1 hr oral; 5 min IV)
inpatient –> esp crash pulmonary edema
Loop diuretic adverse side effects
ototoxicity (gentamycin causes this too)
hyperuricemia (gout) –> no alc or meats (that’s exagerated)
hyperglycemia
fucks with lipids
What should NOT be mixed with diuretics
digoxin, anything ototoxic, other diuretics, NSAIDs (hard on kidneys), lithium (sodium stuff), anti-htns (multiply effect)
what to give with a loop diuretic
PO potassium!!!
Thyazide diuretics
-common one
-dif b/t these and loops
-when NOT to use
-when to use
-Hydrochlorothiazide
-less effective and doesn’t make kidneys work better like loops
-for HTN, edema, diabetes insipidus
-not good when urine is scant
Potassium sparing diuretics
-common one
-how it works
-effectiveness
spironolactone, amiloride, triamterene
-aldosterone antagonist
-safer but doesn’t work as well
Osmotic diuretics
-common one
-how it works
-common use
Mannitol
-promotes diuresis by creating osmotic forse w/in lumen of nephron
-used to reduce intracranial pressure INPATIENT
