Diuretics Flashcards
Thiazides diuretics
hydrochlorothiazide
loop diuretics
furosemide
carbonic anhydrase
acetazolamide
potassium-sparing diuretics
spirionalctone
osmotic diuretics
mannitol
Indications for hydrochlorothiazide
active therapy for edema r/t CHF, cirrhosis, corticosteroids, estrogen therapy & renal dysfunction. First line treatment for HTN
Actions of hydrochlorothiazide
Inhibits reabsorption of Na & Cl in distal renal tubes increase the excretion of Na, Cl and H2O.
blocks chloride pump, increase urine production mild diuretic
Pharmo HCTZ
oral route
2 hr onset
4-6 h peak
6-12 h duration
half-life of HCTZ
5.6 h-15 h; metabolized in liver excreted in urine.
Adverse effects of HCTZ
dizzy, vertigo, orthostatic, N/V anorexia, dry mouth, diarrhea, polyuria, muscle cramps, or spams,
F& E imbalances dehydration, hyperglycemia
Contraindications HCTZ
allergy to thiazides or sulfonamides, F&E imbalances, renal and liver disease, bipolar, pregnancy and lactation
Indication for furosemide
treatment of edema associated with CHF, acute pulmonary edema, HTN.
Powerful- used in acute situations.
Actions of furosemide
Inhibits reabsorption of Na & Cl in the distal renal tubules and loop of Henle, leading to Na- rich diuresis.
Blocks Cl pump
Parmo of furosemide
Oral, IV, IM route
60min, 5 min Onset
60-120 min, 30 min Peak
6-8 h, 2 h Duration
Half-life of furosemide
120 min; metabolized in liver, excreted in urine
Adverse effects of furosemide
dizzy, vertigo, orthostatic, hypotension, N/V, anorexia, paresthesis, rash, urticarial, glycosuria, urinary bladder spasm.
Imbalance F&E especially K
Conra of frusoemide
allergy, electrolyte depletion, anuria, sever renal failure, hepatic coma, pregnancy and lact
Indications for acetzolamide
often used in adjuncts to other diuretics. Used to treat glaucoma and drug induced edema.
Actions of acetzolamide
Inhibits cabonic anhydrase, with decrease aqueous humor formation in the eye and hydrogen secretion by the renal tubules.
More Na and Bicarb are lost inurine
Parmo of acetzolamide
oral, sustained oral, IV routes
1 hr, 2h, 1-2 min onset
2-4h, 8-12h 15-18 min peak
6-12 hr, 18-24 hr, 4-5 hr duration
half-life of acetzolamide
5-6 hr, excreted unchanged in the urine
adverse effects of acetzalomide
weakness, fatigue, rash, anorexia, nausea, nurinary frequency, renal calculi, bone marrow suppression, weight loss
Disrupts acid-base balance and electrolyte balance
contra acetzalomide
allergy, angle closure glaucoma
Indications for spironalctone
primary hyperaldosteronism, adjunctive therapy in the treatment of edema associated with CHF, nephrotic syndrome hepatic cirrhosis, treatment/ prevention of hypokalemia; essential HTN
Preferred if K loss will be detrimental to cardiac or neruomuscular condition.
Actions of spironalctone
Competitively blocks the effects of aldosterone in renal tubule causing Na and H2O loss with retention of K
Parmo of spironalctone
Oral route
24- 48 hr onset
48-72 hr peak & duration
Half-life of spironalctone
20 hr; metabolized in liver, excreted in urine
adverse effects of spironalctone
dizzy, HA, drowsiness, rash, cramping, diarrhea, hyperK, hirsutism, gynecomastia, deepening of the voice, irregular menses
contra for spironalctone
allergy, hyperK, renal disease or anuria, Pt taking amilride or triamterene
Indications for mannitol
treatment of oliguric phase of renal failure (seen in ARF), reduce ICP & cerebral edema, reduction of intraocular pressure (IOP); promotion of urinary excretion of toxic substance; dx and measure GFR. Transurethral irrigation
Acute IOP, ICP, ARF d/t shock, OD, or trauma
Action of mannitol
Elevates the osmolarity of glomerular filtration, resulting in loss of H2O, Na, Cl; creates and osmotic gradient in the eye, reducing IOP.
Remove fluid from intavascular space, deliver H2O into renal tubules without Na loss.
Parmo of mannitol
IV, irrigant route
30-60 min, rapid onset
1hr, rapid peak
6-8hr, short duration
half-life of mannitol
15-100 min; excreted unchanged in urine.
Contra for mannitol
use caution in extreme heart failure pts.
