Diuretics

Question 1

Thiazides diuretics

Answer 1

hydrochlorothiazide

Question 2

loop diuretics

Answer 2

furosemide

Question 3

carbonic anhydrase

Answer 3

acetazolamide

Question 4

potassium-sparing diuretics

Answer 4

spirionalctone

Question 5

osmotic diuretics

Answer 5

mannitol

Question 6

Indications for hydrochlorothiazide

Answer 6

active therapy for edema r/t CHF, cirrhosis, corticosteroids, estrogen therapy & renal dysfunction. First line treatment for HTN

Question 7

Actions of hydrochlorothiazide

Answer 7

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

Question 8

Pharmo HCTZ

Answer 8

oral route
2 hr onset
4-6 h peak
6-12 h duration

Question 9

half-life of HCTZ

Answer 9

5.6 h-15 h; metabolized in liver excreted in urine.

Question 10

Adverse effects of HCTZ

Answer 10

dizzy, vertigo, orthostatic, N/V anorexia, dry mouth, diarrhea, polyuria, muscle cramps, or spams,

F& E imbalances dehydration, hyperglycemia

Question 11

Contraindications HCTZ

Answer 11

allergy to thiazides or sulfonamides, F&E imbalances, renal and liver disease, bipolar, pregnancy and lactation

Question 12

Indication for furosemide

Answer 12

treatment of edema associated with CHF, acute pulmonary edema, HTN.
Powerful- used in acute situations.

Question 13

Actions of furosemide

Answer 13

Inhibits reabsorption of Na & Cl in the distal renal tubules and loop of Henle, leading to Na- rich diuresis.
Blocks Cl pump

Question 14

Parmo of furosemide

Answer 14

Oral, IV, IM route
60min, 5 min Onset
60-120 min, 30 min Peak
6-8 h, 2 h Duration

Question 15

Half-life of furosemide

Answer 15

120 min; metabolized in liver, excreted in urine

Question 16

Adverse effects of furosemide

Answer 16

dizzy, vertigo, orthostatic, hypotension, N/V, anorexia, paresthesis, rash, urticarial, glycosuria, urinary bladder spasm.
Imbalance F&E especially K

Question 17

Conra of frusoemide

Answer 17

allergy, electrolyte depletion, anuria, sever renal failure, hepatic coma, pregnancy and lact

Question 18

Indications for acetzolamide

Answer 18

often used in adjuncts to other diuretics. Used to treat glaucoma and drug induced edema.

Question 19

Actions of acetzolamide

Answer 19

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

Question 20

Parmo of acetzolamide

Answer 20

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

Question 21

half-life of acetzolamide

Answer 21

5-6 hr, excreted unchanged in the urine

Question 22

adverse effects of acetzalomide

Answer 22

weakness, fatigue, rash, anorexia, nausea, nurinary frequency, renal calculi, bone marrow suppression, weight loss
Disrupts acid-base balance and electrolyte balance

Question 23

contra acetzalomide

Answer 23

allergy, angle closure glaucoma

Question 24

Indications for spironalctone

Answer 24

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.

Question 25

Actions of spironalctone

Answer 25

Competitively blocks the effects of aldosterone in renal tubule causing Na and H2O loss with retention of K

Question 26

Parmo of spironalctone

Answer 26

Oral route 24- 48 hr onset 48-72 hr peak & duration

Question 27

Half-life of spironalctone

Answer 27

20 hr; metabolized in liver, excreted in urine

Question 28

adverse effects of spironalctone

Answer 28

dizzy, HA, drowsiness, rash, cramping, diarrhea, hyperK, hirsutism, gynecomastia, deepening of the voice, irregular menses

Question 29

contra for spironalctone

Answer 29

allergy, hyperK, renal disease or anuria, Pt taking amilride or triamterene

Question 30

Indications for mannitol

Answer 30

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

Question 31

Action of mannitol

Answer 31

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.

Question 32

Parmo of mannitol

Answer 32

IV, irrigant route 30-60 min, rapid onset 1hr, rapid peak 6-8hr, short duration

Question 33

half-life of mannitol

Answer 33

15-100 min; excreted unchanged in urine.

Question 34

Contra for mannitol

Answer 34

use caution in extreme heart failure pts.