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PHARM > Diuretics > Flashcards

Diuretics Flashcards

1
Q

Define diuretic drugs

A

Drugs that accelerate rate of urine formation

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2
Q

Types of Diuretic Drugs

A
  • Carbonic anhydrase inhibitors
    -Loop diuretics
    -Osmotic diuretic
    -Potassium sparing diuretics
    -Thiazide & thiazide-like diuretics
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3
Q

What type of diuretic is acetazolamide (Acetazolam)

A

Carbonic anhydrase inhibitors

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4
Q

Acetazolamide indication

A

Open angle Glaucoma. Adjunct therapy for secondary glaucoma

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5
Q

Consideration for use in pregnant women

A

Talk to prescriber: potential benefits may warrant use in pregnant women despite potential fetal risk

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6
Q

Other indications for Acetazolamide

A

Edema (secondary to HF)
High altitude sickness
Epilepsy

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7
Q

Why are miotics used with Acetazolamide

A

Lower intraocular pressure before ocular surgery

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8
Q

Acetazolamide contraindication

A

-drug allergy
-hyponatremia
-hypokalemia
-severe kidney or liver dysfunction
-adrenal gland insufficiency
-cirrhosis

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9
Q

Acetazolamide adverse effects

A

-acidosis
-hypokalemia
-drowsiness*
-anorexia
-paresthesias
-hematuria
-urticaria
-photosensitivity
-melena (blood in stool)*

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10
Q

Acetazolamide interactions

A

-Digoxin: digoxin toxicity (Acetazolamide causes hypokalemia)
-Corticosteroids: hypokalemia
-Amphetamines, carbamazepine, cyclosporine, phenytoin, quinidine sulphate: additive effects

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11
Q

Main loop diuretic drug

A

Furosemide (Lasix)

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12
Q

Primary use of furosemide

A

Edema

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13
Q

Duration of furosemide

A

At least 2 hr

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14
Q

Which drug is a potent diuretic

A

Furosemide

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15
Q

Furosemide indication

A

-Edema (HF, liver or kidney diseasE)
-Hypertension (management)
-Hypercalcemia
-HF from diastolic dysfunction

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16
Q

Furosemide adverse effects

A

CNS: dizziness, headache, tinnitus, blurred vision
GI: nausea, emesis, diarrhea*
Hematological: agranulocytosis, neutropenia, thrombocytopenia*
Metabolic: hypokalemia, hyperglycaemia*, hyperuricemia

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17
Q

Furosemide interaction

A

Thiazide (metolazone): nephron blockage
NSAIDs: decrease effect

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18
Q

Main osmotic diuretic

A

Mannitol (osmitrol)

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19
Q

Mannitol indication

A

-Treatment in early, oliguric phase of acute kidney injury
-Decrease intracranial pressure
-Cerebral edema
-GI irrigant to prepare for transurethral surgery

20
Q

Mannitol adverse effects

A

-convulsion
-thrombophlebitis
-pulmonary congestion

Others: headache, chest pain, tachycardia, blurred vision, chills, fever

21
Q

Route used for mannitol

A

IV infusion only

22
Q

How should mannitol be stored

A

Stored in a warmer: may crystallize when exposed to low temp

23
Q

How should mannitol be used

A

With a filter

24
Q

Main potassium-sparing diuretic

A

Spironolactone (Aldactone)

25
Q

Compare strength of potassium sparing drugs to thiazide & loop diuretics

A

Potassium sparing drugs are relatively weaker

26
Q

Spironolactone indication

A

-Hyperaldosteronism
-hypertension
-reversing potassium loss from other diuretics
-HF

27
Q

Potassium sparing diuretics general adverse effects

A

CNS: dizziness, headache
GI: cramps, nausea, emesis, diarrhea
Other: urinary frequency, weakness, hyperkalemia

28
Q

Spironolactone adverse effects

A

-gynecomastia
-amenorrhea
-irregular menses
-postmenopausal bleeding

29
Q

Spironolactone interactions

A

Lithium, ACE inhibitors, potassium supplements, NSAIDS

30
Q

Main thiazide & thiazide-like drugs

A

Hydrochlorothiazide (Urozide)

31
Q

Range of creatinine clearance that indicates to not use Hydrochlorothiazide

A

Should not be less than 30-50 mL/ min (normal: 125 mL/min)

32
Q

Hydrochlorothiazide indication

A

-hypertension*
-edema
-idiopathic hypercalciuria
-diabetes insipidus
-HF

33
Q

Hydrochlorothiazide adverse effects

A

CNS: dizziness, headache, blurred vision
GI: anorexia, nauseam emesis, diarrhea
Geni’: erectile dysfunction
Integ’: urticaria, photosensitivity

Others: jaundice, leukopeaniy, agranulocytosis, hypokalemia, hyperglycaemia, hyperuricemia

34
Q

What time of day should you take diuretics & why

A

Morning: prevent inference with sleep patterns

35
Q

Main electrolyte to monitor during therapy

A

Serum potassium levels

36
Q

Patient education on nutrition for patients taking diuretics (except: potassium sparing drugs)

A

Potassium rich foods

37
Q

Types of potassium rich foods

A

Banana, orange, dates, apricots, raisin, broccoli, green beans, potatoes, tomatoes, meats, fish, wheat bread, legumes

38
Q

What to monitor for when taking diuretics with digoxin

A

Digoxin toxicity

39
Q

What to do if a s/s of digoxin toxicity is presented

A

-First: monitor for other s/s of digoxin toxicity
-contact prescriber

40
Q

Patient education for patients with diabetes who are taking thiazide or loop diuretics

A

Monitor BCG & watch for hyperglycaemia

41
Q

What tool can you encourage patients to have to monitor their health

A

Log to monitor their daily weight

42
Q

Patient education on ways to prevent dizziness & fainting from orthostatic hypotension

A

Move position slowly

43
Q

What s/s indicate need to contact primary care provider

A

Nausea, emesis, diarrhea: indicates electrolyte imbalance can result

44
Q

S/S of hypokalemia

A

Anorexia, nausea, lethargy, muscle weakness, altered LOC, hypotension

45
Q

What s/s indicate IMMEDIATE need to contact primary care provider

A

Rapid HR, syncope: reflects hypotension or fluid loss

46
Q

Patient education on excessive liquorice consumption while taking thiazides

A

Hypokalemia

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