Diuretics

Question 1

What are some of the adverse effects of loop diuretics

Answer 1

Hyponatremia, Hypochloremia, dehydration (dry mouth, unsusual thirst, oliguria, weight loss. Can result in thrombosis or embolism), hypotension (loss of volume and relaxation of smooth muscles), Hypokalemia, Ototoxicity (can cause transient hearing impairment), hyperglycemia, hyperuremia ->gout, association with maternal death and fetal abortion/resorption, reduction of HDL while increasing LDL and TG, hypomagnesemia, extra secretion of calcium

Question 2

Does 20mg IV lasix= 20mg oral lasix?

Answer 2

No, due to the first pass effect, the bioavailability of the oral form is significantly less

Question 3

What is one consideration when giving IV lasix

Answer 3

Need a bathroom or catheter

Question 4

What are the interactions of Loop diuretics (lasix)

Answer 4

Digoxin, ototoxic meds (aminoglycoside antibiotics such as gentamyacin), potassium sparing diuretics, lithium, antihypertensives, NSAIDs

Question 5

What are the indications of loop diuretics

Answer 5

Rapid mobilization of fluids, pulmonary edema (CHF), HTN, renal failure

Question 6

What is the MOA of loop diuretics

Answer 6

Work in the ascending portion of the loop of Henley to block Na, Chloride, and water reabsorption

Question 7

What are the major differences between loops and thiazides

Answer 7

Level of diuresis, and thiazides are ineffective if GFR is less than 15-20ml/min

Question 8

Thiazides indications

Answer 8

Essential hypertension, edema, diabetes insipidus, postmenopausal osteoporosis

Question 9

Thiazides MOA

Answer 9

Blocks the reabsorption of Na, chloride, and water in the distal convoluted tubule

Question 10

Thiazides Interactions

Answer 10

Digoxin, antihypertensives, lithium, NSAIDs

Question 11

Thiazides AEs

Answer 11

Electrolyte loss, dehydration, hyperglycemia, gout, increased LDLs, decreased HDLs, reduced maternal blood volume

Question 12

K sparing indications

Answer 12

HTN, edema, HF, Primary hyperaldosteronism, PMS, PCOS

Question 13

K sparing MOA

Answer 13

Blocks aldosterone in distal convoluted tubule and collecting ducts, Na and water excretion in exchange for potassium, aldosterone stimulates cells to make proteins for na and k transport

Question 14

K sparing interactions

Answer 14

Thiazides and loops, k increasing agents

Question 15

K sparing adverse effects

Answer 15

Hyperkalemia, endocrine (gynecomastia, menstrual irregularities, impotence, deepening of the voice), tumours