DIURETICS Flashcards
Potassium sparing diuretics (drug names)
-spironolactone
-triamterene
Potassium sparing diuretics (therapeutic actions)
-spironolactone: blocks aldosterone in the distal tubule, which results in the excretion of sodium
-triamterene: block potassium secretion through the tubule (so retaining potassium) This means we are excreting sodium.
Potassium sparing diuretics (indications)
-adjuncts with thiazides or loop diuretics
-for those who need a diuretic, but are at risk for a hypokalemia
-hyperaldosteronism
Potassium sparing diuretics (contraindications and interactions)
-Hyperkalemia and severe renal disease
-Interaction with aspirin
Common adverse effects of potassium sparing diuretics
-muscle weakness
-Respiratory distress
-Decreased cardiac contractility
-ECG changes
-Urine: oliguria
-Reflexes
Implementation of potassium sparing diuretics
Make sure patient doesn’t eat too many high potassium foods
Implementation of potassium sparing diuretics
Make sure patient doesn’t eat too many high potassium foods
Osmotic diuretic (drug names)
Mannitol
Osmotic diuretic (therapeutic actions)
-Pulls water into the renal tubule without sodium loss
-only administer with IV (pulls fluid from extravascular space into the intravascular space)
Osmotic diuretic (indications)
-increased ICP
-acute renal failure due to shock, overdose or trauma
-Decrease IOP before eye surgery or in acute glaucoma attacks
Osmotic diuretic (contraindications)
-pre-existing, severe renal disease
-Pulmonary congestion and edema
-intercranial bleeding
-dehydration
-Heart failure
Common adverse effects of osmotic diuretics
-Fluid and electrolyte imbalance
-Nausea and vomiting
-Hypotension
-Lightheaded and confusion
-Headache
-Heart failure & pulmonary edema
Carbonic anhydrase inhibitors (drug names)
“Amide”
-acetazolamide
Carbonic anhydrase inhibitors ( therapeutic actions)
-Block the effects of carbonic anhydrase; slow down the movement of hydrogen ions
-more sodium and bicarbonate are lost in the urine
Carbonic anhydrase inhibitors ( indications)
-adjuncts to other diuretics
-glaucoma
Carbonic anhydrase inhibitors (contraindications)
-Allergy to sulfonamides or thiazides
Carbonic anhydrase inhibitors (caution and interactions)
- renal or hepatic disease
-adrenocortical insufficiency
-respiratory acidosis/COPD
-Interaction with aspirin
Carbonic anhydrase inhibitors (common adverse effects)
-metabolic acidosis
-hypokalemia
-CNS effects, including confusion, drowsiness, and paresthesias of extremities
Loop diuretics (drug names)
-bumetanide (very powerful)
-furosemide (safest)
-torsemide (very powerful)
Loop diuretics (therapeutic actions)
-Blocks chloride pump, which blocks sodium and chloride rib absorption into circulation
-Large amount of sodium and chloride rich urine is excreted
-works very fast
-loop of henle
Loop diuretics (indications)
-We give it for heart failure, pulmonary edema, edema related to heart failure, or renal/liver disease.
-HTN
Loop diuretics (contraindications)
-electrolyte depletion
-Severe renal failure or liver failure
Loop diuretics (caution and interactions)
-lupus
-hyperglycemia
-interactions with aminoglycosides (toxicity)
-anticoagulants
-digoxin (toxicity)
-anti-diabetic agents
-Lithium (toxicity)
Common adverse effects of loop diuretics
-hypokalemia/hypocalcemia
-hyperglycemia
-ototoxicity/deafness
-hypotension/dizziness
Thiazide/thiazide like diuretics (drug names)
-hydrochlorothiazide
-chlorothiazide
-chlorthalidone
Thiazide/thiazide like diuretics (therapeutic actions)
-action is to block the chloride pump
-keeps chloride in the sodium in the tubule to be excreted in the urine, thus preventing the reabsorption of both in the vascular system
Thiazide/thiazide like diuretics (indications)
-edema associated with CHS liver or renal disease
-Hypertension
Thiazide/thiazide like diuretics (contraindications)
-allergy to sulfonamides
-hypovolemia
-Severe renal disease
Thiazide/thiazide like diuretics (cautions, and interactions)
-Lupus
-Liver disease
-diabetes/glucose tolerance abnormalities
-Interactions include digoxin(toxicity)
-anti-diabetic agents
-Lithium (toxicity)
Adverse effects of thiazide diuretics
-Electrolyte and glucose balances(hypokalemia, hypercalcemia, and hyperglycemia)
-fluid loss(dizzy, weak, and fatigued)
-alkalinize urine (bladder infections)
Diuretics implementation
-can be given with food or milk
-Administer early in the day
-administer diuretics with IV slowly and then switch to oral form as soon as possible
-assess patient’s weight daily
-assess electrolytes and dehydration
Hypokalemia 6 L’s
-lethargy
-leg cramps
-limp muscles
-Low shallow breathing
-Lethal, cardiac dysrhythmias
-lots of urine polyuria
Diuretic agents actions
-Increase urine volume
-increase sodium excretion
-Prevent fluid retention
