Diuretics

Question 1

List the 5 classes of diuretics

Answer 1

Carbonic acid inhibitors
Osmotic
Loop
Thiazides
Potassium-sparing

Question 2

List 4 indications for diuretic use

Answer 2

HF
CKD
HTN
Edema

Question 3

Explain GFR

Answer 3

Glomerular Filtration Rate
-rate of blood flow in/out

Question 4

Which diuretic classes work in the PCT?

How is sodium affected here?

Answer 4

Osmotics
CAIs

Returns 60-70% of sodium

Question 5

Which diuretic class works in the DL?

AL?

Answer 5

DL: osmotics

AL: loop diuretics

Question 6

Most potent/ 2nd most potent diuretic classes?

Answer 6

Loops

Thiazides

Question 7

What hormone regulates DCT sodium reabsorption?

Which diuretic classes in DCT

Answer 7

Aldosterone

Thiazides
K+ sparing

Question 8

Which hormone controls urine excretion in the collecting duct?

Answer 8

ADH

Question 9

Low ____ increased risk of digoxin toxicity?

Answer 9

Potassium

Question 10

Carbonic Anhydrase Inhibitors
-Class?
-Primary use?
-MOA?
-Increases excretion of?

Answer 10

Diuretic

Open-angle glaucoma

MOA: reduces H+ excretion in renal tubules

Increases excretion of Na, water, K, bicarb.

Question 11

List CAI contraindications

AEs?

Answer 11

Renal/hepatic impairement
Low Na
Low K+

Metabolic acidosis, hypokalemia
Increased BG
drowsiness, anorexia, paresthesias

Question 12

Osmotics
-class?
-indications?
-causes?
-example?

Answer 12

Diuretic

-Intracranial pressure/cerebral edema from head trauma
-Early oliguric phase of acute renal failure
-excessive intraocular pressure

Rapid excretion of water and solutes

Mannitol

Question 13

Considerations for mannitol?
-route
-low temps cause?
-must use?

Answer 13

IV only
crystallizes in low temp.
Must use a filter

Question 14

Mannitol
-AEs?
-Contraindications?

Answer 14

AEs: convulsions, pulm. congestion, thrombophlebitis

Cerebral hemorrhage, severe renal disease, Anuria

Question 15

Which diuretics are fluid overload diuretics?

All cause what?

Answer 15

Loops
Thiazides/similars
K+-sparing

Headaches, dizziness
N/V/D

Question 16

How do loop diuretics (____) affect calcium?

Answer 16

Furosemide

Lowers calcium-given for hypercalcemia

Question 17

Loop diuretic MOA?

Answer 17

Inhibits Na and Cl reabsorption

Question 18

How does diminished kidney function affect loop diuretics?

Answer 18

No effect- furosemide will still be effective

Question 19

Which diuretic causes ototoxicity and therefore has additive effects with aminoglycosides

Answer 19

Loops- furosemide

Question 20

Furosemide BBW?

Answer 20

Fluid and electrolyte loss

Question 21

How do loop diuretics affects antidiabetic drugs?

Answer 21

Decreases effectiveness- can cause hyperglycemia

Question 22

How do thiazides affect calcium

Answer 22

Given for idiopathic hypercalcemia because they increase calcium reabsorption

Question 23

Example thiazide?

Answer 23

Hydrochlorothiazide

Question 24

Which diuretic can cause male impotence?

Answer 24

Hydroclorothiazide

Question 25

K+ sparing diuretic example?

Answer 25

Spironolactone

Question 26

Which diuretic causes hormonal effects such as Gynecomastia Amenorrhea Post=menopausal bleeding

Answer 26

Spironolactone -K+sparing

Question 27

What would you check before administering a diuretic?

Answer 27

K+, blood glucose, renal function (BUN/creatinine)

Question 28

Which electrolyte imbalance is most common w/ diuretic use?

Answer 28

K+