Diuretics Flashcards
what are Diuretics used for
Treat HTN and Mobilize edematous fluid to prevent renal fail, also high altitude sickness
3 functions of Diuretic
Maintain acid-base balance, Excrete metabolic waste and foriegn substance, Cleanse ECF and maintain ECF Vol.
how do diuretics work
prevent reabsorbtion of Na and Chloride
Acetazolaminde used to treat
Glaucoma, edema, high altitude sickness
Acetazolamide side effects that can be good
induce metabolic acidosis=seizure prevention also induces respiratory acidosis=increased O2 during hypoxia
Acetazolamide: side effects
elevate blood glucose, drowsy, anorexia, photosensitivity, itching, melena, hematuria
Acetazolamide more or less potent than loop and thiazide diuretic?
Less
Acetazolamide can cause an decrease in what?
Potassium
Acetazolamide toxic with what drug
digitalis
name 2 loop diuretics
Furosemide and Bumetanide
5 Major effects of Loop Diuretic
lower BP, Reduce Pulmonary vascular resistance, reduce central venous pressure, reduce left ventricular end-diastolic pressure
Loop Diurets cause a major loss of
electrolytes (Na & K+) also some CA+ and Chloride
Loop Diuretics treat :
Pulmonary edema, also edema assoc. w/ liver and renal disease. control HTN, inc. secretion of Ca
Loop Diuretics Adverse effects:
HoNatremia, HoChloremia, Dehydration, excessive weight loss
Can Loop Diuretics be used with low GFR?
Yes
what are the effects of Dehydration w/ loop diuretics
thrombosis, embolism: symptoms=pain in chest, calves, or pelvis
Furosemide is reserved for:
rapid or massive mobilization of fluid. pulmonary edema and ascites
Furosemide adverse effects
Ototoxicity, HoKalemia, Electrolyte loss
With Loop Diurectics watch out for what allergy
Sulfa
Nursing Implications for Diuretics: monitor for
Monitor I&O, K+, weight, vitals, hearing loss (1-24hr)
Nursing Implications for Diuretics: teach
medicate early in day=decrease nocturia, report hearing loss or signs of gout
Osmotic diuretic
Mannitol
Mannitol produces
rapid diureses
How does Mannitol work on kidney
induce vasodilation which increase GFR and renal plasma flow=preven kidney damage
Mannitol treats
intracranial and intraocular pressure
What happens to manitol at low levels
crystalize
how to administer Mannitol
Parenterally through IV fliter
SE of Mannitol
Convulsions, thrombophlebitis, & pulmonary congestion
Sprinalactone and triamterene are what type of Diuretic
Potassuim- Sparing
Sprinalactone and Triamteren are given for
Edema, HTN, HF, ascites
Sprinalctone: the ugly
Gynecomastia, amenorrhea, hyperkalemia
Triamterene adverse effects
reduce folic acid and cause kidney stone, leg cramps
Interactions with potassium sparing diuretic
Ace-inhibitor, K+ supplement=hyperkalemia. lithium=lithium toxicity NSAIDS=decreases blood flow to kidney=diminished response
spironolactone monitor for
I&O, K+ and Na+, cardiac dysrhythmias
Spironolactone Teach pt.
restrict K+ food, take meds w/or after meal for GI upset, notify DR. of menstral irregularities and gynecomastia and impotence
Hydrochlorothiazide-what do they do?
Increase output of Na+, K+, H2O Also elevate glucose and uric acid
Are Thiazides More or less effective than loop diuretic
less
Thiazides are used w/ what drug to conteract adverse metabolic effects
Potassium sparing Diuretic
Thiazide AE:
HoNatremia, HoChloremia, HoKalemia, Dehydration
Thiazide drug interaction
Digoxin=slow HR&increase Hrt squeeze also HoKalemia, NSAIDS=decreased diuretic activity, Lithium =accumulation of lithium
Thiazide identify high risk pt.
Digoxin, Lithium, ant-HTN drugs, CVD, renal impairment, Diabetes, Hx of gout
