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Pharm Test 2 > Diuretics > Flashcards

Diuretics Flashcards

1
Q

Osmotic diuretics are effective in what part of the nephron?

A

proximal tubule

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2
Q

what are 2 adverse effects of the osmotic diuretics? why?

A

flash pulmonary edema, increased cardiac workload

-drugs pull fluid from interstitial spaces to the vasculature very quickly.

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3
Q

What are 3 examples of an osmotic diuretics?

A

Mannitol (manages elevated ICP), glycerin and urea

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4
Q

How do aquaretics work? What is the drug called? Where are the patients that need these?

A

decrease ADH
Demeclocycline
Neuro ICU

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5
Q

Carbonic anhydrase inhibitors waste what?

A

bicarb and water follows it

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6
Q

what do CAIs mainly treat? what ELSE can it treat?

A

Glaucoma (increased intraocular pressure)

altitude sickness

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7
Q

What are 3 AEs of CAIs?

A

severe hypokalemia
rash
may affect excretion of other drugs

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8
Q

what is an example of a CAI?

A

Acetazolamide

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9
Q

Thiazides have what level efficacy?

A

medium

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10
Q

Thiazides have an effect on what part of the nephron? what does this mean for those with CrCl

A

DISTAL.

If drug cannot get filtered at the distal tubule, then it will not work.

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11
Q

What are AEs of thiazides?

A

HYPOkalemia, magnesemia
HYPERuricemia, glycemia, calcemia
photosensitivity
rash

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12
Q

what is an example of a thiazide?

A

HCTZ

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13
Q

Loop diuretics have what level efficacy?

A

HIGH

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14
Q

Loops are also known as “high _____”. Also, as Vitamin ___.

A

ceiling (25-2500mg)

Vitamin P

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15
Q

Loops have a ______onset and last _____hours.

A

rapid onset

last 6-8 hours

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16
Q

Loops are commonly used in patients with what 2 conditions?

A

CHF and acute pulmonary edema

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17
Q

What are the AEs of loops?

A

HYPOkalemia, calcemia
HYPERuricemia, glycemia
ototoxicty when pushed too fast
rash

18
Q

What are examples of loop diuretics? Which is more potent?

A

Ethacrynic acid
furosemide 40mg
torsemide 10-20mg
bumetanide (most potent–1mg)

19
Q

Which two diuretics are K sparing? this means that an AE of both of these drugs is….

A

aldosterone antagonists and Nonsteroidal drugs

hyperkalemia

20
Q

Aldosterone antagonists block Na and water reabsorption at the …….

A

distal tubule

21
Q

another AE of aldosterone antagonists is what? therefore, it is often used for what condition?

A

estrogenic effects –gynecomastia!

hirtuism

22
Q

AA have NO effect on what two things? what does this mean?

A

blood sugar and uric acid.

they are the diuretic of choice for those with gout

23
Q

What is the problem with using salt substitutes and potassium sparing diuretics?

A

salt substitutes are potassium based. so hyperkalemia is a problem

24
Q

What other conditions are AA beneficial for? Why?

A

cirrhosis – aldosterone is metabolized in the liver. antagonizing aldosterone lessons the impact on the liver.
primary aldosteronism

25
Q

what is an example of an AA? is it useful in patients who have been adrenalectomized?

A

spironolactone

no

26
Q

what is a second generation AA that is NOT anti-androgenic? is it helpful with hirtuism?

A

Eplerenone (Inspra)

no

27
Q

Nonsteroidal K sparing drugs have an effect on what part of the nephron?

A

distal

28
Q

AE of nonsteroidal KSD are…

A

HYPERkalemia, calcemia

HYPOmagnesemia

29
Q

What is an example of an NSKSD?

A

Triamterene

30
Q

Hypokalemia is an issue for what type of diuretics?

A

K wasting

31
Q

NSKSD are often added to what other therapy? why?

A

HCTZ, so that the therapy is K-neutral

32
Q

what foods are high in potassium?

A

bananas, apricots, figs, oranges, raisins

33
Q

how is K replaced in those who are on K wasting diuretics?

A

food
PO replacement 10-20mEqs KCl
IV formulations –never give >10mEq / hr

34
Q

How do you treat hyperkalemia?

A 
K wasting diuretics
Kayexalate (SPS)
Bicarb
D5W, Insulin
Calcium Cl
35
Q

S/S of hyperkalemia:

A

muscle cramping, bradycardia, asystole

narrow QRS, peaked T waves

36
Q

When you prescribe acetozolamide, and the patient is also taking a acidic drug, what will happen? basic drug?

A

the acidic drug will appear in the urine.

basic drug will not appear in the urine

37
Q

which drug would you prescribe to someone with a CrCl

A

loop diuretic

38
Q

which diuretics cause hyperkalemia?

A

spironolactone (eplerenone), and Triamterene

39
Q

which diuretic is beneficial for a post-menopausal woman?

A

HCTZ (thiazide) because it retains calcium

40
Q

people with bad CHF are prescribed furosemide, but they are not getting enough diuresis. What can you do?

A

prescribe B or T, that is better absorbed. If CHF causes an edematous GI tract, you can use a more potent loop diuretic.

41
Q

what is the major difference between thiazides and loop diuretics?

A

thiazides cause hypercalcemia.

loops cause hypocalcemia. So patients with hypercalcemia are often prescribed a loop diuretic.

Pharm Test 2 (7 decks)

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