Diuretics (44) Flashcards
Diuresis
Increased water loss
Diuretic drugs
Increased urine output and remove excess fluid
Diuretics are first line drugs for
Heart failure and hypertension
Diuretics are drugs that
Accelerate the rate of urine formation
-by excretion of sodium and water
Diuretics control the bodies
Sodium (and then Cl)
-which controls the bodies water, ECF volume and BP control
Where sodium goes…..
Water follows
What percentage of sodium is reabsorbed in the loop of henle
20 to 25%
What percentage of sodium is reabsorbed in the distal tubules
7%
What percentage of sodium is reabsorbed in the collecting ducts
1-2%
If water is not absorbed… it is
Excreted as urine
A small blockade sodium reabsorption can produce
Profound fluid loss
The small blockade Na reabsorption can produce profound fluid loss but can produce…
-excessive fluid loss (dehydration)
-acid base imbalances
-alter electrolyte levels
Example of loop diuretics
Furosemide
Furosemide acts in the
Act in ascending limb of loop of henle
-inhibits sodium and chloride transporter
-secreted into nephron fluid
Furosemide
-significant diuresis (significant loss of fluid)
Decreased fluid volume cases
-reduced edema
-reduced venous return (reduced CO)
Indications of furosemide
-edema associated with heart failure or hepatic or renal disease
-control of hypertension
-hypercalcemia (will inc renal excretion of calcium)
Adverse effects of furosemide
-Excessive fluid loss
-potassium depletion
-hyopkalemia
-hyperuricemia
-hyperglycemia
Adverse effects of furosemide: fluid loss
-lowers Na, Cl
-water (dehydration)
Adverse effects of furosemide: potassium depletion
Adverse effects of furosemide: hypokalemia
-below normal of 3.5 to 5 mmol/L
-treat with K supplements or K sparing diuretic
Adverse effects of furosemide: hyperuricemia
May lead to gout
Symptoms of hypokalemia
-irregular heartbeat
-muscle weakness/lethargy
-leg cramps
-GI disturbances
Dangerous interactions with furosemide: digoxin
Patients using digoxin need to be monitored for hypokalemia
Interactions of furosemide can increase
Digoxin toxicity
-digoxin used to improve heart function in HF
Dangerous interactions with furosemide: aminoglycosides
Ototoxicity
Furosemide may increase levels of
Lithium
-bipolar disorder
-patients with low Na
Furosemide may decrease
Hypoglycaemic effect of anti diabetic drugs which causes hyperglycemia