Diuretics Flashcards
Acetazolamide category
Carbonic Anhydrase Inhibitor
uses of acetazolamide
Diuretic,
Anticonvulsant,
brand name acetazolamide
Diamox
dose of acetazolamide for edema
Edema- 250-375 mg
dose of acetazolamide for epilepsy
Epilepsy-
8-30 mg/kg/day
dose of acetazolamide for metabolic acidosis
Metabolic acidosis- 500 mg
onset of acetazolamide
5-10 minutes
peak of acetazolamide
15 minutes
DOA acetazolamide
4-5 hours
uses of acetazolamide
Treatment of glaucoma, edema, epilepsy, acute mountain sickness, metabolic acidosis
metabolism of acetazolamide
Distribution to erythrocytes,
kidneys.
crosses BBB.
elimination of acetazolamide
urine
major adverse effects of acetazolamide
Acidosis, bicarbonaturia, hypokalemia, paresthesias, renal stones
contraindications of acetazolamide
Hypersensitivity to sulfonamides,
hepatic disease,
low sodium or potassium levels
Ethacrynic acid category
loop diuretic
dose of ethacrynic acid
0.5-1 mg/kg/dose
max dose of ethacrynic acid
(MAX- 100 mg/dose)
onset of ethacrynic acid
5 minutes
peak of ethacrynic acid
30 minutes
DOA ethacrynic acid
2 hours
uses of ethacrynic acid
Treatment of edema r/t CHF
hepatic cirrhosis,
renal disease
metabolism of ethacrynic acid
hepatic
elimination of ethacrynic acid
feces and urine
major adverse s/e ethacrynic acid
Hypocalcaemia hypokalemia hypomagnesaemia alkalosis ototoxicity (
contraindications of ethacrynic acid
Anuria, severe watery diarrhea, infants
what is unique about ethacrynic acid as a loop diuretic
Only loop diuretic with no cross reactivity to sulfonamides or sulfonylureas
Furosemide category
loop diuretic
furosemide dose
20-40 mg/dose IV
furosemide onset
5 minutes
DOA furosemide
2 hours
uses of furosemide
Treatment of HTN and edema r/t CHF
hepatic cirrhosis
renal disease
acute pulmonary edema (improves before diuretic effect)
metabolism of furosemide
minimally hepatic
binds to albumin
elimination of furosemide
feces and urine
adverse reactions of furosemide
Hypocalcaemia, hypokalemia, hypomagnesaemia, metabolic alkalosis, ototoxicity
conditions contraindicated with furosemide
SLE, Digoxin use, Allergy to sulfonamides, sulfonylureas, carbonic anhydrase inhibitors, and thiazides
Hydrochlorthiazide (HCTZ) category
thiazide diuretic
Hydrochlorthiazide (HCTZ) dose PO
12.5-100 MG PO
Hydrochlorthiazide (HCTZ) onset
Diuresis 2 hrs
Hydrochlorthiazide (HCTZ) peak
1-5 hrs
Hydrochlorthiazide (HCTZ) DOA
6-12 hrs
Hydrochlorthiazide (HCTZ) uses
Treatment of HTN and edema r/t CHF hepatic cirrhosis renal disease corticosteroid estrogen therapy
Hydrochlorthiazide (HCTZ) metabolization
not metabolized
Hydrochlorthiazide (HCTZ) excretion
urine
Hydrochlorthiazide (HCTZ) major adverse effects
Hypocalcaemia, hyperkalemia, hypokalemia, hyperglycemia, hypomagnesaemia, hypovolemia, allergy, hyperlipidemia, sexual d/f, alkalosis, ototoxicity
Hydrochlorthiazide (HCTZ)
Allergy to sulfonamides or sulfonylureas, anuria
mannitol category
Osmotic diuresis
mannitol dose
0.25-1 g/kg/dose q 6-8 hrs PRN
mannitol onset
1-3 hrs
mannitol DOA
1.5-6 hrs
mannitol uses
Early oliguria, early brain edema, post ischemic ARF, neurosurgery, GU irrigant in TURP resection, severe traumatic brain injury
metabolism mannitol
Hepatic to glycogen
excretion mannitol
urine
major s/e mannitol
Pulmonary edema in pts w/ HF,
fluid/e- imbalance,
acute tubular necrosis
contraindications mannitol
Severe renal impairment, active intracranial bleed,
heart failure,
pulmonary congestion,
anuria,
Spironolactone category
Potassium sparing diuretic,
spironolactone MOA
antihypertensive,
selective aldosterone blocker
spironolactone dose
25-200 mg PO
spironolactone onset PO
2-3 days PO
spironolactone peak
3-4 hrs
spironolactone DOA
2-3 days
spironolactone uses
Management of edema r/t excessive aldosterone w/CHF, HTN,
hyperaldosteronism,
spironolactone metabolism
hepatic
spironolactone major a/e
Acidosis, azotemia, gynecomastia, hepatotoxicity, hyperkalemia,
spironolactone contraindications
Anuria, acute renal insufficiency,
impairment of renal excretion,
hyperkalemia,
Addison’s disease
