Diuretics Flashcards
Furosemide (Lasix)
loop diuretic
Used for pulmonary edema, edematous states, hypertension
blocks rebasorption at the ascending limb of Henle’s loop, causes maximum water loss
Most frequently prescribed loop diuretic
bumentanide
loop diuretic
indications for loop diuretics
Rapid onset—pulmonary edema, edematous states, hypertension, heart failure
adverse effects of loop diuretics
Hyponatremia, hypochloremia, hypokalemia, hypomagnesia (cramps) dehydration, hypotension ototoxicity- headache, dizziness hyperglycemia hyperuricemia, gout adverse effect on lipids
mannitol
simple 6 carbon sugar that can’t be absorbed- increases osmotic gradient inside tubule sytem- pulls water out of the kidneys
Does not have a big effect on electrolytes- pulls water out
reduction of intracranial pressure, prophylaxis of renal failure, reduction of intraocular pressure
Must be given parenterallyc
Which diuretics are potassium sparing?
Sprionolactone and triamterene
Pulmonary edema symptoms and treatment
Short of breath, low O2, Pulse ox <93%, RR up, coughing- pink frothy sputum. Treated with Lasix.
Drug interactions of furosemide and bumetanide (loop diuretic)
- Digoxin - lowers levels of potassium - increases risk of dysrhythmias
- Ototoxic drugs - like aminoglycoside antibiotics (drugs ending in -mycin)
- Lithium - blood sodium levels go down, kidney retains lithium - could lead to toxic levels of lithium
- Antihypertensive agents
- NSAIDs- attenuate the effects
- Potassium-sparing diuretics- good interaction (pt may be prescribed both)
Bumetanide
high-ceiling loop diuretic
Thiazides
diuretic
Increase renal excretion of sodium, chloride, potassium, and water
Less dehydration than loop diuretics
Not effective when urine flow is scant and GFR is low due to advanced kidney disease.
Hydrochlorothiazide (HydroDIURIL)
Only PO- peaks in 4-6 hours
Used for essential hypertension and edema
Adverse effects of thiazide diruetics
hyponatremia, hypochloremia, hypokalemia, hypomagnesia
hyperuricemia, hyperglycemia
adverse effects on lipids
Thiazide interactions
Digoxin- increases dysrhythmias
Lithium- levels increase (reduced renal excretion)
NSAIDs- blunt effect
NO OTOTOXICITY- can be combined with -mycins.
Spironolactone
Blocks aldosterone receptor (-one, -one)
Modest increase in urine production— rarely used alone
Substantial decrease in potassium excretion
May be used if hypokalemia
Triamterene, Amiloride (midamore)
small fluid loss, blocks potassium excretion
Uses for spironolactone
Hypertension edematous states heart failure (decreases mortality) PCOS premenstrual syndrome primary hyperaldosteronism acne in young women
Spironolactone adverse effects
hyperkalemia, benign and malignant tumors, endocrine effects
Mannitol adverse effects
Stays within the tubules of the kidney and capillaries of brain… BUT
Can escape the capillaries in the lungs and cause pulmonary edema! Crackles
Headache, nausea, vomiting.
