Diuretics Flashcards
What are the 5 classes of diuretics?
- Thiazide and thiazide-like diuretics
- Loop Diuretics
- Carbonic Anhydrase Inhibitors
- Potassium- Sparing Diuretics
- Osmotic Diuretics
What do diuretic agents increase?
Increase:
- The amount of urine produced by the kidneys
- Sodium excretion
What are the indications that diuretics need to be used?
- Edema associated with CHF
- Acute pulmonary edema
- Liver disease (including cirrhosis)
- Renal disease
- Hypertension
- Conditions that cause hyperkalemia
What is the prototype for thiazide and thiazide like diuretics?
Hydrochlorothiazide
When should a prescriber use caution when prescribing thiazide and thiazide-like diuretics?
- Gout
- Systemic lupus
- Diabetes
- Hyperparathyroidism
What are the adverse effects associated with thiazide and thiazide-like diuretics?
- Related to interference with the normal regulatory mechanisms of the nephron
- Hypokalemia
- Lithium
- Altered blood glucose levels
- Urine will be slightly alkalinized
- Decreased calcium excretion
What drugs interact with thiazide and thiazide-like diuretics?
- Cholestyramine or colestipol
- Digoxin
- Antidiabetic agents
What is the action of thiazide diuretics? A. Blocks the chloride pump B. Blocks the sodium pump C. Blocks the potassium pump D. Blocks the carbonic anhydrase pump
A. Blocks the chloride pump
What do loop diuretics do?
Block the chloride pump in the ascending loop of Henle causing the reabsorption of sodium and chloride
What are the indications for the use of loop diuretics?
- Acute CHF
- Acute pulmonary edema
- Edema associated with CHF
- Edma associated with renal or liver disease
- Hypertension
What are the contraindications for use of loop diuretics?
- Electrolyte depletion
- Anuria
- Severe renal failure
- Hepatic coma
- Pregnancy and lactation
What are the adverse effects associated with loop diuretics?
- Related to the imbalance in electrolytes and fluid
- Hypokalemia
- Alkalosis
- Hypocalcemia
When should a prescriber use caution when prescribing loop diuretics?
- Systemic Lupus Erythematosus
- Gout
- Diabetes Mellitus
What drugs interact with loop diuretics?
- Aminoglycosides or cisplatine
- Anticoagulation
- Indomethacin, ibuprofen, salicylate, or NSAIDs
What is the prototype drug for loop diuretics?
Furosemide
What is the indication that a patient should be prescribed furosemide?
They need treatment of edema associated with heart failure, acute pulmonary edema, hypertension
How are potassium-sparing diuretics described?
They are not as powerful as loop diuretics, but they retain potassium instead of wasting it.
What do potassium-sparing diuretics do?
They cause a loss of sodium while retaining potassium; blocking the actions of aldosterone in the distal tubule.
What are the indications that potassium-sparing diuretics should be prescribed?
The patient is at risk for hypokalemia. They need a drug to be used in adjunction with thiazide or loop diuretics.
What are the contraindications for prescribing potassium-sparing diuretics?
- Hyperkalemia
- Renal disease
- Anuria
- Patients taking amiloride or triamterene
What is the adverse effect associated with potassium-sparing diuretics?
Hyperkalemia
What drug interacts with potassium-sparing diuretics?
Salicylates
What is the prototype for potassium-sparing diuretics?
Spironolactone
True or False:
The loop diuretics cause the body to excrete a copious amount of potassium-rich urine.
False:
They result in a production of copious amount of sodium-rich urine.
What do osmotic diuretics do?
Pull water into the renal tubule without sodium loss
When is it indicated for a patient to take osmotic diuretics?
- Increased cranial pressure
- Acute renal failure due to shock
- Drug overdose
- Trauma
What are the contraindications when prescribing osmotic diuretics?
-Renal disease and anuria
-Pulmonary congestion
-Intracranial bleeding
Dehydration
CHF
What are the adverse effects associated with osmotic diuretics?
- Related to sudden drop in fluid levels
- Nausea
- Vomiting
- Hypotension
- Light-headedness
- Confusion
- Headache
What is the prototype for osmotic diuretics?
Mannitol
