Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Diuretics > Flashcards

Diuretics Flashcards

1
Q

Diuresis

A

Increased water loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Diuretic general

A

Diuretic Drugs: increase urine output and remove excess fluid

First line drugs for heart failure and hypertension. Also good for a

Most use excretion of sodium and water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

BP CONTROL

A

BP = Cardiac output x total peripheral resistance

Cardiac output = HR x Stroke volume (blood volume)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Nephron review

A
  1. Glomerulus
  2. Proximal convoluted tubule
  3. Loop of henle
  4. Distal convoluted tubule
  5. Collecting duct

Loop of henle and collecting duct are in the medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Sodium controlling water movement

A

67% in Proximal convuluted tubule
20-25% of Na is reabsorbed in loop of Henle
7% in the distal tubules
1-2% in collecting ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Diuretic drug actions

A

Blocks Na reabsorption and causes fluid loss

  • Hypovolemia
  • Acid-base imbalances
  • Alter electrolyte levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Types of Diuretics

A
  1. Loop diuretics
  2. Thiazide and thiazide-liek diuretics
  3. Potassium-sparing diuretics
  4. Osmotic diuretics - not focusing on
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Loop Diuretics general

A

Furosemide (Lasix)

“High ceiling” diuretics

Act in the ascending limb of the loop of henle
- Inhibits sodium and chloride transporter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Loop Diuretics - Med Effects

A

Significant diuresis

  • significant loss of fluid
  • reduced edema
  • reduced venous return
  • reduced CO

Potassium depletion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Loop Diuretics: Indications

A

Edema associated with heart failure or hepatic or renal disease

Control of hypertension

Increase renal excretion of calcium for patients with hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Loop Diuretics: Contraindication

A
  • Known drug allergy
  • Allergy to sulfonamide antibiotics (related structure)
  • Hepatic coma
  • Severe electrolyte loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Furosemide (Lasix)

A

Secreted into nephron fluid
- luminal site of action

  • Crosses placenta and enters breast milk
  • High albumin binding (91-97%)
  • Metabolized in liver
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Loop diuretics - Adverse efffects

A

Hypokalemia (normal is 3.5-5)

  • Irregular heartbeat, potentially fatal dysrhythmias
  • Muscle weakness/lethargy
  • Leg cramps
  • GI disturbances (constipation)

Hyperglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Furosemide Interactions

A

Patients using digoxin (symptom relief from heart failure) needs to have normal potassium levels

  • Furosemide can increase digoxin toxicity
  • Increased hypokalemia with other diuretics
  • Increased levels of lithium (bi polar disorder)
  • May cause hyperglycemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Thiazide and Thiazide-like Diuretics

A

Hydrochlorothiazide (Hydrodiuril)

Very frequently used for hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Thiazide Actions

A

Inhibits reabsorption of sodium and chloride in the distal convoluted tubule

Depletion of sodium and water - reduced blood volume

Lowered peripheral vascular resistance

17
Q

Hydroholorthiazide

A

Oral administration - quick absorption

Excreted mostly unchanged by kidneys. Site of action in luminal membrane

18
Q

Thiazide Med Effects

A

Drug effect reduced as kidney function decreases

Not to be used if creatinine is below 30ml/min
- normal is 125ml/min (GFR)

19
Q

Thiazide Indications

A

Hypertension

  • First line treatment
  • Single or combination (loop)

Edematous states
- treatment of HF, hepatic cirrhosis

20
Q

Thiazide Contraindications

A

Severe kidney failure

  • Known drug allergy
  • Hepatic coma
  • Anuria - absence of urine formation
21
Q

Thiazide Adverse Effects

A

Hypokalemia*

Hyperuricemia
Hyperglycemia (inhibits insulin secretion)

Genitourinary system
- Impotence

22
Q

Thiazide Interactions

A

Digoxin
- increased risk of toxicity due to hypokalemia

Antidiabetic drugs
- reduces effect from diabetic drugs so may lead to hyperglycemia

23
Q

Potassium-sparing Diuretics

A

Spironolactone (aldactone)

  • Aldosterone receptor blocker
  • Onsent is 24-48 hours
  • peka 2-3 days
  • Other P-S drugs are Na channel blockers

Collecting tubules of nephrons
- Limited effectiveness used on their own

Used to prevent hypokalemia

24
Q

P-S Actions

A

Reduced sodium-potassium exchange, body retains K+

Blocks the reabsorption of sodium and water usually induced by aldosterone

25
Q

Spironolactone Indications

A
  • Edema associated with HF
  • Hypertension
  • Reversing K loss
  • Hyperaldosteronism
26
Q

P-S Contraindications

A

Hyperkalemia
- above 5 mmol

Severe kidney failure or anuria
- Known drug allergy

27
Q

P-S Adverse Effects

A

Hyperkalemia

  • Cardiac dysrhythmias
  • Muscle weakness
  • GI cramps, nausea, vomiting, diarrhea.

Sex hormone like effectsion

  • Amenorrhea
  • Irregular menses
  • Postmenopausal bleeding
  • Gynecomastia - concern for males
28
Q

P-S Interactions

A

With other HF drugs that also increase plasma K+

RAAS drugs - Ace inhibitors

Don’t give potassium supplements

29
Q

Nursing Implications

A
  • Take in morning to minimize interference with sleep
  • Monitor serum potassium levels
  • Teach clients to eat potassium rich-foods (bananas, raisins, plums, legumes, potatoes) when on antidiuretics (not P-S)
  • Monitor digitalis toxicity
  • Look for fatigue, GI problems, heart rate changes, anorexia, and visual disturbances
  • Diabetic indications
  • Signs and symptoms of hypokalemia
  • Notify physician of rapid heart rate or syncope
  • teach clients to change positions slowly due to orthostatic hypotension

Pharmacology (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions