Diuretics Flashcards
Diuretics are first line drugs for treatment of?
Heart failure and Hypertension
example of a life threatening edematous state?
pulmonary edema
Diuretics
drugs that accelerate the formation of urine
excessive fluid loss
hypovolemia
Furosemide is a
loop diuretic
how do loop diuretics work?
inhibits sodium from leaving the loop of henle, this causes more water to be left in the tubule and therefore causes it to be excreted by urine
loop diuretics are also called
high ceiling diuretics
decreased fluid volume causes
reduced edema and reduced venous return which produced reduced cardiac output
loop diuretics are mostly used for
edema associated with heart failure, or hepatic or renal disease
loop diuretics can be used for hypertension but…?
they are not normally used as a blood pressure medication
Furosemide is contraindicated in?
patients with a sulfonamide allergy because they are related structurally.
furosemide is also called
Lasix
Loop diuretics can cause
potassium depletion
Normal range of K+
3.5-5 mmol/L
Major adverse effect of furosemide
hypokalemia
Hypokalemia symptoms (think muscle activity)
- irregular heartbeat
- muscle weakness/lethargy
- leg cramps
- GI disturbances
patients using digoxin need to be monitored for
hypokalemia
digoxin, like diuretics, is also used in?
heart failure
digoxin is okay to use with furosemide as long as?
furosemide does not cause hypokalemia
interactions of furosemide with diabetic patients
may decrease effectiveness of antidiabetic drugs and insulin cause hyperglycemia.
Why is hydrochlorothiazide less powerful than furosemide?
Because hydochlorothiazide works on a different part of the tubule where less sodium is typically lost.
where is the action of hydochlorothiazide?
in the distal convuluted tubule
Hydrocholorthiazide mechanism of action?
- depletion of water and sodium
- lowered peripheral vascular resistance
thiazide diuretics are also called low ceiling diuretics because?
the maximum amount of diuresis produced is less than loop diuretics, this is merely a consequence of where the drug acts
drug effect of hydrochlorothiazide is reduced as
kidney function decreases
if GFR decreases, you can use thiazide until?
the GFR reaches less than 30ml/min
first line of treatment for hypertension?
hydrochlorothiazide
thiazide diuretics are mainly used for
hypertension
thiazide diuretics cannot be used when there is?
severe kidney failure (low GFR)
adverse effects of thiazide
hypokalemia
example of a K+ sparing diuretic
spironolactone
spironolactone mechanism
aldosterone recepetor blocker
aldosterone
promotes sodium reabsorption
less sodium leaving tubule equals
more K+ staying in
why does spironolactone have a slow onset (2-3 days)
inhibiting proteins and pumps takes time
aldosterone receptor antagonist
spironolactone
major contraindication of spironolactone?
hyperkalemia
what to do if hyperkalemia results?
hold spironolactone
hyperkalemia symptoms
- tachycardia
- muscle weakness
spironolactone could have?
sex-hormone like effects
teach clients to take diuretics in the?
morning
teach clients to eat ______ foods during diuretic therapy?
potassium rich
The more Na that stays in the tubules as a result of diuretic use..?
The more K+ that is lost. Na and K have opposite directions
