Diuretics Flashcards

1
Q

What are two main types of diuretics?

A

Thiazide and Loop diuretics

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2
Q

What are thiazide diuretics used for?

A

Oedema (due to chronic HF) and hypertension

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3
Q

Name a thiazide diuretic. Explain what dose is used for which condition.

A

Bendroflumethiazide.
2.5mg OM is used for hypertension
Anything higher - its used for chronic HF.

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4
Q

Name some loop diuretics. What are they normally used for?

A

Furosemide
Bumetanide

Used for pulmonary oedema due to left ventricular failure and CHD

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5
Q

Can more than 1 diuretic be used at the same time?

A

Yes, if the patient is not getting relief from using one of them.

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6
Q

Which patients would be using two diuretics at the same time?

A

Resistance oedema patients

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7
Q

What dose would you normally give to elderly patients and why?

A

Lower doses as they’re more susceptible to S/E. Shouldn’t be used on long-term to treat gravitational oedema - this can be treated by raising the legs, using compression stockings and increasing movement

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8
Q

What is the main S/E of diuretics? How would you overcome this S/E?

A

Hypokalaemia.

With the use of potassium-sparing diuretic.

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9
Q

Should the potassium-sparing diuretic and the diuretic be prescribed in combination?

A

Preferably no. They should be prescribed separately. But if compliance is a problem for the patient, they can be used in a combination therapy for example co-amilofruse and co-amilozide

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10
Q

Where in the nephron do both diuretics work on?

A

Loop - ascending loop of Henle

Thiazide - act on distal convoluted tubule and inhibit Na reabsorption

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11
Q

What is the onset of action and duration of thiazide diuretics?

A

1-2 hours onset

12-24 hours duration

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12
Q

When would you take thiazide diuretics?

A

OM - so diuresis does not interfere with sleep

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13
Q

Which thiazide diuretics are preferred for hypertension?

A

Chlortalidone and indapamide

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14
Q

Why would you give chlortalidone on alternate days?

A

Longer duration than other thiazines

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15
Q

What are conditions can diuretics exacerbate?

A

GOUT, diabetes, systemic lupus erythematosus

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16
Q

What would you monitor if patients are on diuretics?

A

ELECTROLYTES

17
Q

If patient has moderate, established, severe kidney failure, which diuretic would you avoid?

A

Avoid thiazides as these are affected.

18
Q

What else could loop diuretics be used for?

A

Resistant HTN

19
Q

What are S/E of furosemide?

A

Deafness when it is infused too quickly and it exceeds 4mg/min

20
Q

What are S/E of bumetanide ?

A

Myalgia + deafness

21
Q

What are both drugs ONSET and duration of action?

A

act within an hour and last 6 hours and can be given twice a day without affecting sleep

22
Q

Name a potassium sparing diuretic. Can this be given with thiazide? What is a side effect of amiloride?

A

Amiloride. Yes as it’s weak on its own.

Urine can appear BLUE.

23
Q

Name an aldosterone antagonist.

A

Spironolactone

24
Q

IF potassium sparing diuretics are given with ACEI or an angiotensin II antagonist, what is their a severe risk of?

A

HYPERKALAEMIA.

25
Q

What are symptoms of hyperkalaemia?

A

Fatigue
Palpitations
N/V
Chest pain