Diuretics Flashcards
What are two main types of diuretics?
Thiazide and Loop diuretics
What are thiazide diuretics used for?
Oedema (due to chronic HF) and hypertension
Name a thiazide diuretic. Explain what dose is used for which condition.
Bendroflumethiazide.
2.5mg OM is used for hypertension
Anything higher - its used for chronic HF.
Name some loop diuretics. What are they normally used for?
Furosemide
Bumetanide
Used for pulmonary oedema due to left ventricular failure and CHD
Can more than 1 diuretic be used at the same time?
Yes, if the patient is not getting relief from using one of them.
Which patients would be using two diuretics at the same time?
Resistance oedema patients
What dose would you normally give to elderly patients and why?
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
What is the main S/E of diuretics? How would you overcome this S/E?
Hypokalaemia.
With the use of potassium-sparing diuretic.
Should the potassium-sparing diuretic and the diuretic be prescribed in combination?
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
Where in the nephron do both diuretics work on?
Loop - ascending loop of Henle
Thiazide - act on distal convoluted tubule and inhibit Na reabsorption
What is the onset of action and duration of thiazide diuretics?
1-2 hours onset
12-24 hours duration
When would you take thiazide diuretics?
OM - so diuresis does not interfere with sleep
Which thiazide diuretics are preferred for hypertension?
Chlortalidone and indapamide
Why would you give chlortalidone on alternate days?
Longer duration than other thiazines
What are conditions can diuretics exacerbate?
GOUT, diabetes, systemic lupus erythematosus