Diuretics Flashcards
Diuretics are medications that..
increase renal excretion of water, sodium and other electrolytes, thereby increasing urine formation and output
diuretics are used in the management of what conditions?
Edematous: HF, renal disease and hepatic disease
non-edematous: HTN, opthalmic surgery
nephron is the functional unit of the kidney and it functions via three processes
glomerular filtration, tubular reabsorption, tubular secretion
daily minimum urine output is?
400 ml to remove normal amounts of metabolic end products
general characteristics of diuretics
- act on kidney to decrease reabsorption of:
- sodium, chloride, water and other substances
major subclasses of diuretics are?
- thiazide and related diuretics
- loop diuretics
- potassium sparing diuretics
_______ diuretic is preferred when rapid diuretic effect is necessary or when renal impairment is present
Loop
_______ diuretic may be used concurrently to prevent or manage hypokalemia
potassium-sparing
Loop diuretics mechanism of action
act directly on the ascending limb of the loop of henle to block chloride and sodium reabsorption
one drug effect with loop diuretics is the depletion of
potassium and sodium
one metabolic adverse effect that may be caused by loop diuretics is
hyperglycemia
loop diuretics interact with ______ drugs and cause___
NSAID’s and may decrease the reduction of vascular resistance
Furosemide
-most commonly used loop diuretic
when giving an IV injection of furesomide administer over _____
and when administering high-dose furosemide continuous IV infusions given at a rate of
- 1-2 minutes
- 4 mg/min a less
potassium sparing diuretics are also known as ______ and some examples are
-aldosterone inhibiting diuretics (amilodride, spironolactone, trimaterene
potassium sparing diuretics mechanism of action:
- work in collecting ducts and distal convoluted tubules
- interfere with sodium-potassium exchange
- competitively bind to aldosterone receptors
- block reabsorption of sodium and water usually induced by aldosterone secretion
how to prevent and manage potassium imbalances (HYPOKALEMIA)
hypokalemia is cardiotoxic event- prevent when possible by:
- low dosing of diuretics
- using supplemental potassium, potassium sparing diuretics
- increase food intake of potassium
- restrict dietary sodium intake
how to prevent and manage potassium imbalances
HYPERKALEMIA
two adverse effects from thiazide and thiazide like diuretics
- photosenstivity
- hyperglycemia
teach pts to eat foods high in _____ when taking diuretics
potassium (expect when taking potassium sparing diuretics)
foods high in potassium: bananas, oranges, dates, apricots, raisins, broccoli, green beans, potatoes, tomatoes, meats, fish, wheat bread & legumes
pts taking digoxin along with diuretics should watch for _____
digoxin toxicity
pts with diabetes mellitus who are taking a thiazide or loop diuretic should be told to monitor_____ and watch for _____
told to monitor blood glucose and watch for elevated levels
