Diuretics part 2

Question 1

How are loop and thiazide diuretics similar and different?

Answer 1

Similar:
-excrete sodium, chloride, potassium, and water
-elevate uric acid (causing gout)
-must have appropriate renal function
Different:
-thiazides produce less diuresis than loop

Question 2

What is the mechanism of action of thiazide (hydrochlorothiazide) diuretics?

Answer 2

blocks reabsorption of sodium and chloride in the early segment of the distal convoluted tubule

Question 3

What are the therapeutic uses of thiazide diuretics?

Answer 3

• hypertension
• edema (caused by mild to moderate HF, hepatic, or renal disease)
• diabetes insipidus: reduces urine for this pt
• protection against postmenopausal osteoporosis: promotes tubular reabsorption of calcium

Question 4

What are the adverse effects of thiazide diuretics?

Answer 4

• same as loop except thiazides are not ototoxic
• hyponatremia, hypochloremia, and dehydration
• hypokalemia
• hyperglycemia: for diabetic pt’s
• hyperuricemia: (causing gout)
• chloresterol: raise LDL and decrease HDL
• Magnesium: deficiency

Question 5

Are thiazides ototoxic?

Answer 5

no

-loop diuretics are

Question 6

What are the drug interactions of thiazides?

Answer 6

• same as loop
• increases toxicity of digoxin
• increases effects of antihypertensives
• NSAIDs prevent diuresis
• prevents lithium from being excreted (watch toxicity)
• can be combined with ototoxic drugs

Question 7

What diuretic should and should not be used for a pt with renal impairment?

Answer 7

Thiazide diuretic should NOT

Loop diuretic should be used for renal impairment