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pharm > diuretics - Sheet1 > Flashcards

diuretics - Sheet1 Flashcards

1
Q

What are the four regions of the nephron?

A

Glomerulus, proximal convoluted tubule, loop of Henle, and distal convoluted tubule.

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2
Q

What are the three processes involved in kidney function?

A

Filtration, reabsorption, and active secretion.

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3
Q

What are diuretics commonly used to treat?

A

Hypertension, heart failure, edema fluid accumulation, and renal failure.

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4
Q

How do most diuretics work?

A

By blocking sodium (Na⁺) and chloride (Cl⁻) reabsorption, changing osmotic pressure, and increasing water and solute excretion by the kidneys.

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5
Q

What are common adverse effects of diuretics?

A

Electrolyte imbalances, acid-base imbalances, and hypovolemia.

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6
Q

What are the four major types of diuretics?

A

Loop (high-ceiling), thiazide, osmotic, and potassium-sparing diuretics.

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7
Q

What is an example of a loop diuretic?

A

Furosemide.

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8
Q

What is an example of a thiazide diuretic?

A

Hydrochlorothiazide (HCTZ).

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9
Q

What is an example of an osmotic diuretic?

A

Mannitol.

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10
Q

What are the two types of potassium-sparing diuretics?

A

Aldosterone antagonists (e.g., spironolactone) and nonaldosterone antagonists (e.g., triamterene).

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11
Q

What is the fifth type of diuretic and its primary use?

A

Carbonic anhydrase inhibitors, primarily used to lower intraocular pressure (IOP).

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12
Q

What are nursing considerations for diuretics?

A

Monitor for dehydration symptoms (e.g., dry mouth, thirst, oliguria), chest, calf, or pelvic pain, blood pressure, intake and output, dizziness, postural hypotension, daily weights, and electrolyte levels (K⁺, Na⁺, Cl⁻, Mg²⁺, Ca²⁺).

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13
Q

What additional monitoring is needed for diabetic patients on diuretics?

A

Blood glucose levels.

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14
Q

What additional monitoring is needed for patients with gout on diuretics?

A

Uric acid levels.

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15
Q

When should diuretics be administered?

A

Early in the day, typically at 0800 and 1400, to avoid nighttime urination.

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16
Q

What is the site of action for loop diuretics like Furosemide (Lasix)?

A

Loop of Henle.

17
Q

How quickly do loop diuretics act when given PO and IV?

A

PO: Onset 1 hr, lasts 8 hrs; IV: Onset 5 min, lasts 2 hrs.

18
Q

What conditions are loop diuretics used to treat?

A

Pulmonary edema in CHF, edema (hepatic, cardiac, renal), and hypertension.

19
Q

What is an advantage of loop diuretics over thiazides?

A

Effective even with renal impairment.

20
Q

What are common adverse effects of loop diuretics?

A

Hyponatremia, hypochloremia, dehydration, hypotension, ototoxicity, hypokalemia, hyperglycemia, hyperuricemia, hypocalcemia, and hypomagnesemia.

21
Q

Why is ototoxicity a concern with loop diuretics?

A

It can cause tinnitus; avoid ototoxic drugs like aminoglycosides (e.g., gentamicin).

22
Q

What interactions should be monitored with loop diuretics?

A

Digoxin, lithium, NSAIDs.

23
Q

What is the main difference between thiazide diuretics and loop diuretics?

A

Thiazides do not work in renal impairment and act on the early distal convoluted tubule.

24
Q

How long do thiazide diuretics like HCTZ last?

A

Up to 12 hours.

25
Q

What are thiazide diuretics used for?

A

Hypertension, edema in HF, diabetes insipidus, and postmenopausal osteoporosis prevention.

26
Q

What adverse effects do thiazide diuretics share with loop diuretics?

A

Dehydration, hyponatremia, hypokalemia, hyperglycemia, and hyperuricemia.

27
Q

What is a key difference in side effects between thiazide and loop diuretics?

A

Thiazides do not cause ototoxicity.

28
Q

What is the function of potassium-sparing diuretics?

A

Retain potassium by blocking aldosterone (e.g., spironolactone) or inhibiting the sodium-potassium exchange pump (e.g., triamterene, amiloride).

29
Q

What are potassium-sparing diuretics used to treat?

A

Hypertension, edema, and heart failure.

30
Q

What are adverse effects of potassium-sparing diuretics?

A

Hyperkalemia, nausea/vomiting, leg cramps, dizziness, and specific effects like bluish urine (triamterene) or endocrine effects (spironolactone).

31
Q

What interactions increase the risk of hyperkalemia with potassium-sparing diuretics?

A

ACE inhibitors, ARBs, DRIs, potassium supplements, salt substitutes, and other potassium-sparing diuretics.

32
Q

What is the site of action for osmotic diuretics like mannitol?

A

Proximal convoluted tubule.

33
Q

What are osmotic diuretics used for?

A

Prophylaxis of renal failure, reduction of ICP (intracranial pressure), and IOP (intraocular pressure).

34
Q

What adverse effects are associated with osmotic diuretics?

A

Heart failure, pulmonary edema, rebound ICP, fluid/electrolyte imbalances, and metabolic acidosis.

35
Q

What are nursing considerations for administering diuretics?

A

Monitor dehydration signs, blood pressure, daily weight, intake/output, electrolytes, ECG, and specific interactions like lithium and potassium.

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