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1 Pharmacology > Diuretics - Urine Output > Flashcards

Diuretics - Urine Output Flashcards

1
Q

categories of diuretics + overall effect

A 
PLOT:
potassium-sparing
loop
osmotic
thiazide

overall effect: get rid off excess fluid
-change electrolyte

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2
Q

*potassium-sparing diuretics

drug names

A 
TEAS:
Triamterene
Eplerenone
Amiloride
Spironolactone
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3
Q

potassium-sparing diuretics (TEAS)

MOA

A

-blocks the action of aldosterone on the renal cortex

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4
Q

aldosterone action

A

reabsorbs Na

secretes K

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5
Q

potassium-sparing diuretics (TEAS)

Tx

A
  • to get rid of excess fluid

- often combined to avoid electrolyte problems

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6
Q

potassium-sparing diuretics (TEAS)

CI

A
  • severe kidney failure
  • anuria
  • caution w ACE/ARB/DRI
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7
Q

*potassium-sparing diuretics (TEAS)

A/E

A
  • hyper-K
  • hypo-Na (lithium danger)
  • endocrine effects (weird sex stuff)
  • drowsiness
  • metab acidosis
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8
Q

what are some s/s of the endocrine effects of potassium-sparing diuretics (TEAS)

A
  • deep voice
  • gynecomastia
  • hirsute
  • irreg menstrual cycle
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9
Q

*potassium-sparing diuretics (TEAS)

RN/teaching

A
  • reduce high K food or K supplemenents
  • Triamterene makes your pee blue green
  • if pt is hyper-K, then cardiac monitor
  • concurrent use w ACE, ARB, DRI can incr risk of hyper-K
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10
Q

Insulin MOA

A

uptake of glucose + K

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11
Q

priority treatments for patient w hyper-K

A
  • IV push of Ca gluconate or CaCl 10%
  • —does NOT stabilize K levels
  • —DOES stabilize heart walls
  • Insulin + D50
  • Neb Betal Agonist (Albuterol)
  • IV Na Bicarbonate (decr acid, drives K into cell)
  • Polystyrene sulfonate/Kayexylate
  • loop diuretics
  • dialysis
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12
Q

which is the strongest diuretic?

A

LOOP

-thiazide is just like loop but not as strong

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13
Q

**LOOP diurects

drug name

A

furosemide (Lasix)
Ethacrynic acid
Bumetanide

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14
Q

furosemide, ethacrynic acid, bumetanide (loop)

MOA

A

block reabsorption of Na + Cl

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15
Q

furosemide, ethacrynic acid, bumetanide (loop)

Tx

A
  • HTN
  • edema
  • CHF
  • hyper-Ca
  • hyper-K
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16
Q

*furosemide, ethacrynic acid, bumetanide (loop)

CI

A

-caution w LITHIUM, DIGOXIN, NSAID, + anti HTN

17
Q

*furosemide, ethacrynic acid, bumetanide (loop)

A/E

A
  • dehydration
  • drop BP
  • hypo-Na
  • hypo-K
  • hypo-Ca
  • hypo-Mg
  • hyper-glucose
  • ototoxicity
  • tinnitus
18
Q

*furosemide, ethacrynic acid, bumetanide (loop)

RN/teaching

A
  • monitor I/O
  • daily weights
  • UOP <30mL/Hr
  • tinnitus
  • chvostek’s trousseau’s
  • monitor K levels
  • daily weight in
  • orthohypotension
19
Q

always check for ___ before giving K or diuretics

A

BP

20
Q

if patient is at risk for orthohypotension, what should we be on the lookout for?

A

ambulation + getting up too fast

-def encourgae getting up slowly

21
Q

what are some things to consider for a patient that requires daily weigh ins?

A

same time

same clothing or bedding

22
Q

low K makes ___ toxic

A

Digoxin

23
Q

low Na makes ___ toxic

A

Lithium

24
Q

low Ca makes cause ____

A

Chvostek + Trousseau

+also hypo-Mg

25
Q

type of diuretic that will suck water out of the eyeball + brain

A

Osmotic Diuretic

26
Q

Osmotic Diuretic

drugs

A

mannitol or isosorbide

27
Q

Osmotic Diuretic

MOA

A

incr serum osmolality + pulls fluid back into intravascular space

28
Q

*Osmotic Diuretic

Tx

A
  • reduce intracranial + intraocular pressure
  • prevents AKI in setting of hypovol shock
  • decr cerebral edema in Neuro units
29
Q

Osmotic Diuretic

CI

A
  • active intracranial bleeding

- anuria

30
Q

*Osmotic Diuretic

A/E

A
  • HF (fluid overload)
  • rebound ICP
  • metab acidosis
  • electrolyte abnorm
31
Q

*Osmotic Diuretic

RN/teach

A

monitor s/s of incr ICP

  • changes in LOC
  • pupil
  • headache
  • N/V

*can form crystals

32
Q

mannitol + isosorbide can form ____

+ nursing priorities

A

crystals

  • draw up in filter needle
  • use filter IV
  • if you can see crystals in the viable, then warm up and agitate
33
Q

*thiazide diuretics

drug names

A

hydrochlorothiazide [HCT/HCTC], metolazone

34
Q

HCT/HCTC + metolazone (thiazide)

MOA

A

blocks reabsorption of Na + H2Oin DCT

35
Q

HCT/HCTC + metolazone (thiazide)

Tx

A
  • 1st line of Tx for HTN
  • edema
  • mild CHF
  • kidney disease
  • osteoporosis
  • DI
36
Q

HCT/HCTC + metolazone (thiazide)

CI

A
  • anti-HTN
  • cautions w digoxin, lithium
  • lactation
37
Q

*HCT/HCTC + metolazone (thiazide)

A/E

A
  • hyper-CA
  • hyper-glycemia
  • hypo-Na
  • hypo-K
  • dehydration

1 Pharmacology (33 decks)

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