Hypertension - Diuretics - Loop Diuretics

Question 1

What are some uses for loop diuretics?

(1) Severe edema r/t 3 organs
(2) Buildup of fluids in an organ…
(3) Parathyroid

Answer 1

(1) Diuresis, severe edema related to CHF, cirrhosis, renal disease (GFR <30)
(2) Acute pulmonary edema
(3) Hypercalcemia (Loop diuretics are used to decrease calcium)

Question 2

Name common types of loop diuretics

Answer 2

(1) Bumetanida (Bumex) most potent
(2) furosemida (Lasix) most popular
(3) Torsemide (Demedex)
(4) Ethacrynic acid

Question 3

What is the mechanism of action for loop diuretics

Answer 3

Inhibit NaK2Cl cotransporter in the thick ascending limb loop of henle

Question 4

Adverse effects of loop diuretics

(1) R/t diuresis

Answer 4

(1) R/t diuresis
(a) Hypokalemia
(b) Hyponatremia
(c) Hypotension
(d) Hyperuricemia

(2) Hypersensitivity
(a) Rash
(b) Interstitial nephritis

(3) Ototoxicity
(a) Transient (30 mins - 1 day)
(b) Permanent
This happens at high doses or if paired with an aminioglycide

Question 5

Contraindications to using loop diuretics

Answer 5

Anuria

Question 6

What OTC pain reliever can reduce the effectivness of loop diuretics for patients with underlying renal disease?

Answer 6

NSAIDs

Question 7

Drug interactions with loop diuretics

Answer 7

(1) Lithium (reducution in renal clearance causes lithium toxicity
(2) Aminoglycides and some cephalosoporin antibiotics have ototoxic potential
(3) With NSAIDS monitor for nephrotic syndrome / hepatic cirrhosis