Lesson 5

Question 1

increase urine output to remove edema fluids of various diseases

Answer 1

Diuretics

Question 2

Three approaches to the treatment of edema

Answer 2

1. Correction of underlying disease
2. Restriction of dietary or other sodium intake
3. Administration of diuretics

Question 3

what remains the cornerstone for the treatment of edema or volume overload

Answer 3

Diuretics

Question 4

Therapeutic indications for diuretics include

Answer 4

1. maintenance of urine flow
2. mobilization and reduction of inappropriate ECF
3. correction of specific ion imbalances
4. reduction in the rate of intraocular fluid formation causing glaucoma
5. reduction of blood pressure
6. reduction of pulmonary blood pressure

Question 5

Diuretics that target sodium or chloride reabsorption by tubular cells

Answer 5

1. loop diuretics
2. thiazides
3. potassium-sparing diuretics

Question 6

Diuretics that increase net urinary excretion of sodium chloride or sodium bicarbonate are referred to as

Answer 6

natriuretic

Question 7

most useful osmotic diuretic

Answer 7

Mannitol

Question 8

most common indication for mannitol is to relieve _________ to reduce the pressure and volume of the _______ fluid

Answer 8

cerebral edema; cerebrospinal

Question 9

Mannitol is contraindicated in?

Answer 9

cardiovascular shock as it can worsen cardiovascular hypovolemia

Question 10

Clinical uses of Mannitol

Answer 10

1. Cerebral edema
2. prophylaxis of acute renal ischemia
3. evaluate acute oliguria
4. encourage urine output

Question 11

Mannitol adverse effects if not excreted (2)

Answer 11

1. cardiovascular overload
2. vacuolization of kidney cells

Question 12

What are the diuretics that increase glomerular filtration rate?

Answer 12

1. Xanthine derivatives such as Caffeine, Theophylline, Theobromine and Aminophylline
2. Cardiac glycosides (Digoxin, Digitoxin, and Ouabain)

Question 13

Xanthine derivatives other actions other than diuresis

Answer 13

1. CNS stimulation
2. Cardiac stimulation
3. Bronchodilation

Question 14

Digitalis glycosides DO NOT cause diuresis in patients without _____

Answer 14

congestive heart failure

Question 16

Give 4 carbonic anhydrase inhibitors

Answer 16

1. Acetazolamide
2. Dichlorphenamide
3. Methazolamide
4. Ethoxolamide

Question 16

Carbonic anhydrase inhibitors cause large loss of sodium bicarbonate ions and water, thereby resulting to ______ and _______

Answer 16

1. alkaline urine
2. systemic acidosis

Question 17

major clinical use of carbonic anhydrase inhibitors

Answer 17

treating glaucoma by relieving intra-ocular pressure

Question 18

a diuretic drug been used to remove udder edema in dairy cows

Answer 18

Acetazolamide

Question 19

believed to inhibit Na+ and Cl- reabsorption in the early distal tubule of the nephron

Answer 19

Thiazides

Question 20

Side effects observed with thiazide

Answer 20

1. hypokalemia
2. hyperglycemia
3. hypomagnesemia
4. hypercalcemia

Question 21

Give some example of loop diuretics

Answer 21

1. Furosemide
2. Bumetanide
3. Ethaycrynic acid
4. Muzolimine

Question 22

inhibit Na+ and Cl- reabsorption throughout the nephron but especially in the ascending loop of Henle

Answer 22

loop diuretics

Question 23

major side effect of loop diuretics

Answer 23

potassium loss (hypokalemia)

Question 24

peak action of loop diuretics after IM or IV route

Answer 24

30-45 mins

Question 25

peak action of loop diuretic after oral administration

Answer 25

1-2 hours

Question 26

duration of loop diuretics after IV or IM route

Answer 26

6-8 hours

Question 27

how many percent of sodium is lost in the urine after administration of loop diuretics?

Answer 27

30-40%

Question 28

Loop diuretics administration may result to ototoxicity which cannot be administered together with this antibiotic

Answer 28

Aminoglycoside antibacterial

Question 29

used in combination with thiazides or loop diuretics

Answer 29

amiloride

Question 30

Acts on the collecting duct but its action is not associated with aldosterone

Answer 30

triamterene

Question 31

Directly inhibits the reabsorption of sodium and promote the conservation of potassium

Answer 31

amiloride, spironolactone

Question 32

Competitively inhibits aldosterone in the collecting duct region

Answer 32

spironolactone

Question 33

not too useful as a sole diuretic but useful in combination with potassium – depleting diuretics such as thiazides and loop diuretics

Answer 33

spironolactone

Question 34

onset of action of spironolactone

Answer 34

2-3 days