lilley ch 28 (diuretic drugs) Flashcards
when are diuretic drugs commonly used (3)
hypertension
renal failure
heart failure
what structure do diuretics act on
nephron of kidney
where in the kidney is the majority of sodium and water from the filtered fluid returned back to the bloodstream
proximal convoluted tubule
class of diuretic:
- acts at proximal tubule
- secretes bicarbonate, sodium, potassium, water
- retains hydrogen ions
carbonic anhydrase inhibitors
what class of diuretic is acetazolamide
carbonic anhydrase inhibitor
class of diuretic:
- acts at proximal tubule
- limits passive tubular reabsorption
- causes expansion of plasma volume
osmotic diuretics
what class of diuretic is mannitol
osmotic
class of diuretic:
- acts on loop of henle, proximal and distal tubules
- inhibits chloride reabsorption
loop diuretic
what class of diuretic are bumetanide and furosemide
loop diuretic
class of diuretic:
- acts on distal convoluted tubule
- inhibits sodium chloride cotransporter
thiazide diuretic
what class of diuretic are bendroflumethiazide, chlortalidone, metolazone, hydrochlorothiazide
thiazide diuretic
class of diuretic:
- acts on distal convoluted tubule and collecting duct
- binds to aldosterone receptor
- mild diuresis
- limited potassium loss
potassium sparing diuretic
what class of diuretic are amiloride, eplerenone, spironolactone, triamterene
potassium sparing diuretic
contraindications for carbonic anhydrase inhibitor diuretics (5)
- hyponatremia
- hypokalemia
- severe renal or hepatic dysfunction
- adrenal gland insufficiency
- cirrhosis
adverse effects of carbonic anhydrase inhibitor diuretics (6)
- acidosis
- paresthesia
- hematuria
- photosensitivity
- melena
- hyperglycemia
med interactions with carbonic anhydrase inhibitor diuretics (2)
- digoxin toxicity
- corticosteroids (hypokalemia)
when to use loop diuretics (3)
hypertension
heart failure
edema
side effects of loop diuretics (4)
- hyponatremia
- hypokalemia
- hypomagnesemia
- ototoxicity
med interactions with loop diuretics (7)
- aminoglycosides
- vancomycin
- corticosteroids
- digoxin
- lithium
- NSAIDs
- antidiabetic drugs
adverse effects of loop diuretics (8)
- tinnitus
- blurred vision
- N/V/D
- stevens-johnson syndrome
- neutropenia
- thrombocytopenia
- hypokalemia
- hyperglycemia
S+S hypokalemia (“A SIC WALT”)
Alkalosis Shallow respirations Irritability Confusion, drowsiness Weakness Arrhythmias Lethargy Thready pulse
what is the black box warning for furosemide (lasix)
fluid and electrolyte loss
what is furosemide (lasix) commonly used to treat
pulmonary edema
what class of diuretic produces rapid diuresis
osmotic diuretics
what is a common use for osmotic diuretics
reduce intracranial pressure
adverse effects of osmotic diuretics (3)
convulsions
thrombophlebitis
pulmonary congestion
adverse effects of potassium sparing diuretics (4)
- N/V/D
- polyuria
- hyperkalemia
- gynecomastia
med interactions with potassium sparing diuretics (4)
NSAIDs
lithium
potassium supplements
angiotensin-converting enzyme inhibitors
what are thiazide diuretics most commonly prescribed for
hypertension
adverse effects thiazide diuretics (6)
- N/V/D
- impotence
- jaundice
- leukopenia
- hypokalemia
- hyperglycemia
