objective 2.2 (pt.3) (4)

Question 1

are drugs that accelerate the rate of urine formation resulting in removal of sodium and water
Mainstay of therapy for the treatment of HTN and HF
Where sodium goes, water follows
So if sodium is excreated, water is as well- as urine
Give in the early morning if ordered daily

Answer 1

diuretics

Question 2

what are the types of diuretics?

Answer 2

Carbonic anhydrase inhibitors
Loop diuretics
Potassium-sparing diuretics
Thiazide and thiazide-like diuretics

Question 3

what are the indications of carbonic anhydrase inhibitors?

Answer 3

Adjunct drugs in the long-term management of open-angle glaucoma and adjunct therapy for secondary glaucoma
Used with miotics to lower intraocular pressure before ocular surgery in certain cases
Also useful in the treatment of: edema, secondary to HF, high-altitude sickness, epilepsy

Question 4

what are the contraindications of carbonic anhydrase inhibitors?

Answer 4

Known drug allergy
hyponatremia/hypokalemia
Severe kidney or liver dysfunction

Question 5

Causes more sodium and therefore water to be excreated

Answer 5

acetazolamide

Question 6

what are the AE of carbonic anhydrase inhibitors?

Answer 6

Acidosis, hypokalemia, drowsiness, hematuria, urticaria, melena

Question 7

what are the interactions of carbonic anhydrase inhibitors?

Answer 7

Because carbonic anhydrase inhibitors can cause hypokalemia, an increase in digoxin toxicity may occur when they are combined with digoxin
Use with corticosteroids may also cause hypokalemia
Increased effects amphetamines, carbamazepine, cyclosporine, phenytoin, and quinidine sulphate with concurrent use of carbonic anhydrase inhibitors

Question 8

are commonly used diuretics
Furosemide is a fast working, commonly used diuretic
Inhibit the reabsorption of sodium and chloride
Useful in treatment of edema
Rapid onset and lasts at least 2 hrs
Potent diuresis and subsequent loss of fluid, potassium and sodium

Answer 8

loop diuretics

Question 9

what re loop diuretics used to treat?

Answer 9

edema
HTN
HF
pulmonary edema
ascites

Question 10

what are the indications of loop diuretics?

Answer 10

Edema associated with heart failure and liver or kidney disease
Hypertension
Kidney excretion of calcium in pts with hypercalcemia
Heart failure resulting from diastolic dysfunction

Question 11

what are the interactions with loop diuretics?

Answer 11

Neurotoxic
Nephrotoxic
Increase serum levels of uric acid, glucose aminotransferase, and aspartate aminotransferase
Thiazide: sequential nephron blockade
Nonsteroidal anti-inflammatory drugs (NSAIDs) may decrease the reduction of vascular resistance

Question 12

what are the AE of loop diuretics?

Answer 12

Dizziness, headache, tinnitus, blurred vision
N/V, diarrhea
Hypokalemia, hyperglycemia, hyperuricemia
Nephrotoxic

Question 13

Most commonly used loop diuretic
Uses: pulmonary edema and the edema associated with HF, liver disease, nephrotic syndrome, ascites, hypertension

Answer 13

furosemide

Question 14

produce an osmotic effect in the kidneys
Pulls water into the renal tubules from the surrounding tissues
Inhibit resorption of water and solutes, thus producing rapid diuresis

Answer 14

osmotic diuretics

Question 15

the most used osmotic diuretic

Answer 15

Mannitol

Question 16

what are the indications of osmotic diuretics?

Answer 16

Treatment of pts in the early, oliguric phase of acute kidney injury
To promote excretion of toxic substances
To reduce intracranial pressure
Treatment of cerebral edema
Used as a genitourinary irrigant in the prep of pts for transurethral surgical procedures

Question 17

what are the AE of osmotic diuretics?

Answer 17

Convulsions
Thrombophlebitis
Pulmonary congestion
Other: headaches, chest pains, tachycardia, blurred vision, chills, fever

Question 18

Block resorption sodium and water but do not deplete K supplies as bad
Weaker effect than thiazide or loop diuretics
Example: spironolactone

Answer 18

potassium-sparing diuretics

Question 19

what are the indications of potassium-sparing diuretics?

Answer 19

HTN
Reversing potassium loss caused by potassium-wasting diuretics

Question 20

what are the AE of potassium-sparing diuretics?

Answer 20

dizziness/headache, N/V, diarrhea, urinary frequency, *hyperkalemia, gynecomastia, amenorrhea, postmenopausal bleeding

Question 21

inhibit resorption of sodium, chloride, and potassium ions
Result in wtr loss

Answer 21

thiazide and thiaside-like diuretics

Question 22

what are the indications of thiazide/like diuretics?

Answer 22

HTN
Edema
Diabetes insipidus
HF

Question 23

what are the AE of thiazide/like diuretics?

Answer 23

Dizziness, hypotension, headache, N/V, diarrhea, erectile dysfunction, hypokalemia, hyperglycemia, hyperuricemia