Renal

Question 1

Any substance that promotes diuresis, the increased production of Urine

Answer 1

Diuretics

Types:
Osmotic Diuretics
Carbonic Anhydrase Inhibitor
Loop Diuretics
Thiazide Diuretics
Potassium Sparing Diuretics

Question 2

OSMOTIC DIURETICS:

~Increased serum osmolality into fluid shift from interstittium to intravascular space into increased urine flow

CI:
Drug Overdose, elevated intracranial/intraocular pressure

SE:
Pulmonary Edema, Dehydration, Hypo/Hypernatremia (CONTRAINDICATED IN ANURIA)

Answer 2

MANNITOL

Question 3

CARBONIC ANHYDRASE:

Causes self limited sodium bicarbonate diuresis and decreased total body bicarbonate stores, alkalinizes the urine

CI:
Glaucoma
Metabolic Alkalosis
Altitude Sickness
Idiopathic Intrcranial Hypertension

SE:
Proximal Renal Tubular
Paresthesia
Renal Stores
Sulfonamide

Answer 3

Acetazolamide and Dorzolamide

Question 4

LOOP DIURETICS:

Sulfonamide loop diuretics inhibit cotransport system of thick ascending limb of loop of henle. Abolish hypertonicity medulla, preventing concentration of urine
~Associated with increased PGE

CI:
Edematous States (Heart Failure, Cirrhosis, Nephrotic syndrome, pulmonary edema)
Hypertension
Hypercalcemia

SE: (OHH DANG)
Ototoxicity
Hypokalcemia
Hypomagnesemia
Dehydration
Allergy
Nephritis
Gout

Answer 4

Furosemide, Bumetanide and Torsemide

Question 5

LOOP DIURETICS:

Nonsulfonamide inhibitor of cotransport system of thick ascending limb of loop of henle

CI: Diuresis in patients allergic to

Question 6

THIAZIDE DIURETICS:

CI:
Hypertension
Heart Failure
Idiopathic Hypercalciuria
Nephrogenic Diabetes Insipidus
Osteoporosis

SE: (GLUC)
HyperGlycemia
HyperLipidemia
Hyperuricemia
HyperCalcemia

Sulfonamide
Hypokalemic

Answer 6

Hydrochlorothiazide, Chlorthalidone, Metolazone

Question 7

Potassium Sparing Diuretics:

~ Spironolactone and Eplerenone competitive aldosterone antagonists in cortical collecting tubule

~ Triamterene and Amiloride block Na+ channels at the same part of the tubule

CI:
Hyperaldosteronism
Potassium Depletion
Heart Failure
Hepatic Ascites
Nephrogenic Diabetes

SE:
Hyperkalemia
Endocrine effects with spironolactone
Metabolic Acidosis

Answer 7

Spironolactone, Eplerenone, Amiloride and Triamterene

Question 8

Diuretics NR:

Answer 8

Monitor VS
Monitor Serum Electrolyte Levels
Ask Patient to sit to prevent orthostatic hypotension
WOF signs of hypotension
Monitor Weight
Monitor Urine output
Proper Nutrition
DO NOT ADMINISTER AFTER MID AFTERNOON
Slow IV push

Question 9

Diuretics NR:

Answer 9

Monitor VS
Monitor Serum Electrolyte Levels
Ask Patient to sit to prevent orthostatic hypotension
WOF signs of hypotension
Monitor Weight
Monitor Urine output
Proper Nutrition
DO NOT ADMINISTER AFTER MID AFTERNOON
Slow IV push