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renal failure
antidiuretics
| Question | Answer |
|---|---|
| diuretics | Increase rate of urine flow and excretion of excess fluid tx for HTN, HF, kidney failure, liver failure/cirrhosis, or pulmonary edema. |
| Three types of diuretics | Loop diuretics thiazides potassium sparing |
| Electrolyte | Small charge molecules essential to homeostasis. Too little or too much can result in serious complications and must be quickly corrected |
| Kidney/renal failure | pt's w/ Renal impairment have increased risk of drug toxicity. Lower doses are indicated. labs: urinalysis serum creatinine (CR) blood urea nitrogen (BUN) Glomerular filtration rate (GFR). |
| Adverse effects of all diuretics | Fluid and electrolyte disturbances dehydration orthostatic hypotension (sitting, standing, lying) potassium and sodium and balances |
| Furosemide/ Lasix bumetanide/ Bumex | Loop diuretics act by blocking the reabsorption NA+ and CL- in the loop of Henle to reduce edema w heart hepatic renal failure HTN. action: HF/HTN admin: check K+ & Preg Cat C. side: hypokalemia dehydration hypotension hypovolemia syncope ototoxicity |
| loop diuretics- contraindictions/ drug interactions | contrain: Hypersensitivity anuria the hepatic coma drug: cardiac glycosides w digoxin monitored. no w aminoglycoside antibiotics poss nephrotoxicity & ototoxicity. loop w/ K+ depleting corticosteroids, amphotercin B (hypokalemia) lasix (-) hypoglycemic |
| Loop diuretics – labs/herbal/food | labs: ^ Bld glucose, BUN, serum amylase or electrolytes, cholesterol and triglycerides herbal/food: Hawthorne ^ hypotensive effects, ginseng decrease effectiveness, ^ NA+ decrease effectiveness. |
| hydrochlorathiazide / Microzide | Class: thiazide diuretics act on the distal tubal to block NA+ reabsorption, increase K+ & H2O excretion. Action: HTN & edema admin: give am to prevent nocturia Preg Cat B. increase K+ intake. side: electrolyte imbalance, gout, hyperuricemia |
| thiazide diuretics- contraindictions/interactions | Con:Hypersensitivity preeclampsia preg HTN inter:Anti-HTN ^ effects on BP (-) effects of anticoagulants sulfonylureas or anti-DM Cholestyramine (-) the absorption of med ^ renal toxicity from NSAIDs Corticosteroids ^ K+ loss -digoxin (-) lithium tox |
| thiazide diuretics- labs/herbal/food | labs: ^ Glucose, cholesterol, bilirubin, triglyceride & calcium. (-) Serum magnesium, potassium, sodium ginkgo biloba produce paradoxical + BP, Hawthorne ^ hypotensive effect |
| Spironolactone/ Aldactone triamterene | Class: potassium sparing that blocks the action of the hormone aldosterone and NA+ and H2O excretion increased and K+ retained. Action: antihypertensive reducing edema admin: Give with food and other anti-HTN, No K+ suppl, Preg Cat C |
| Potassium sparing diuretics- side affects/warnings/labs | Side: Hyperkalemia, muscle weakness, fatigue, bradycardia. Men- gynecomastia, impotence, (-) libido women- irregular menses, hirsutism, breast tenderness Warming: only for specific indications Labs: ^ plasma cortisol & interfere w serum glucose level |
| Potassium sparing diuretics- interactions drugs/food.herbal | Inter: ammonium chloride (acidosis), ASA ^ half-life (digoxin toxicity), w/ digoxin (-) effects of digoxin, w/ K+, ACE, ARB's (hyperkalemia), other anti-HTN (^ hypotensive effect) herbal: Hawthorne ^ hypotensive effect |
| assessments for diuretics all baseline and monitor | Patient's weight intake/output skin turgor/moisture vital signs sounds presence of edema BUN/CR/GFR labs ECG |
| lifespan of diuretics | older adults- hypotension/ risk of falls/ electrolyte imbalances infants/young children- audiology pregnancy/ breast-feeding Cat D should not be used |
Created by:
bryant-41892
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