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Diuretics
| Term | Definition |
|---|---|
| Diuretics | Increase excretion of urine: act on kidneys to produce urine |
| Edema | Fluid overload / retention of excess fluid - swelling in 1 or 2 areas of body - Causes hypertension (more volume in blood vessels causing HR to increase) - Shortness of breath, crackles/wet sounds in lungs - Weight gain - Heart failure - Effusion |
| Anasarca | Swelling everywhere in body, much more than edema |
| Diuretics are contraindicated in those who are | Anuric (don't make urine) |
| Carbonic Anhydrase Inhibitors (Diuretics) | - Prototype: acetazolamide (Diamox) - Commonly used for glaucoma - ADRs: weakness, fatigue, GI upset - ****Contraindicated for those allergic to SULFA |
| Osmotic Diuretics | - Prototype: mannitol - Commonly used to reduce intraocular pressure (IOP), and **cerebral edema - ADRs: F/E imbalance, headache, vision problems - Contraindicated for active bleeds - ****Do a neuro check every 15 mins pupil constriction, grips, LOC |
| Potassium-Sparing Diuretics | - Relates heavily to heart - Increase Na + H2O in urine, but not the K - Prototype: spironolactone - Uses: hypertension, heart failure, cirrhosis - ADRs: headache, hyperkalemia, GI - ****Take BMP to see electrolytes & follow up |
| Thiazide & Related Diuretics | - Prototype: hydrochlorothiazide (HCTZ) - Uses: hypertension, heart failure - ADRs: hypotension, dizziness, weakness, GI, gout issues (pain in big toe) - *Cause increase in ortho hypotension - ***20 points change in systolic BP is a sign - falls risk! |
| What time are patients most likely to fall? | 4am or 5am trying to go to the bathroom |
| Loop Diuretics (not potassium sparing) | - Prototype: furosemide (Lasix - lasts 6 hours!) acts on 3 sites of kidney and very effective - *Should be on strict input & output - Uses: heart failure, cirrhosis, hypertension - *Check basic panels BMPs, BUN/creatinine (checks kidneys) |
| Extra info on Loop Diuretics | - Push in slowly, to prevent ototoxicity (ears tingling, ringing are signs) - Most common diuretic pushed in IVs |
| Potassium sparing vs. Lasix | - Potassium sparing: tell patient not to eat lots of potassium - Lasix: tell patient to eat some potassium so you do not get hypokalemic |
| Patient Education on Diuretics | - Weigh themself at the same time a few times a week - Concerning: 2-3 lbs in 24 hours, 5 lbs in a week |
| When should you take diuretic? | Do not take after 3 or 4pm |
Created by:
alowe26
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