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Diuretics
| Term | Definition |
|---|---|
| Function of Carbonic Anhydrase Inhibitors | Prevents the exchange of hydrogen ions for Na+ ions in the proximal tubule, allowing for more urine |
| side effects of CAIs | respiratory and metabolic acidosis (increases oxygenation- compensation), increases blood glucose and glycosuria (can lead to K+ loss in urine) |
| uses of CAIs | glaucoma (open- angle) edema, and sx of high-altitude sickness (N/V, shortness of breath, dizziness, drowsiness, fatigue, headache) |
| Contraindications for CAIs | drug allergy, hyponatremia, hypokalemia, severe renal or hepatic dysfunction, adrenal gland insufficiency, cirrhosis |
| Adverse effects of CAIs | risk of acidosis, hypokalemia; drowsiness, anorexia, paresthesias, hematuria, urticaria, photosensitivity, melena (blood in stool) |
| Drug interactions | Don't use with digoxin (risk of digoxin toxicity); corticosteroids may cause hypokalemia, The effects of amphetamines, carbamazepine, cyclosporine, phenytoin, and quinidine may be increased with CAI use (synergist effect) |
| Nursing care for taking CAIs | assess F&Es, especially potassium |
| Patient teaching for CAIs | Pregnancy Category C |
| Examples of CAIs | Acetazolamide (Diamox) |
| Function of Loop Diuretics | Acts primarily on ascending loop of by activating renal prostaglandins, which results in dilation of blood vessels in kidneys, lungs, and rest of body. Used when rapid diuresis is needed. Continues even after creatinine clearance goes below 25 ml/min. |
| side effects of LDs | POTENT;decreases blood pressure, pulmonary vascular resistance, systemic vascular resistance, venous pressure, and left ventricular end-diastolic pressure, Secondary: electrolyte (Na+ , K+, Ca2+) loss; changes in plasma levels, |
| uses of LDs | Edema- associ. with heart failure, hepatic or renal disease, controls high B/P, increase in Ca2+ excretion in pts with hypercalcemia. |
| Contraindications of LDs | Known drug allergy, hepatic coma, severe electrolyte loss. |
| Adverse effects of LDs | CNS- dizziness, headache, tinnitus, blurred vision; Gastrointestinal- N/V, diarrhea; Hematologic (blood- related)- agranulocytosis, thrombocytopenia, neutropenia; Metabolic- hypokalemia, hyperglycemia, hyperuricemia. General dehydration |
| Drug interactions of LDs | Neurotoxic and nephrotoxic; Thiazide+LDs= additve effect; NSAIDs+ LDs= cancel effect of prostaglandins |
| Nursing care for taking LDs | watch for electrolyte loss and dehydration, provide adequate access to bathroom |
| Patient teaching on LDs | Tell patient to call for help when using restroom |
| Examples of LDs | BumetanIDE, FurosemIDE (Lasix), TorsemIDE, AmilorIDE |
| Function of Osmotic Diuretics | works like a vein; uses osmotic pressure to reabsorb water into renal tubules for surrounding tissue. Also inhibits tubular reabsorption, WORKS FAST. Produces only small loss of electrolytes (not good for Na+ excretion). |
| side effects of ODs | convulsions, thrombophlebitis, pulmonary congestion |
| uses of ODs | Acute renal failure, cerebral edema (fro head trauma) , cellular edema ( NOT GOOD FOR Na+ EXCRETION- PERIPHERAL EDEMA) |
| Contraindications of ODs | Known drug allergy, SEVERE renal disease, pulmonary edema (which one to use?), active IC bleeding |
| Nursing care for patients who use OD | Works fast, move objects away that could impede on pt voiding |
| Patient teaching with OD | pregnancy category C drug |
| Potassium Sparing Diuretics Mechanism of Action | bind to aldosterone receptors and blocks resorption of water and Na+. Keeps the K+ |
| side effects of PSDs | dizziness, headaches, cramps, N/V, diarrhea, urinary frequency, weakness, hyperkalemia. Spiro: gynecomastia, amenorrhea, irregular menses, postmenopausal bleeding, Tri: kidney stone formation, Megaloblastic anemia, |
| uses of PSDs | MAY VARY: Spiroch, triameterene- tx of hyperaldosteronism and high B/P and reversal of K+ loss caused by other diuretics. Spiro- prevents heart remoldling after; Metabolic alkalosis, |
| contraindications of PSDs | HYPERKALEMIA (serum K+ of greater than 5.5), SEVERE renal failure, or anuira. |
| Drug interactions of PSDs | DO NOT USE with Lithium, ACE inhibitors, K+ supplements. NSAIDS INHIBIT renal prostaglandin (vasodilation), resulting in a lack of med in needed areal. |
| Nursing care for PSDs | assess F&Es, especially K levels |
| Patient teaching for PSDs | avoid K+ rich foods |
| Function of Thiazide Diuretics | works of DISTAL CONVOLUTED TUBULES to inhibit reabsorption of Na+, K+, and Cl-. Relaxes arterioles; works to relieve heart failure, hypertension, DIABETES INSIPIDUS, |
| side effects for TDs | watch for reduced potassium, and elevated levels of calcium, lipids, glucose, and uric acid. Dizziness, blurred vision, headache, anorexia, N/V, diarrhea, impotence (WITH MALES), decreased libido, vertigo. |
| uses for TDs | Heart failure, HPTN, edema, DI, cirrhosis. |
| contraindications for TDs | drug allergies, hepatic coma, anuria, renal failure |
| Drug interactions for thiazide diuretics | corticosteroids , diazoxide, digitalis, oral hypoglycemics, |
| Nursing care for thiazide diuretics | ask if pt has been using diuretics, monitor blood sugar, |
| Patient teaching with Thiazide diuretics | tell pt (males) that impotence can occur. CAN cross placenta- DO NOT give to PREGNANT WOMEN; CAN CROSS BREASTMILK |
| Types of Thiazide diuretics | chlorothiazide, Hydrocholorothiazide, Metolazone, Thiazide-like diuretic: chlorthalidone |
| Types of ODs | Mannitol |
| Types of PSDs | Spironolactone, Triameterene |
Created by:
Elysefinney
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