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diuretics

pharm final

QuestionAnswer
physiology regulatory factors of BP fluid balance; acid-base balance; electrolyte regulation; osmotic pressure
secretory factors of BP renin production; erythropoeitin production; prostaglandin production
excretory factors of BP metabolic waste removal
How do diuretics help control BP increase urinary salt excretion and water follows
Goal of diuretics increase excretion of solutes (NaCl) and water
What does the excretion of solutes do to fluid volume reduce extracellular fluid volume and rid the body of interstitial fluid
diuretics are used to treat what? high blood pressure; congestive heart failure; edema; glaucoma
What type of diuretic are Thiazides? diluting segment diuretics
Thiazide (diluting segment diuretic) prototype chlorothiazide (Diuril); hydrochlorothiazide (Hydrodiuril)
thiazide (diluting segment diuretics) dynamics decrease reabsorption of sodium/chloride/potassium/bicarbonate in distal tubules
effect of thiazides (diluting segment diuretics) on blood vessels widen blood vessels
Thiazide (diluting segment diuretics) therapeutic use edema; hypertension; heart failure; hypercalciuria
site of action of thiazides early part of distal tubule; inhibit sodium/chloride symporter
contraindication for thiazides gout = secretion of medication in proximal tubules inhibit secretion of uric acid
Increased tubular flow rate as seen in thiazides (diluting segment diuretics) causes the increase of what electrolyte excretion? potassium
GI side effects of thiazides (diluting segment diuretics) nausea/vomiting, diarrhea
CNS side effects of thiazides (diluting segment diuretics) drowsiness, confusion, headache
Hematopoietic side effects of thiazides (diluting segment diuretics) agranulocytosis, anemia
What is another name for loop diuretics? high ceiling
loop diuretics (high ceiling) prototypes furosemide (Lasix); torsemide (Demadex); bumetanide (Bumex)
chlorothiazide (Diuril) thiazide (diluting segment diuretic)
hydrochlorothiazide (hydrodiuril) thiazide (diluting segment diuretic)
furosemide (Lasix) loop diuretics (high ceiling)
torsemide (Demadex) loop diuretics (high ceiling)
bumetanide (Bumex) loop diuretics (high ceiling)
dynamics of loop diuretics (high ceiling) block sodium/potassium/chloride transporter, inhibits reabsorption of sodium, calcium, potassium, magnesium in thick ascending loop of henle
Therapeutic uses of loop diuretics (high ceiling) edema (CHF), hypertension, pulmonary edema, ascites
Kinetics of loop diuretics (high ceiling) oral(acts 40 minutes to 1 hour( IV (5-10 minutes)
Adverse effects of loop diuretics (high ceiling) hypovolemia = decreased blood pressure, weakness
Side effects of loop diuretics (high ceiling) rapid fluid and electrolyte depletion; GI upset; ototoxicity
Caution to take with loop diuretics (high ceiling) very powerful, close monitoring especially digitalis
electrolyte side effects of loop diuretics (high ceiling) hypokalemia, hyponatremia, hypercalcemia; hypovolemia; photosensitivity
Drug interactions with loop diuretics (high ceiling) digoxin, beta-blockers
What agents act on the distal tubule potassium-spapering diuretics
potassium-sparing diuretic prototype spironolactone (Aldactone)
spironolcatone (Aldactone) potassium-sparing diuretic prototype
potassium-sparing diuretic dynamics antagonized aldosterone; inhibits potassium/sodium exchange in disal tubules
What type of diuretic are potassium-sparing diuretics weak diuretics
Potassium-sparing diuretic uses edema, hypertension, cirrhosis of liver
potassium-sparing diuretic kinetics oral peak 2-3 days; duration = 24 hours
Adverse effects of potassium-sparing diuretics hyperkalemia; GI upset; headache; confusion
Sexual changes with potassium-sparing diuretics decreased libido, impotence
what diuretics work on the proximal tubule osmotic diuretics
osmotic diuretic prototype mannitol
mannitol osmotic diuretics (proximal tubule)
Kinetics of mannitol (osmotic diuretic) IV; acts in 10 minutes and oral
dynamics of mannitol (osmotic diuretic) increased water excretion
therapeutic uses of mannitol (osmotic diuretic) prevent acute renal failure during surgery or trauma; prevent/decrease cerebral, intraocular pressure
side effects of mannitol (osmotic diuretic) increases plasma osmolality
adverse effects of mannitol (osmotic diuretic) nausea/vomiting, headache, electrolyte imbalance
contraindicaitons for mannitol (osmotic diuretic) congestive heart failure, renal failure
Where do CAH inhibitors act proximal tubules
CAH carbonic anhydrase
CAH inhibitor prototype acetazolamide (Diamox)
acetazolamide (Diamox) CAH ihnibitor
CAH inhibitor dynamics inhibit action of CAH enzyme
Therapeutic uses for CAH inhibitors claucoma; increased CNS pressure; altitude sickness; edema (CHF)
What do CAH inhibitors do to urine makes it alkaline
what does alkaline urine (from CAH inhibitors) do? decreases excretion of some drugs; increases excretion of salycylates
What drugs are not as excreted as much when urine is alkaline from CAH inhibitors procainamide
What drugs are excreted more when urine is alkaline from CAH inhibitors salycylates
Kinetics of CAH inhibitors oral; IM; IV
distribution of CAH inhibitors throughout body widely distributed throughout body
Frequency of dosage of CAH inhibitors daily dosage or alternate day dosage
What drugs can produce diuresis as a side effect digitalis; Xanthines (Theophylline, caffine)
How do Xanthines cause diuresis increases heart rate and blood flow
why does diuresis occur when kidney function is impaired due to hypovolemia increase pressure in glomerulus and restores function
nursing assessment with diuretics baseline weight, CBC, chemistry, presence of edema (abdominal-ascites), note allergies
What allergies should you be aware of with diuretics sulfa
Nursing interventions with diuretics monitor fluid and electrolyte balance
Signs of hypovolemia hypotension, weak pulse, tachycardia, clammy skin, reduced urinary output
define hyponatremia low sodium levels (135-145)
symptoms of hyponatremia lethargy, disorientation
define hypokalemia low potassium levels (3.5-3)
symptoms of hypokalemia weakness, abnormal EKG
What diruetics may cause hyperkalemia potassium-sparing diuretics
define hypocalcemia low calcium levels (8.4-10.2)
symptoms of hypocalcemia irritability, twitching, nausea, vomiting, tetany
what to monitor when on diuretics diet (sodium/potassium); intake and output, daily weight
what teaching needs to be done with diuretics "take it easy on salt"; constipation and orthostatic hyptension may be a problem
treatment for orthostatic hypotension elevating feet, using compression hose
Diet modifications when on diuretics high potassium diet or potassium supplement
Created by: 1818554924