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Urinary/Diuretics
Srugs that Affect the Urinary System
| Question | Answer |
|---|---|
| Carbonic Anhydrase Inhibitors: Action | Sulfonamides with non-bacteriostatic action, that inhibit the enzyme carbonic anhydrase. |
| Loop Diuretics: Action | Increase the excretion of sodium and chloride by inhibiting the reabsorption of these ions in the distal and proximal tubules in the Loop of Henle. |
| Osmotic Diuretics: Action | Increase the density of the filtrate in the glomerulus. This prevents selective reabsorption of water, which allows water, sodium and chloride to be excreted. |
| Edema | Retention of Fluid |
| Diuretic | A drug that increases the excretion of urine by the kidneys. |
| Types of Diuretic drugs: | Carbonic anhydrase inhibitors, Loop diuretics, Osmotic diuretics, Potassium-sparing diuretics, Thiazides and related diuretics. |
| Carbonic anhydrase inhibition: | results in the excretion of sodium, potassium, bicarbonate and water |
| Diuretic to treat Glaucoma | Carbonic Anhydrase inhibitors |
| Carbonic Anhydrase Inhibitors: Drugs | Trade: Generic: Diamox acetazolamide Neptazane methazolamide |
| Diamox/acetazolamide: Uses | Open angle glaucoma, secondary glaucoma, preoperatively to lower IOP, edema due to HF, drug-induced edema, centrencephalic epilepsy |
| Diamox/acetazolamide: Adverse Reactions | Weakness, fatigue, anorexia, vomiting, rash, paresthesias, photosensitivity, urinary frequency, renal colic, renal calculi, crystalluria, polyuria |
| Diamox/acetazolamide: Dosage Ranges | Glaucoma: up to 1g/day orally in divided dosses; Acute glaucoma: 500mg initially then 125-250mg orally q 4hr; Epilepsy: 8-30mg kg/day in divided doses; HF and edema: 250-375 mg/day orally. |
| Diamox/acetazolamide: Available Forms | Tablets: 125, 250 mg; ER capsules: 500mg; Powder for injection: 500mg/vial. |
| Take with Food or Milk: | Diamox, Neptazane,Edecrin, Lasix, Demadex, Midamor, Aldactone/spironolactone, Dyrenium Diuril, Thalitone, Microzide, Oretic/hydrochlorothiazide, Lozol, Zarozolyn, Enduron, Monopril, Hipex, Macrodantin, Enablex, |
| Neptazane/methazolamide: Uses | Glaucoma |
| Neptazane/methazolamide: Adverse Reactions | Weakness, fatigue, anorexia, vomiting, rash, paresthesias, photosensitivity, urinary frequency, renal colic, renal calculi, crystalluria, polyuria |
| Neptazane/methazolamide: Dosage Ranges | 50-100 mg orally BID, TID |
| Loop Diuretics: Drugs | Trade: Generic: Bumex bumetanide Edecrin ethacrynic Lasix furosemide Demadex torsemide |
| Burmex/bumetanide: Uses | Edema due to HF, cirrhosis of the liver, renal disease, acute pulmonary edema |
| Burmex/bumetanide: Adverse Reactions | Electrolyte and hematologic imbalances, anorexia, nausea, vomiting, dizziness, rash, photosensitivity, orthostatic hypotension, glycosuria. |
| Burmex/bumetanide: Dosage Ranges | 0.5-10 mg/day orally, IV, IM |
| Edecrin/ethacrynic acid: Uses | Edema due to HF, cirrhosis of the liver, renal disease, acute pulmonary edema, ascites due to malignancy, idiopathic edema, lymphedema |
| Edecrin/ethacrynic acid: Adverse Reactions | Electrolyte and hematologic imbalances, anorexia, nausea, vomiting, diarrhea, dizziness, rash, photosensitivity, orthostatic hypotension, glycosuria. |
| Edecrin/ethacrynic acid: Dosage Ranges | 50-200 mg/day orally, IV |
| Lasix/furosemide: Uses | Edema due to HF, cirrhosis of the liver, renal disease, acute pulmonary edema, hypertension |
| Lasix/furosemide: Adverse Reactions | Electrolyte and hematologic imbalances, anorexia, nausea, vomiting, diarrhea, constipation, cramping, jaundice, pancreatitis, dizziness, rash, photosensitivity, orthostatic hypotension, glycosuria. |
| Lasix/furosemide: Dosage Ranges | Edema: 20-80 mg/day, may to up to 600 mg/day for severe edema; Hypertension: 40 mg orally BID; HF/renal failure: up to 2.5 g/day |
| Lasix/furosemide: Available Forms | Injection (IM/IV): 10 mg/ml Oral solution: 10 mg/ml, 40 mg/ml Tablets: 20, 40, 80 mg |
| Demadex/torsemide: Uses | Edema due to HF, cirrhosis of the liver, renal disease, acute pulmonary edema, hypertension |
| Demadex/torsemide: Adverse Reactions | Electrolyte and hematologic imbalances, anorexia, nausea, vomiting, diarrhea, dizziness, rash, photosensitivity, orthostatic hypotension, glycosuria, headache, gastric irritation and pain, dry mouth, pancreatitis, jaundice, polydipsia. |
| Demadex/torsemide: Dosage Ranges | HF/renal failure: 10-20 mg/day orally, IV; Cirrhosis/hypertension: 5-10 mg/day orally, IV |
| Demadex/torsemide: Available Forms | Tablets - 5, 10, 20, 100mg; Injection - 10mg/ml |
| Osmotic Diuretics: Drugs | Trade: Generic: Fleet glycerin (glycerol) isosorbide Osmitrol mannitol urea |
| Fleet/glycerin (glycerol): Uses | Glaucoma, before and after surgery |
| Fleet/glycerin (glycerol): Adverse Reactions | Headache, nausea, vomiting |
| Fleet/glycerin (glycerol): Dosage Ranges | 1-2g/kg orally in solution |
| isosorbide: Uses | Glaucoma, before and after surgery |
| isosorbide: Adverse Reactions | Headache, nausea, vomiting |
| isosorbide: Dosage Ranges | 1-3 mg/kg orally, BID-QID |
| Osmitrol/mannitol: Uses | To promote diuresis in acute renal failure, reduction of IOP, treatment of cerebral edema, irrigation solution in prostrate surgical procedures |
| Osmitrol/mannitol: Adverse Reactions | Edema, fluid and electrolyte imbalance, headache, blurred vision, nausea, vomiting, diarrhea, urinary retention, seizures |
| Osmitrol/mannitol: Dosage Ranges | Diruesis: 50-200 g/24 hr IV; IOP: 1.5-2 g/kg IV |
| Osmitrol/mannitol: Available Forms | Injection (IV): 5%, 10%,15%, 20%, 25% GU irrigant solution: 5% |
| urea: Uses | Reduction of IOP, reduction of intracranial pressure. |
| urea: Adverse Reactions | Headache, nausea, vomiting, fluid and electrolyte imbalance, syncope |
| urea: Dosage Ranges | Up to 120 g/day IV |
| Potassium-Sparing Diuretics: Drugs | Trade: Generic: Midamor amiloride Aldactone spironolactone Dyrenium triamterene |
| Midamor/amiloride: Uses | HF, hypertension, prevention of hypokalemia in at-risk patients, polyuria prevention with lithium use. |
| Midamor/amiloride: Adverse Reactions | Headache, dizziness, nausea, dry mouth, constipation, jaundice, gas pain, GI bleeding, anorexia, diarrhea, vomiting, weakness, fatigue, rash, hypotension. |
| Midamor/amiloride: Dosage Ranges | 5-20 mg/day orally |
| Midamor/amiloride: Available Forms | Tablets - 5 mg |
| Aldactone/spironolactone: Uses | Hypertension, edema due to HF, cirrhosis, renal disease: hypokalemia, prophylaxis of hypokalemia in at-risk patients, hyperaldosteronism |
| Aldactone/spironolactone: Adverse Reactions | Headache, diarrhea, drowsiness, lethargy, hyperkalemia, cramping, gastritis, erectile dysfunction, gynecomastia, dry mouth, thirst |
| Aldactone/spironolactone: Dosage Ranges | Up to 400 mg/day orally in single dose of divided doses May crush. |
| Aldactone/spironolactone: Available Forms | Tablets: 25, 50, 100 mg |
| Dyrenium/triamterene: Uses | Prevention of hypokalemia, edema due to HF, cirrhosis, renal disease, hyperaldosteronism |
| Dyrenium/triamterene: Adverse Reactions | Diarrhea, nausea, vomiting, hyperkalemia, photosensitivity, anorexia, dry mouth, jaundice, hepatic impairment. |
| Dyrenium/triamterene: Dosage Ranges | Up to 200 mg/day orally in divided doses |
| Dyrenium/triamterene: Available Forms | Capsules: 50, 100 mg |
| Thiazides and Related Diuretics: Drugs | Diuril chlorothiazide Thalitone chlorthalidone Microzide/Oretic hydrochlorothiazide Saluron hydroflumethiazide indapamide Zaroxolyn metolazone Enduron methyclothiazide |
| Diuril/cholorthiazide: Uses | Hypertension, edema due to HF, cirrhosis, corticosteroid and estrogen therapy |
| Diuril/cholorthiazide: Adverse Reactions | Orthostatic hypotension, dizziness, vertigo, weakness, anorexia, gastric distress, N/V/D, constipation, rash, photosensitivity reactions, hyperglycemia, fluid and electrolyte imbalances, reduced libido, jaundice, pancreatitis, dry mouth, hepatitis. |
| Diuril/cholorthiazide: Dodage Ranges | 0.5-2 g orally or IV, QID or BID |
| Diuril/cholorthiazide: Available Forms | Oral suspension: 250 mg/5ml Injection (IV): 0.5 g/vial Tablets: 250, 500 mg Powder for injection: 500mg |
| Thailtone/chlorthalidone: Uses | Hypertension, edema due to HF, cirrhosis, corticosteroid and estrogen therapy |
| Thailtone/chlorthalidone: Adverse Reactions | Orthostatic hypotension, dizziness, vertigo, weakness, anorexia, gastric distress, N/V/D, constipation, hematologic changes, rash, photosensitivity reactions, hyperglycemia, fluid and electrolyte imbalances, reduced libido, jaundice, pancreatitis. |
| Thailtone/chlorthalidone: Dosage Ranges | Edema: 50-120 mg/day orally; Hypertension: 25-100 mg/day orally |
| Thailtone/chlorthalidone: Available Forms: | 15, 25, 50, 100 mg |
| Microzide, Oretic/hydrochlorothiazide: Uses | Hypertension, edema due to HF, cirrhosis, corticosteroid and estrogen therapy |
| Microzide, Oretic/hydrochlorothiazide: Adverse Reactions | Orthostatic hypotension, dizziness, vertigo, weakness, anorexia, gastric distress, N/V/D, constipation, hematologic changes, rash, photosensitivity reactions, hyperglycemia, fluid and electrolyte imbalances, reduced libido, jaundice, pancreatitis. |
| Microzide, Oretic/hydrochlorothiazide: Dosage Ranges | Edema: 25-200 mg/day orally; Hypertension: 12.5-50 mg/day orally |
| Microzide, Oretic/hydrochlorothiazide: Available Forms | Tablets: 25 mg Capsules: 12.5 mg Oral solution: 10mg/ml, 100mg/ml |
| Saluron/hydrochlorothiazide: Uses | Hypertension, edema due to HF, cirrhosis, corticosteroid and estrogen therapy |
| Saluron/hydrochlorothiazide: Adverse Reactions | Orthostatic hypotension, dizziness, vertigo, weakness, anorexia, gastric distress, N/V/D, constipation, hematologic changes, rash, photosensitivity reactions, hyperglycemia, fluid and electrolyte imbalances, reduced libido, jaundice, pancreatitis. |
| Saluron/hydrochlorothiazide: Dosage Ranges | Edema: 25-200 mg/day orally; Hypertension: 50-100mg/day orally |
| Lozol/indapamide: Uses | Hypertension, edema due to HF |
| Lozol/indapamide: Adverse Reactions | Orthostatic hypotension, dizziness, vertigo, weakness, anorexia, gastric distress, N/V/D, constipation, hematologic changes, rash, photosensitivity reactions, hyperglycemia, fluid and electrolyte imbalances, reduced libido, jaundice, pancreatitis. |
| Lozol/indapamide: Dosage Ranges | Edema: 2.5-5 mg/day orally; Hypertension: 1.25-5 mg/day orally |
| Lozol/indapamide: Available Forms | Film-coated tablets: 1.25, 2.5 mg |
| Zaroxolyn/metolazone: Uses | Edema in HF, cirrhosis, corticosteroids, estrogen therapy, renal dysfunction |
| Zaroxolyn/metolazone: Adverse Reactions | Orthostatic hypotension, dizziness, vertigo, weakness, anorexia, gastric distress, N/V/D, constipation, hematologic changes, rash, photosensitivity reactions, hyperglycemia, fluid and electrolyte imbalances, reduced libido, jaundice, pancreatitis. |
| Zaroxolyn/metolazone: Dosage Ranges | 2.5 - 20 mg/day orally |
| Zaroxolyn/metolazone: Available Forma | Tablets: 2.5, 5, 10mg |
| Enduron/methyclothiazide: Uses | Hypertension, edema due to HF, cirrhosis, corticosteroid and estrogen therapy |
| Enduron/methyclothiazide: Adverse Reactions | Orthostatic hypotension, dizziness, vertigo, weakness, anorexia, gastric distress, N/V/D, constipation, hematologic changes, rash, photosensitivity reactions, hyperglycemia, fluid and electrolyte imbalances, reduced libido, jaundice, pancreatitis. |
| Enduron/methyclothiazide: Dosage Ranges | Edema: 2.5-10 mg/day orally; Hypertension: 2.5-5 mg/day orally |
| Enduron/methyclothiazide: Available forms | Tablets: 2.5, 5 mg |
| Potassium Sparing Diuretics Action: | depress the excretion of potassium. |
| Thiazides and Related Diuretics Action: | inhibit the reabsorption of sodium & chloride in the ascending portion of the loop of Henle & in the distal tubule of the nephron. |
| Main diuretic uses: | Edema, Hypertension, Renal Disease, Cerebral edema, Acute Glaucoma & increased IOP |
| Main Neuromuscular reactions to Diuretics: | Dizziness, lightheadness, headache, weakness, fatigue. |
| Main Cardiovascular reactions to Diuretics: | Orthostatic hypotension, electrolyte imbalances, glycosuria |
| Main Gastrointestinal reactions to Diuretics: | Anorexia, N/V |
| Parensthesias | numbness or tingling |
| Hypokalemia | Low blood potassium |
| Hyperkalemia | an increase in potassium in the blood |
| Gynecomastia | breast enlargment |
| Anuria | cessation of urine production |
| Herbal diuretics | celery, chicory, sassafras, juniper berries, St. John's Wort, foxglove, horsetail, licorice, dandelion, digitals, purpurea, ephedra, hibiscus, parsley & elderberry |
| Dehydration (Excessive Water Loss): S/S | Thirst, poor skin turgor, dry mucous membranes, weakness, dizziness, fever, low urine output |
| Hyponatremia (Excessive Loss of Sodium): S/S | Cold, clammy skin, decreased skin turgor, confusion, hypotension, irritability, tachycardia |
| Sodium Normal Lab Value: | 132-145 mEq/L |
| Hypomagnesemia (Low Levels of Magnesium): S/S | Leg and foot cramps, hypertension, tachycardia, neuromuscular irritability tremor, hyperactive deep tendon reflexes, confusion, visual or auditory hallucinations, paresthesias |
| Magnesium Normal Lab Value: | 1.5-2.5 mEq/L |
| Hypokalemia (Low Blood Potassium): S/S | Anorexia, nausea, vomiting, depression, confusion, cardiac arrhythmias, impaired thought processed, drowsiness |
| Potassium Normal Lab Value: | 3.5-5 mEq/L |
| Hyperkalemia (High Blood Potassium): S/S | Irritability, anxiety, confusion, nausea, diarrhea, cardiac arrhythmias, abdominal distress |
| UTI | Urinary tract infection |
| Cystitis | Inflammation of the bladder |
| Overactive Bladder | Involuntary contractions of the detrusor or bladder muscle. |
| Urinary urgency | a strong and sudden desire to urinate |
| Urge incontinence | involuntary urination after sudden sensation to void |
| Prostatitis | Inflammation of the Prostate gland |
| Pyelonephritis | Inflammation of the kidney & renal pelvis |
| Urethritis | Inflammation of the urethra |
| Urinary Tract Anti-Infectives: Action | They are uses because of their rapid excretion from the body. They have a high concentration in the urine |
| Antispasmodics: Action | Cholinergic blocking drugs that inhibit bladder contractions and delay the urge to void. |
| Urinary Tract Anti-infectives: Drugs | Amoxil, Trimox - amoxicillin Wymox Monurol - fosfomycin Hiprex, Urex - methenamine NegGram - nalidixic Furadantin, Macrobid, Macrodantin - nitrofurantoin Primsol, Trimpex - trimethoprim |
| Amoxil, Trimox, Wymox/amoxicillin: Uses | Acute bacterial UTI's, other bacterial infections. |
| Amoxil, Trimox, Wymox/amoxicillin: Adverse Reactions | Glossitis, stomatitis, gastritis, furry tongue, N/V/D, rash, fever, pain at injection site, hypersensitivity reactions, hematopoietic changes. |
| Amoxil, Trimox, Wymox/amoxicillin:Dosage Ranges | 250-500 mg orally q 8 hr or 875 my orally BID |
| Amoxil, Trimox, Wymox/amoxicillin: Available Forms | Chewable tablets - 125, 250mg Tablets - 500, 875mg Capsules - 250, 500mg Powder for oral suspension - 125mg/5ml, 200mg/5ml, 250mg/5ml Tablets for oral suspension - 200, 400mg ER tablets - 775mg. Available in oral preparations only. |
| Monurol/fosfomycin: Uses | Acute bacterial UTI's |
| Monurol/fosfomycin: Adverse Reactions | Nausea, diarrhea, vaginitis, rhinitis, headache, back pain |
| Monurol/fosfomycin: Dosage Ranges | 3-g packet orally, provided in powder that must be mixed with fluid. |
| Monurol/fosfomycin: Available Forms | Granule packet - 3g |
| Hipex, Urex/methenamine: Uses | Chronic bacterial UTI's |
| Hipex, Urex/methenamine: Adverse Reactions | Nausea, vomiting, abdominal cramps, bladder irritation |
| Hipex, Urex/methenamine: Dosage Ranges | 1 g orally BID |
| Hipex, Urex/methenamine: Available Forms | Tablets - 0.5, 1g |
| NegGram/nalidixic: Uses | Acute/chronic bacterial UTI's |
| NegGram/nalidixic: Adverse Reactions | Abdominal pain, N/V/D, anorexia, rash, drowsiness, dizziness, photosensitivity reactions, blurred vision, weakness, headache |
| NegGram/nalidixic: Dosage Ranges | 1g orally QID for 1-2 wk; may reduce to 2g/day for prolonged therapy |
| Furadantin, Macrobid, Macrodantin/nitrofurantoin: Uses | Acute bacterial UTI's |
| Furadantin, Macrobid, Macrodantin/nitrofurantoin: Adverse Reactions | Nausea, anorexia, peripheral neuropathy, headache, bacterial superinfection |
| Furadantin, Macrobid, Macrodantin/nitrofurantoin: Dosage Ranges | 50-100mg orally QID |
| Furadantin, Macrobid, Macrodantin/nitrofurantoin: Available Forms | Capsules - 25, 50, 100mg Dual-release capsules - 100mg Oral suspension - 25mg/5ml |
| Primsol, Trimpex/trimethoprim (TMP): Uses | Acute bacterial UTI's |
| Primsol, Trimpex/trimethoprim (TMP): Adverse Reactions | Rash, pruritus, nausea, vomiting |
| Primsol, Trimpex/trimethoprim (TMP): Dosage Ranges | 200mg/day orally |
| Primsol, Trimpex/trimethoprim (TMP): Available Forms | Tablets - 100mg Solution - 50mg/5ml |
| Urinary Anti-Infective Combinations:Drugs | Bactrim, Septra/trimethoprim & sulfamethoxazole |
| Bactrim, Septra/trimethoprim& sulfamethoxazole (TMP-SMZ): Uses | Acute bacterial UTI's, shigellosis, and acute otitis media |
| Bactrim, Septra/trimethoprim& sulfamethoxazole (TMP-SMZ): Adverse Reactions | Gastrointestinal (GI) disturbances, allergic skin reactions, headache, anorexia, glossitis, hypersensitivity |
| Bactrim, Septra/trimethoprim& sulfamethoxazole (TMP-SMZ): Dosage Ranges | 160mg TMP/800 SMZ orally q 12ht; 8-10mg/kg/day (based on TMP) IV in 2-4 divided doses |
| Bactrim, Septra/trimethoprim& sulfamethoxazole (TMP-SMZ): Available Forms | Tablets - 80mg TMP, 400mg SMZ, 160mg TMP, 800mg SMZ Oral suspension - 40mg TMP, 200mgSMZ per 5ml |
| Enablex/darifenacin: Uses | Overactive bladder |
| Enablex/darifenacin: Adverse Reactions | Dry mouth, constipation |
| Enablex/darifenacin: Dosage Ranges | 7.5mg/day orally |
| Enablex/darifenacin: Available Forms | ER tablets - 7.5, 15mg |
| Urispas/flavoxate: Uses | Urinary symptoms caused by cystitis, prostatitis, and other urinary problems |
| Urispas/flavoxate: Adverse Reactions | Dry mouth, drowsiness, blurred vision, headache, urinary retention |
| Urispas/flavoxate: Dosage Ranges | 100-200mg orally TID or QID |
| Urispas/flavoxate: Available Forms | Tablets - 100mg |
| Ditropan/oxybutynin: Uses | Overactive bladder, neurogenic bladder |
| Ditropan/oxybutynin: Adverse Reactions | Dry mouth, nausea, headache, drowsiness, constipation, urinary retention |
| Ditropan/oxybutynin: Dosage Ranges | 5 mg orally BID or TID |
| Ditropan/oxybutynin: Available Forms | Tablets - 5mg Syrup - 5mg/5ml ER tablets - 5, 10, 15mg Transdermal patch - 3.9mg/day Topical gel - 100mg/g, 3% |
| Vesicare/solifenacin: Uses | Overactive bladder |
| Vesicare/solifenacin: Adverse Reactions | Dry mouth, constipation, blurred vision, dry eyes |
| Vesicare/solifenacin: Dosage Ranges | 5mg/day orally |
| Vesicare/solifenacin: Available Forms | Tablets - 5, 10mg |
| Detrol, Detrol LA/tolterodine: Uses | Overactive bladder |
| Detrol, Detrol LA/tolterodine: Adverse Reactions | Dry mouth, constipation, headache, dizziness |
| Detrol, Detrol LA/tolterodine: Dosage Ranges | 2mg orally TID, Extended release: 4mg/day |
| Detrol, Detrol LA/tolterodine: Available Forms | Tablets - 1, 2mg ER capsules - 2, 4mg |
| Sanctura/trospium: Uses | Overactive bladder |
| Sanctura/trospium: Adverse Reactions | Dry mouth, constipation, headache |
| Sanctura/trospium: Dosage Ranges | 20mg orally TID |
| Sanctura/trospium: Available Forms | Tablets - 20 mg ER capsules 60 mg |
| Pyridium/phenazopyridine: Uses | Relief of pain associated with irritation of the lower genitourinary tract |
| Pyridium/phenazopyridine: Adverse Reactions | Headache, rash, pruritus, GI disturbances, red-orange discoloration of the urine, yellowish discoloration of the skin or sclera |
| Pyridium/phenazopyridine: Dosage Ranges | 200 mg orally TID |
| Pyridium/phenazopyridine: Available Forms | Tablets - 95, 97.2, 97.5, 100, 200 mg |
| Sandimmune/cyclosporine: Uses | For organ rejection |
| Sandimmune/cyclosporine: Adverse Reactions | Renal impairment, nephrotoxicity |
| Sandimmune/cyclosporine: Available Forms | Capsules - 25, 100mg Soft gel capsules for microemulsion - 25, 100 Oral solution 100mg/ml IV solution - 50mg/ml |
| Bacteriostatic | Slows or retards the multiplication of bacteria |
| Bactericidal | Destroys bacteria |
| Dysuria | Painful of difficult urination |
| Nocturia | Excessive urination during the night |
| Neurogenic bladder | Impaired bladder function caused by a nervous system abnormality, typically an injury to the spinal cord |
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