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Pharmacology, Nursing, diuretics

Diuretics Increase urine output
How do diuretics work? By increasing glomerular filtration rate and decreasing tubule reabsorption
What are the classes of diuretics? Thiazides, High Ceiling (loop), Osmotics, Carbonic Anhydrase Inhibitors, Potassium Sparing
How do thiazides work? By decreasing the reabsorption of Mg, Na, Cl, water, carbonic acid, and K. Also, it increases the reabsorption of glucose, Ca and lipids.
What is the prototype for thiazides? HCTZ hydroclorothiazide
What are some clinical uses for diuretics? to treat hypertension and edema. To decrease interocular pressure and to soften the eye for surgery.
HCTZ hydrochlorozide. The prototype for thiazides.
What is the prototype for high ceiling diuretics? Lasix/furosemide
How do high ceiling/loop diuretics work? By decreasing reabsorption of Ca, Na and Cl.
What are they key features of thiazides? They are not a strong diuretic, they take 2 hours to start working, they can be used to treat hypercalcemia in the urine, they are a poor choice to use on diabetics and risk of allergy in people who are allergic to sulfonamides.
What are common adverse effects of diuretics? hypotension, fluid deficit, hypokalemia, hyponatrimia, hyperglycemia
What are some causes of edema? heart failure, renal failure, poor circulation
Polyurea large urine output
Oligurea small urine output
Anurea no urine output
Edema excessive fluid in the tissues
Hypokalemia low levels of serum potassium
How is mannitol/Osmitrol administered? By IV only
mannitol/Osmitrol osmotic diuretic
Why would you need to monitor hr and rhythm when using potassium sparing diuretics? abnormal potassium affects the conduction of cardiac nerve impulses and myocardial contraction
How do potassium sparing diurectics work? Promotes the loss of sodium and retains potassium
What is a risk with using an osmotic diuretic? hypervolemia then hypovalemia
What are the key features of high ceiling diuretics? stronger/faster onset of action, sodium restriction is often needed, treats hypercalcemia, is ototoxic
Which diuretic would you use to treat anuria, increased IOP, and/or edema? Osmotic diuretics
spironolactone/Aldactone potassium sparing diuretic
Explain how osmotic diuretics affect the blood volume fluid is drawn from the tissues into the blood, as the blood filters through the kidneys, water is excreted. If too much water is excreted then hypovalemia can occur.
How do carbonic anhydrase inhibitors work? by inhibiting bicarbonate reabsorption and by inhibiting production of aqueous humor and cerebrospinal fluid
What is the prototype for the osmotic diuretic? mannitol/Osmitrol
What are clinical uses for osmotic diurectics? Used to treat anuria, increased IOP, and edema
How do osmotic diuretics work? By increasing osmotic pressure in blood and in the glomerular filtrate.
What are the key features of potassium sparing diuretics? There is the potential for hyperkalemia, potassium supplements are not needed, monitor hr and rhythm.
What is the potassium sparing diuretic? spironolactone/Aldactone
Why is a sodium restriction needed in conjunction with use of a high ceiling diuretic? post-diuretic rebound effect
furosemide/Lasix high ceiling (loop) diuretic
why are thiazides a poor choice as a diuretic for pts w/diabetes? b/c it increases serum gluose and lipids
Why are thiazides useful in treating elevated urine calcium? B/c it increases reabsorption of Ca. (meaning less Ca in the urine!)
Carbonic anhydrase inhibitor prototype? acetazolamide/Diamox
What are the key points of carbonic anhydrase inhibitors? Reduces IOP and ICP (intercranial pressure)also decreases blood pH.
When your pt is on diuretics what do you need to monitor? I&O, weight, edema, serum electrolytes, neuromuscular status, serum glucose and mental status.
When your pt is on a diuretic, what should you see on thier I&O? output should be higher than input
What is the best method for detecting fluid loss or gain? daily weight
Where is edema most prevalent? ankles, on the back (when pt is on bed rest). And auscultation of the lungs may reveal pulmonary edema.
Serum glucose is most likely to be affected by which type of diuretic? Thiazides
assessment of reflexes and muscle tone may be indicative of ____. This is important b/c _____. electrolyte imbalance; impulse conduction and muscle activity depend on specific concentrations of electrolytes.
cerebral edema causes ______. confusion or decreased alertness.
What are signs of hypovolemia? hypotension, tachycardia, dry mucous membranes and concentrated urine.
What are signs of hypokalemia? irregular pulse, hypotension, weak respirations, muscle weakness, and abdominal distention.
What do you need to know about administering potassium? always dilute and give slowly
In a pt w/hyponatremia, what would you assess for? Hypotension, tachycardia, oliguria, confusion, and abdominal cramps.
In a pt w/hypocalcemia what would you assess for? neuromuscular irritability
In a pt w/hypercalcemia what would you assess for? depressed neuromuscular function
What do you need to do to treat hypocalcemia? provide Ca as ordered
How do you treat hypercalcemia? encourage fluids to prevent urinary stones, administer a high ceiling diuretic as ordered
What should you include in pt teaching about diuretics? take diuretics in the morning, report muscle weakness, palpations, muscle cramps, confusion, reduce sodium intake (as ordered), salt subtitutes contain potassium
acetazolamide/Diamox Carbonic anhydrase inhibitor
Which group of pts are at higher risk for sodium depletion? the elderly
Created by: mercerw