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Diuretic Agents
Module 3 Drug Classifications
| Question | Answer |
|---|---|
| What is the function of diuretic agents? | Increase the amount of urine produced by the kidneys and increase sodium excretion |
| What are diuretic agents used for? | Edema r/t congestive heart failure. Acute pulmonary edema. Liver & Renal disease. Hypertension & Hyperkalemia (high potassium) |
| What are the 5 classes of diuretics? | Loop diuretics, Osmotic, Potassium-Sparing diuretics, Thiazide and Thiazide-like diuretics, and Carbonic Anhydrase Inhibitors |
| Which drugs are thiazide diuretics? | Hydrochlorothiazide & Chlorothiazide |
| Which drug is a thiazide-like diuretic? | Chlorthalidone |
| What is the action for both thiazide and thiazide-like diuretics? | They block the chloride pump to keep chloride & sodium in the tubule to be excreted in the urine, which prevents the reabsorption of both in the vascular system. |
| What are the indications for thiazide and thiazide-like diuretics? | To treat edema associated w/ CHF, liver, or renal disease. Monotherapy of adjuncts for the treatment of hypertension. |
| What are the contraindications for thiazide and thiazide-like diuretics? | Known allergy to thiazides or sulfonamides, fluid & electrolyte imbalances, renal disease, and lactation |
| What are the adverse effects for thiazide and thiazide-like diuretics? | GI upset, Fluid and electrolyte imbalances, Hypotension, HypoKalemia, HyperCalcemia, HyperGlycemia, Tingling, Drowsiness, Numbness, Confusion, Alkalinized urine & Bladder infections |
| What should you be cautious for when giving thiazide and thiazide-like diuretics? | Lupus, liver disease, pregnancy/lactation, and diabetes/ glucose intolerance |
| What are the drug-drug interactions for thiazide and thiazide-like diuretics? | Digoxin: increases risk of digoxin toxicity r/t potassium changes, Antidiabetic agents: may need adjustments of antibiotic agents, and Lithium: increase the risk of lithium toxicity (monitor levels closely) |
| What is the prototype for thiazide and thiazide-like diuretics? | Hydrochlorothiazide |
| Which drugs are loop diuretics? | End in -ide, BumetanIDE, FurosemIDE, and TorsemIDE |
| What is the action of loop diuretics? | Blocks the chloride pump, which blocks the sodium & chloride reabsorption into circulation. As a result, large amounts of sodium & chloride rich urine is excreted. They work quickly & significant diuresis (urine excretion). |
| What are the indications for loop diuretics? | To treat acute heart failure, acute pulmonary edema, edema r/t CHF, renal disease, and liver disease, and hypertension. |
| What are the contraindications for loop diuretics? | Known allergy, electrolyte depletion, anuria (lack of urine production)/ severe renal failure, hepatic coma, and pregnancy & lactation. |
| What should you be cautious for when giving loop diuretics? | Lupus, hyperglycemia, gout (painful arthritis), and children under 18 yrs old |
| What are the adverse effects of loop diuretics? | Hypokalemia/hypocalcemia, hyperglycemia, ototoxicity, and hypertension & dizziness |
| What are the drug-drug interactions for loop diuretics? | Aminoglycosides or cisplatin: increase risk of ototoxicity, Anticoagulants: increased anticoagulant effects, and indomethacin, ibuprofen, salicylates, or NSAIDS: they decrease therapeutic effect of diuretics. |
| What is the prototype for loop diuretics? | Furosemide |
| Which drugs are carbonic anhydrase inhibitors? | End in "-amide" AcetazolAMIDE |
| What is the action of CAIs? | They block the effect of carbonic anhydrase, which slows down the movement of hydrogen ions. As a result, more sodium and bicarbonate are lost in the urine. |
| What are CAIs used for? | They are adjuncts to other diuretics and used for Glaucoma. |
| When should CAIs not be used? | Known allergy to CAIs, sulfonamides, for thiazides. Pregnancy & lactation. |
| What should you be cautions for when giving CAIs? | Fluid & electrolyte imbalances, renal & hepatic diseases, and respiratory acidosis/COPD. |
| What are the adverse effects of CAIs? | Metabolic acidosis, hypokalemia, effects on the CNS r/t electrolyte changes, such as paresthesia of extremities, confusion and drowsiness. |
| Which drugs are Potassium-Sparing Diuretics? | Spironolactone & Triamterene |
| What is the action of potassium-sparing diuretics? | Retain potassium and loss of sodium. |
| What is Spironolactone? | It is an aldosterone antagonist, which blocks aldosterone in the distal tubule resulting in the excretion of sodium. |
| What is Triamterene? | It is a potassium-sparing drug that blocks potassium secretions through the tubule (thus retains potassium) resulting in sodium excretions. |
| What are the indications for potassium-sparing diuretics? | They are adjuncts with thiazides or loop diuretics and used for those who need a diuretic but are at risk for hypokalemia. Also used to treat hyperaldosteronism. |
| What are the contraindications for potassium-sparing diuretics? | Known allergy, hyperkalemia, renal disease/anuria. Caution: pregnancy & lactation. |
| A patient is experiencing lethargy, ataxia (impaired coordination), muscle cramps, and cardiac arrhythmias. The patient is experiencing _______________. | Hypokalemia |
| What is the prototype for potassium-sparing diuretics? | Spironolactone |
| What is the action of osmotic diuretics? | Pulls water into the renal tubule without losing sodium. |
| What are the indications for osmotic diuretics? | These drugs are used to decrease intercranial pressure, acute renal failure due to shock, drug overdose, or trauma. Decreases interocular pressure prior to eye surgery or in acute glaucoma attacks. |
| What is an osmotic diuretic? | Mannitol |
| What are the contraindications for osmotic diuretics? | Renal disease/anuria, Pulmonary congestion, Intracranial bleeding, Dehydration, Heart failure, and Lactation. Caution in pregnant women. |
| What are the adverse effects when using osmotic diuretics? | Sudden drop in fluid levels, nausea/ vomiting, hypotension, light-headedness, confusion, and headache |
| Name the triple D's for Diuretics | Triple D's: Decrease BP, Drains fluid. & Dehydrate patients w/ heavy fluid |
Created by:
jmajalca
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