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Diuretics
| Question | Answer |
|---|---|
| What is the main action of diuretics? | Remove excess fluid by increasing renal excretion of electrolytes and water. |
| What are diuretics commonly used to treat? | Hypertension and fluid overload (e.g., heart failure, edema). |
| How are diuretics classified? | Based on site of action in the nephron and effect on potassium levels (wasting vs. sparing). |
| What are common adverse effects of all diuretics? | Dehydration, electrolyte imbalance, orthostatic hypotension, urinary frequency. |
| What should be monitored in patients taking diuretics? | HR, BP, weight, intake/output, electrolytes, and renal function (BUN, creatinine). |
| When should diuretics be given? | In the morning — to prevent nocturia and reduce fall risk. |
| What foods are high in potassium? | Bananas, oranges (or juice), potatoes, raisins. |
| What are signs of hypokalemia? | Dysrhythmias (irregular pulse, flat T waves), muscle cramps. |
| What are signs of hyperkalemia? | Dysrhythmias (peaked T waves), muscle weakness. |
| What should patients on potassium-wasting diuretics do? | Eat potassium-rich foods. |
| What should patients on potassium-sparing diuretics do? | Avoid potassium-rich foods and salt substitutes. |
| Thiazide Diuretic example? | Hydrochlorothiazide |
| Thiazide Diuretic Mechanism of Action Major Side Effects Considerations | MOA: Blocks sodium reabsorption in distal convoluted tubule → ↑ excretion of water, sodium, and potassium (K-wasting). SE: Hypokalemia, hyperglycemia. Cons: Monitor renal function Encourage K-rich foods. Monitor blood glucose in diabetics. |
| Loop Diuretic example? | Bumetanide, furosemide, torsemide. |
| Loop Diuretics Mechanism of Action Major Side Effects | MOA: Blocks sodium, chloride, and potassium reabsorption in the loop of Henle → rapid fluid/electrolyte excretion (K-wasting). SE: Hypokalemia, ototoxicity. |
| How should IV furosemide be administered? | Slowly over 1–2 minutes to prevent hearing loss. |
| What dietary teaching is important for loop diuretics? | Encourage potassium-rich foods (bananas, oranges, potatoes). |
| Potassium-Sparing Diuretic examples? | Spironolactone, triamterene. |
| Potassium-Sparing Diuretics Mechanism of Action Side Effects | MOA: Causes sodium and water excretion while retaining potassium. SE: Hyperkalemia. |
| When should potassium-sparing diuretics be avoided? | In renal failure or when combined with ACE inhibitors or potassium supplements. |
| What dietary teaching is important with potassium sparing diuretics? | Avoid potassium-rich foods and salt substitutes. |
| Osmotic Diuretic examples? | Mannitol, SGLT2 inhibitors (empagliflozin, dapagliflozin). |
| Osmotic Diuretic Mechanism of Action Uses | MOA: Block sodium, water, or glucose reabsorption in glomerulus/proximal tubule. Uses: Mannitol → treat increased ICP; SGLT2 inhibitors → treat diabetes. |
| What time of day should diuretics be given? | Morning. |
| IV furosemide should be administered over ___ minutes to prevent ___? | 1–2 minutes; ototoxicity. |
| Clients taking thiazide or loop diuretics should eat a ___-potassium diet to prevent ___? | High-potassium; hypokalemia. |
| Clients taking spironolactone should eat a ___-potassium diet and avoid ___ substitutes. | Low-potassium; salt substitutes. |