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pharm test 4

chapter 25 diuretic agents

diuretic agents -probably the first drug they will put you on if you are hypertensive
diuretic agents -loop diuretics (strongest) -osmotic diuretics (trauma & ICU) -potassium sparing diuretics (hold on to potassium) -thiazide and thiazide-like diuretics (most prescribed for hypertensives)
carbonic anhydrase inhibitors (CAIs) -acetazolamide (diamox) -methazolamide -dichlorphenamide
carbonic anhydrase inhibitors -adjunct agents in the long term management of open angle glaucoma (used for glaucoma as a drop) **very rare to use these; it would be the last diuretic you would choose
carbonic anhydrase inhibitors: side effects -metabolic acidosis -anorexia -drowsiness
Loop diuretics -bumetanide (bumex) -ethacrynic acid (edecrin) -furosemide (lasix)--> STRONGEST DIURETIC (works right away; very rapidly)
what is the biggest drawback of loop diuretics? -loss of potassium (can cause problems with the heart, weakness)
loop diuretics used for edema associated with HF, hepatic, or renal disease **increase renal excretion of calcium in pts with hypercalcemia**
Osmotic diuretics -these draw fluid back into the vascular space (if you have cerebral edema and swelling, you would give mannitol) **mannitol (osmitrol) mannitol (osmitrol) **an ICU type drug
Potassium sparing diuretics -these are the weakest kind **amiloride (midamor), spironolactone (aldoctone), triamterene (dyrenium)
potassium sparing diuretics one of the main side effects is hyperkalemia b/c youre hanging on to potassium
Thiazide and Thiazide-like diuretics **MOST PRESCRIBED DIURETICS FOR HTN MAINLY** -hydrochlorothiazide, chlorothiazide, trichlorothiazide (thiazides) -chlorthalidone, metolazone, indapamide (thiazde-like)
when is the best time to take a diuretic -in the morning so that you avoid interference with sleep patterns
Foods high in potassium include: bananas, oranges, dates, raisins, plums, fresh vegetables, potatoes, met and fish
S/S of hypokalemia muscle weakness, constipation, irregular pulse rate, and overall feeling of lethargy
the nurse is reviewing the medications that have been ordered for pt with a loop diuretic. the loop diuretic may have a possible interaction with which of the folowing? NSAIDs
when monitoring lab results for pts receiving loop and thiazide diuretics, the nurse knows to look for decreased serum levels of potassium
when the nurse is checking the lab data for a pt. taking sprironolactone (aldactone), which result would be a potential concern? serum potassium level of 5.8 mEq/L
which statement should be included in pt. education for a pt. w/ HF who is taking daily doses of spironolactone (aldactone) ? "avoid foods that are high in potassium"
a pt. with diabetes has a new prescription for a thiazide diuretic. which statement should the nurse include when teaching the pt. about the thiazide drug? "monitor your BG level closely, b/c the thiazide diuretic may cause the levels to increase"
an elderly pt. has been discharged following treatment for a mild case of heart failure. He will be taking a loop diuretic. which instruction(s) from the nurse are appropriate? select all that apply -"take the diuretic at the same time each morning" -"be sure to stand up slowly b/c the medicine may make you feel dizzy if you stand up quickly" -"please call your doc immediately if you notice muscle weakness or increased dizziness"
Created by: lissy11