Question | Answer |
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" |