Diuretics
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| Adverse Effects of all diuretics. | Renal failure, dehydration, hypotension, dizziness, GI distress (nausea, vomiting, diarrhea).
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| Contraindication for all diuretics. | Complete renal failure (Caution with renal injury).
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| Teaching points for all diuretics. | Take in morning.
Monitor serum potassium levels.
Careful with potassium supplements and potassium rich foods.
Diabetics should monitor blood sugar more closely.
Change positions slowly.
Monitor weight daily.
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| 3 functions of diuretic agents. | Increase urine production.
Increase sodium excretion.
Block re-absorption of sodium.
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| Indications for diuretic use. | Heart failure, pulmonary edema, edema, liver disease, renal disease, hypertension, hyperkalemia.
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| Symptoms of heart failure | Tiredness/fatigue, shortness of breath/coughing, pulmonary edema, weakend pumping action of the heart, pleural effusion, swelling in the abdomen, swelling in the ankles and legs.
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| Thiazide and Thiazide-Like diuretics PROTOTYPE: | Hydrochlorothiazide (Hydro Diuril)
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| Thiazide's MOA | Hydrochlorothiazide retains sodium in the distal tubule.
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| Thiazide's Indications | Hydrochlorothiazide is indicated for hypertension and mild to moderate heart failure.
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| Thiazide's adverse effects | Hypokalemia, hyperglycemia (diabetics), hyponatremia.
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| Thiazide Contraindications/Cautions | Diabetes, Gout, hypokalemia, dehydration and kidney failure.
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| Thiazide (Hydrochlorothiazide) interactions | Digoxin.
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| Loop Diuretics PROTOTYPE: | furosemide (Lasix)
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| Loop Diuretics MOA. | furosemide (Lasix) retain sodium and chloride in the ascending loop of henle.
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| Loop Diuretics indication | furosemide (Lasix) are indicated for hypertension, heart failure and edema that is not responding to thiazides.
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| Loop diuretics adverse effects. | hypokalemia
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| Loop diuretics (furosemide, Lasix) contraindications/cautions | Hypokalemia, Gout, Dehydration, Kidney Failure
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| Loop Diuretics (furosemide, Lasix) interactions | NSAIDs (prostaglandin blocking decreases renal blood flow)
Aminoglycosides
Digoxin
Lithium
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| Potassium-sparing diuretics PROTOTYPE: | spironolactone (Aldactone)
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| Potassium-sparing diuretics MOA | spironolactone (Aldactone) Antagonizes aldosterone causing a loss of sodium but retention of potassium in the collecting duct.
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| Potassium-sparing diuretics indication. | spironolactone (Aldactone) is indicated for patients at risk for hypokalemia.
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| Potassium-sparing diuretics adverse effects | Hyperkalemia
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| Potassium-sparing diuretics contraindications/cautions | Hyperkalemia, dehydration, kidney failure.
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| Potassium-sparing diuretics drug interactions. | ACE inhibitors, potassium supplements, NSAIDs
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| Osmotic Diuretics PROTOTYPE: | mannitol (Osmitrol)
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| Osmotic Diuretics Indications | mannitol (Osmitrol) is indicated only for intercranial pressure and sever fluid over load. It is administered only IV typically in emergent/ICU settings.
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| Osmotic Diuretics MOA | Pulls water into the proximal tubule without sodium loss, increases osmotic pressure in the tubule.
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| Osmotic Diuretics Adverse Effects | hypotension, dizziness, confusion, headache, nausea, vomiting
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| Osmotic Diuretics Contraindications/Cautions | Intracranial bleeding, Dehydration/kidney failure
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