CCC - [Pharmacology] - Chapter 20
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| Uses for diuretics | used to treat extracellular fluid volume such as edema or ascites
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| Furosemide pt teaching | eat foods high in K+ because therapy can lead to excess fluid and electrolyte loss. May increase glucose levels. Store solution in the refrigerator. Orthostatic hypotension may b aggravated by alcohol. Report sore throat, fever, or severe abdominal pain.
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| HTN risk factors | smoking, high serum cholesterol, age over 60, men, postmenopausal women, family history of heart disease, left ventricular hypertrophy, angina/MI history, diabetes, prior cardiac revascularization, heart failure, stroke/TIA, nephropathy, PVD, retinopathy.
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| Methyldopa side effects | considerable sedation, tolerance, coombs’-positive hemolytic anemia, and hepatic dysfunction
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| Thiazide diuretic adverse effects | hypokalemia, hyperuricemia, hyperglycemia, skin rashes, toxicity (visual disturbances, bradycardia, bigeminy, n/v, anorexia)
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| Class of diuretics most likely to be affected by salicilates | loop diuretics like ethacrynic acid because they may enhance the effects of oral anticoagulants.
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| Osmotic diuretics most common use | tx of increased intracranial pressure
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| Class of diuretics most likely to produce ototoxicity | loop diuretics
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| Reserpine adverse effects- Rauwolfia derivatives | can cause depression, exacerbate PUD (due to stimulation of gastric secretions), and nasal congestion, suicide ideation.
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| Pt should avoid adding salt during cooking and avoid very salty foods such as potato chips and pickles. | Mild sodium-restricted diet
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| Spironolactone pt teaching | excessive K+ intake may cause hyperkalemia. May cause drowsiness and mental confusion. Also some male pts develop gynecomastia after prolonged use.
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| When should routine diuretics be administered | early in the day to prevent nocturia
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| Side effects of HCTZ when taken with digoxin | Assess patient, especially if taking digoxin, for anorexia,electrolyte imbalance (N/V, muscle cramps, paresthesia, and confusion). Pts taking digitalis glycosides are at risk of digitalis toxicity because of the potassium-depleting effect of the diuretic
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| How to recongize ACE inhibitors | end in -pril.
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| Advantage of irbesartan over other antihypertensives | can be used as a tx for diabetic neuropathy in clients with Type 2 diabetes and is currently in the investigational phases for the tx of heart failure.
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| Pt teaching for methyldopa | use c caution in pt c liver disease, observe 4 signs of anemia and liver dysfunction, may cause drowsiness early in tx. Admin of QD dose at noc may alleviate this problem. may cause ortho hypoTN or rapid decrease in BP on rising from sitting or lying.
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