Diuretics Flashcards

1
Q

Diuretics

A

Produce increased urine outflow; treatment of HTN move fluid assc with heart failure cirrhosis or kidney disease

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2
Q

Every minute the kidney produces

A

125mL of filtrate… about 180 L/day; 99% of water, electrolytes, and nutrients t

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3
Q

Small particles such as electrolytes, amino acids, drugs, glucose & waste products are filtered in

A

the glomeruli

Larger products such as protein and lipids remain in circulation

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4
Q

Basic functions of the kidneys:

A

Cleansing and maintaining ECF volume and composition

acid-base balance

excretion of metabolic wastes

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5
Q

Diuretics can cause:

A

Hypovolemia
Acid-base imbalances
Altered electrolyte levels

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6
Q

Diuretics can cause the loss of electrolytes including:

A

Potassium

Sodium
Magnesium
Chloride
Bicarbonate

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7
Q

Diuretic Classes

A

Loops
Thiazide
Osmotics
Potassium Sparing

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8
Q

Loop Diuretics

K waste

A

block the reabsorption of sodium and chloride; Sodium & water are lost along with potassium

very potent/most affective/marked depletion

furosemide (Lasix)
bumetanide (Bumex)

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9
Q

furosemide (Lasix)

bumetanide (Bumex)

A

for renal impaired
rapid movement of fluid
in morning

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10
Q

furosemide (Lasix)
bumetanide (Bumex)
education

A

Assess vital signs, daily weights (report gain or loss >2lbs in 24 hours) & electrolytes; orthostatic hypotension

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11
Q

furosemide (Lasix)
bumetanide (Bumex)
side effects

A

Ototoxicity

Dehydration
Hypotension
Electrolyte imbalances
Hyponatremia
Hypokalemia
Hyperglycemia
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12
Q

furosemide (Lasix)
bumetanide (Bumex)
interactions

A
Digoxin-secondary to low potassium
Ototoxic drugs
Lithium-secondary to low sodium
Antihypertensive agents
NSAIDs-can counteract diuretic effect
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13
Q

WARNING: furosemide (Lasix)

A

pushed SLOWLY, not to exceed 20mg/min;

to fast cause ringing and hearing loss;

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14
Q

Potassium Supplements

A

Normal serum potassium levels are 3.5-5.0

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15
Q

Diuretics: Thiazides

K waste

A
hydrochlorothiazide (HCTZ)
not as effective
treat hypertension & peripheral edema
First-line drugs for HTN
not immediate
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16
Q

hydrochlorothiazide (HCTZ)

side effects

A

Electrolyte imbalances
Can cause hyperglycemia
Dehydration
only with normal renal function; not if BUN and Creatinine elevated

17
Q

Potassium-Sparing Diuretics

A

Spironolactone
Amiloride
Triamterene

weaker

if K greater than 5 stop

18
Q

Spironolactone

A

potassium retaining effects
Effects take up to 48 hours to develop
aldosterone antagonist

19
Q

Triamterene

A

Nonaldosterone antagonist
Inhibits sodium and potassium exchange
acts faster

20
Q

Triamterene
Spironolactone
adverse effects

A

life-threatening hyperkalemia, especially if given with an ACE inhibitors, ARBs, or direct renin inhibitor

21
Q

Potassium-Sparing Diuretics…

A

dont use with salt substitutes bc they have high K

22
Q

Osmotic diuretics

A

Inhibits passive reabsorption of water (causing diuresis)

no significant effect on the excretion of potassium

prevent kidney failure to decrease intracranial pressure and intraocular pressure

mannitol

23
Q

mannitol

A

emergency for intracranial pressure; side effects: edema

24
Q

Potassium Rich Foods

A

Good idea for people on potassium-wasting diuretics.

bananas and orange juice