Diuretics Flashcards
Diuretics
Produce increased urine outflow; treatment of HTN move fluid assc with heart failure cirrhosis or kidney disease
Every minute the kidney produces
125mL of filtrate… about 180 L/day; 99% of water, electrolytes, and nutrients t
Small particles such as electrolytes, amino acids, drugs, glucose & waste products are filtered in
the glomeruli
Larger products such as protein and lipids remain in circulation
Basic functions of the kidneys:
Cleansing and maintaining ECF volume and composition
acid-base balance
excretion of metabolic wastes
Diuretics can cause:
Hypovolemia
Acid-base imbalances
Altered electrolyte levels
Diuretics can cause the loss of electrolytes including:
Potassium
Sodium
Magnesium
Chloride
Bicarbonate
Diuretic Classes
Loops
Thiazide
Osmotics
Potassium Sparing
Loop Diuretics
K waste
block the reabsorption of sodium and chloride; Sodium & water are lost along with potassium
very potent/most affective/marked depletion
furosemide (Lasix)
bumetanide (Bumex)
furosemide (Lasix)
bumetanide (Bumex)
for renal impaired
rapid movement of fluid
in morning
furosemide (Lasix)
bumetanide (Bumex)
education
Assess vital signs, daily weights (report gain or loss >2lbs in 24 hours) & electrolytes; orthostatic hypotension
furosemide (Lasix)
bumetanide (Bumex)
side effects
Ototoxicity
Dehydration Hypotension Electrolyte imbalances Hyponatremia Hypokalemia Hyperglycemia
furosemide (Lasix)
bumetanide (Bumex)
interactions
Digoxin-secondary to low potassium Ototoxic drugs Lithium-secondary to low sodium Antihypertensive agents NSAIDs-can counteract diuretic effect
WARNING: furosemide (Lasix)
pushed SLOWLY, not to exceed 20mg/min;
to fast cause ringing and hearing loss;
Potassium Supplements
Normal serum potassium levels are 3.5-5.0
Diuretics: Thiazides
K waste
hydrochlorothiazide (HCTZ) not as effective treat hypertension & peripheral edema First-line drugs for HTN not immediate