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NURS 252 (Pharmacology 2) > Diuretic Drugs > Flashcards

Diuretic Drugs Flashcards

1
Q

What are diuretic drugs?

A

Drugs that accelerate the rate of urine formation

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2
Q

What do diuretics drugs result in?

A

Removal of sodium and water from the body

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3
Q

What returns 60 - 70% of sodium back into the bloodstream

A

PCT

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4
Q

What returns 20 - 25% of sodium back into the bloodstream

A

Loop of Henle

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5
Q

What returns 5 - 10% of sodium back into the bloodstream

A

DCT

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6
Q

What happens if water is not absorbed?

A

It is excreted as urine

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7
Q

What are the 5 types of Diuretic Drugs?

A

Carbonic anhydrase inhibitors
Loop Diuretics
Osmotic Diuretics
Potassium-sparing diuretics
Thiazide and Thiazide-like diuretics

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8
Q

Name a carbonic anhydrase inhibitor (CAI)

A

Acetazolamide

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9
Q

What is acetazolamide also used for?

A

Glaucoma

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10
Q

What is the MOA of acetazolamide

A

Carbonic anhydrase makes Hydrogen available for exchange with sodium and water in the proximal tubules
CAIs block this action resulting in an increased excretion of bicarbonate, sodium, water, and potassium

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11
Q

What are the indications of CAIs

A

Used adjunctly in the long-term treatment of open-angle glaucoma
Used with miotics (constriction of pupils) to lower intraocular pressure before ocular surgery
Edema resulting from HF
High altitude sickness
Epilepsy

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12
Q

What are the contraindications of CAIs

A

Hyponatremia
Hypokalemia
Severe liver or kidney dysfunction
Adrenal gland insufficiency
Cirrhosis

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13
Q

What are the adverse effects of Acetazolamide

A

Acidosis
Hypokalemia
Drowsiness
Anorexia
Paresthesia
Hematuria
Urticaria
Photosensitivity
Melena (stool in blood)

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14
Q

What are possible interactions with CAIs

A

May cause an increase in digoxin toxicity
Hypokalemia with corticosteroids
Increase effects of amphetamines, carbamazepine, cyclosporine, phenytoin and quinidine sulphate

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15
Q

What is the MOA of furosemide

A

It acts directly on the ascending limb of the loop of Henle to block chloride and sodium resorption.
Increases kidney prostaglandins resulting in the dilation of blood vessels and reduced kidney, pulmonary and vascular resistance

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16
Q

What are the uses for loop diuretics

A

Edema associated with HF and liver or kidney disease
HTN
Kidney excretion
HF resulting from diastolic dysfunction

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17
Q

What are the adverse effects of loop diuretics

A

Dizziness, headache, tinnitus, blurred vision, Agranulocytosis, neutropenia, thrombocytopenia, Hypokalemia, Hyperuricemia, Hyperglycemia

18
Q

What are the possible interactions of loop diuretics

A

NSAIDs may decrease the reduction of vascular resistance
Increase serum levels of uric acid, glucose, alanine aminotransferase and aspartate aminotransferase

19
Q

What is the most commonly used loop diuretic?

A

Furosemide

20
Q

What is the most commonly used osmotic diuretic

A

Mannitol

21
Q

What is the MOA of mannitol?

A

Works along entire nephron but mostly PCT and descending loop of Henle
Pulls water into renal tubules from the surrounding tissues and inhibits resorption of water and solutes, thus producing diuresis

22
Q

What are some of the effects of osmotic diuretics (not adverse effects)

A

Increase eGFR
Reduce intracranial pressure or cerebral edema associated with head trauma
Reduces excessive intraocular pressure

23
Q

What are the indications for osmotic diuretics?

A

Early phase of acute kidney injury
Excretion of toxic substances
Reduce intracranial pressure
Cerebral edema
GU irrigant in the prep of patients for transurethral surgical procedures

24
Q

What are the adverse effects of mannitol

A

Convulsions
Thrombophlebitis
Headaches, chest pains, tachycardia, blurred vision, chills and fever

25
Q

What is the only form mannitol and what are 2 considerations?

A

IV infusion only
Crystallizes when exposed to lower temps so vials are stored in a warmer
A use of a filter is also required

26
Q

What are potassium-sparing diuretics AKA and name one

A

AKA aldosterone-inhibiting diuretics
Spironolactone

27
Q

What is the MOA of spironolactone?

A

Works in collecting ducts and DCT
Interfere with Na-K exchange by competitively binding to aldosterone receptors which results in decreased resorption of Na and h2o

28
Q

What are the indications of spironolactone?

A

Hyperaldosteronism
HTN
Reversing K loss by potassium-wasting diuretics
Sometimes HF

29
Q

What are the adverse effects of aldosterone-inhibiting diuretics

A

Dizziness
Headache
Cramps
Urinary frequency
Diarrhea
Weakness
Hyperkalemia

30
Q

What are some specific adverse effects for spironolactone?

A

Gynecomastia
Amenorrhea
Irregular menses
Postmenopausal bleeding

31
Q

What are possible interactions with K-sparing diuretics?

A

Lithium
ACE inhibitors
K supplements
NSAIDs

32
Q

Name a thiazide diuretic

A

Hydrochlorothiazide

33
Q

What is the MOA of Hydrochlorothiazide

A

Inhibit tubular resorption of NA, C and K ions
Primarily in DCT
Results in osmotic water loss
Dilates arterioles by direct relaxation

34
Q

What is normal creatinine clearance

A

125 mL/min

35
Q

When should thiazides not be used?

A

When creatinine clearance is less than 30 - 50 mL/min

36
Q

What are the indications of thiazides?

A

HTN
Edematous states
Idiopathic hypercalciuria
Diabetes insipidus
HF caused by diastolic dysfunction

37
Q

What are some adverse effects of Hydrochlorothiazide

A

Urticaria, photosensitivity, ED, Anorexia, Jaundice, leukopenia, agranulocytosis, Hypokalemia, glycosuria, hyperglycemia, hyperuricemia, hyperchloremic alkalosis

38
Q

What time of the day should diuretics be taken?

A

In the morning to avoid interferences with sleep patterns

39
Q

For which diuretics should patients eat more K-rich foods ?

A

All of them except potassium-sparing diuretics

40
Q

What are some foods high in potassium?

A

Bananas, oranges, raisins, broccoli, potatoes, tomatoes, meats, fish, wheat bread, etc.

41
Q

What is a consideration for patients with Diabetes mellitus who are taking thiazide or loop diuretics?

A

Monitoring blood glucose and watch for elevated levels

42
Q

What are some signs and symptoms of hypokalemia?

A

Anorexia, nausea, lethargy, muscle weakness, mental confusion and hypotension

NURS 252 (Pharmacology 2) (23 decks)

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