51: Diuretics Flashcards
(33 cards)
Classes of Diuretics: 5
Thiazide Loop Carbonic Anhydrase Potassium-Sparing Osmotic
Function of Diuretics
Increase the amount of urine produced by the kidneys
Increase sodium excretion
Indications for Diuretic Use
Edema associated with congestive heart failure Acute pulmonary edema Liver disease (including cirrhosis) Renal disease Hypertension Conditions that cause hyperkalemia
Thiazide: Mechanism
Blocks chloride pump
Keeps chloride and the sodium in the tubule to be excreted in the urine, thus preventing the reabsorption of both in the vascular system
Thiazide: Indications
Tx of Edema r/t CHF, Liver or Renal Disease
Monotherapy for HTN
Thiazide: Pharmokinetics
Absorbed in GI
Metab: Liver
Excreted: Urine
Thiazide: Contraindications
Allergy to Thiazides or Sulfonamides
Fluid and Electrolyte Imbalance
Bipolar DO
Pregnancy and Lactation
Thiazide: Caution
Gout
Lupus
Diabetes
Hyperparathyroidism
Thiazide: Adverse Effects
Nephron issues Hypokalemia Lithium Decreased Ca2+ excretion Altered B-G Alkalinized Urine
Thiazide: Drug Interactions
Cholestyramine or colestipol
Digoxin
Antidiabetic agents
Loop Diuretics: Three Brands
Furosemide: Lasix
Bumetande: Bumex + Toresmide: Demadex (New, powerful)
Ethacrynic acid: Edecrin (Rarely used)
Loop Diuretics: Actions
Block the chloride pump in the ascending loop of Henle
This causes reabsorption of sodium and chloride
Loop Diuretics: Indications
Acute CHF Acute pulmonary edema Edema associated with CHF Edema associated with renal or liver disease Hypertension
Loop Diuretics: Pharmokinetics
Metabolized and excreted in urine
Loop Diuretics: Contraindications
Allergy Electrolyte depletion Anuria Severe renal failure Hepatic coma Pregnancy and lactation
Loop Diuretics: Caution
Lupus, gout, DM
Loop Diuretics: Adverse Effects
Related to the imbalance in electrolytes and fluid
Hypokalemia
Alkalosis
Hypocalcemia
Loop Diuretics: Drug Interactions
Aminoglycosides or cisplatine
Anticoagulation
Indomethacin, ibuprofen, salicylates, or NSAIDs
Potassium-Sparing Diuretics: Function
Not as powerful as the loop diuretics, but they retain potassium instead of wasting it.
Potassium-Sparing Diuretics: Three Brands
Amiloride (Midamor)
Spironolactone (Aldactone)
Triamterene (Dyrenium)
Potassium-Sparing Diuretics: Actions
Cause a loss of sodium while retaining potassium
Block the actions of aldosterone in the distal tubule
Potassium-Sparing Diuretics: Indications
Adjuncts with thiazide or loop diuretics
Patients who are at risk for hypokalemia
Potassium-Sparing Diuretics: Pharmokinetics
Well absorbed, protein bound, and widely distributed
Metabolized in the liver and excreted in the urine
Potassium-Sparing Diuretics: Contraindications
Allergy
Hyperkalemia, renal disease, or anuria
Patients taking amiloride or triamterene
