Wk 12. AntiDiuretics Flashcards

1
Q
  1. When should diuretics be taken?
A

In the morning if daily, morning and 2 pm if bid

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2
Q
  1. Where does the most reabsorption take place?
A

Proximal convoluted tubule

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3
Q
  1. Where is 20% of the sodium reabsorbed?
A

Ascending loop of Henle

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4
Q
  1. Which diuretics have the greatest potential for diuresis? Why?
A

Osmotic diuretics followed by loop diuretics.

They block sodium reabsorption at sites where more sodium is normally reabsorbed.

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5
Q
  1. Large dose of loop diuretics may adversely affect what organ?
A

Ear, ototoxicity

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6
Q
  1. What permanent adverse effect may occur with ethacrynic acid (Edecrin)?
A

Ototoxicity

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7
Q
  1. What change in calcium may occur with loop diuretics?
A

Hypocalcemia

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8
Q
  1. What class of diuretics does not cause calcium loss?
A

Thiazides

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9
Q
  1. What change in blood sugar may be seen with loop diuretics?
A

Hyperglycemia

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10
Q
  1. Thiazide diuretics are contraindicated with an allergy to what?
A

Sulfonamides

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11
Q
  1. When might thiazide diuretics be ineffective?
A

When the glomerular filtration rate (GFR) is below 15-20 mL/min

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12
Q
  1. What are some signs of electrolyte imbalance?
A

Muscle weakness, twitching, nausea and vomiting, dysrhythmias, dry mouth and thirst, confusion, etc.

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13
Q
  1. Loop diuretics decrease which electrolytes?
A

K+, Na+, Cl-, Ca2+, Mg2+

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14
Q
  1. The coadministration of digoxin (Lanoxin) and diuretics may precipitate what condition?
A

Digoxin toxicity with dysrhythmias.

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15
Q
  1. Potassium-sparing diuretics should not be used with which three antihypertensive drug categories? Name two common potassium-sparing diuretics.
A

ACE inhibitors, Angiotensin II receptor blockers, direct renin inhibitors.
Spironolactone (Aldactone) and triamterene (Dyrenium)

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16
Q
  1. Diuretics and antihypertensive drugs can cause what adverse effect?
A

Additive hypotension

17
Q
  1. Why are osmotic diuretics used in renal failure?
A

To maintain urine flow through the tubule.

18
Q
  1. Why are osmotic diuretics used for cerebral edema?
A

Used to reduce intracranial pressure

19
Q
  1. What is added to deter patients from taking diphenoxylate (Lomotil) for analgesic effects?
A

Atropine, causes dry mouth and tachycardia.

20
Q
  1. Name 2 contraindications for Diphenoxylate (Lomotil)?
A

Infectious diarrheas and pseudomembranous colitis.

21
Q
  1. What are the mechanisms of action for bulk-laxatives? Where do they work?
A

Form nondigestible gel that expands with bacterial action. The enlarged fecal size triggers peristalsis. Small intestine and colon.

22
Q
  1. List contraindications for laxatives. Why?
A

Abdominal pain, nausea, cramps, appendicitis, bowel obstruction, diverticulitis, ulcerative colitis, enteritis.
Worry about bowel perforation.

23
Q
  1. Why must a bulk laxative be administered with a full glass of fluids?
A

To prevent bowel obstructions.

24
Q
  1. What are the mechanisms of action for surfactant laxatives? Where do they work?
A

Decrease surface tension allowing water to penetrate stool, inhibit fluid absorption in gut, and increase water and electrolyte secretion into gut. Small intestine and colon.

25
Q
  1. What is the difference between Docusate sodium (Colace) and Peri-Colace?
A

Peri-Colace includes a stimulant laxative, sennosides.

26
Q
  1. What are the mechanisms of action for stimulant laxatives? Where do they work?
A

Increase peristalsis, inhibit fluid reabsorption in gut, and increase water and electrolyte secretion in gut. Colon.

27
Q
  1. What food substance and drug category may not be taken with Bisacodyl (Dulcolax), a stimulant laxative? Why?
A

Milk and antacids. They dissolve the enteric coating meant to protect the stomach from the drug.

28
Q
  1. What harmless urinary side effect is caused by senna, a stimulant laxative?
A

Yellowish-brown or pinkish urine.

29
Q
  1. What are the mechanisms of action for saline laxatives? Where do they work?
A

Attracts water that stretches the gut and causes peristalsis. Small intestine and colon.

30
Q
  1. What is a non-GI contraindication to magnesium hydroxide? Why?
A

Renal disease. Magnesium accumulates and causes CNC toxicity.

31
Q
  1. What are the mechanisms of action for sugar laxatives? Where do they work?
A

The disaccharide is metabolized into acid by gut bacteria. The acids cause an osmotic action. Colon.

32
Q
  1. Name a non-GI use for lactulose?
A

High ammonium blood levels.

33
Q
  1. What are the mechanisms of action for glycerin suppositories? Where do they work?
A

Softens and lubricates stool. Stimulates rectal contraction. Rectum.

34
Q
  1. What is the most important indication of constipation?
A

Hard, pellet-like feces.

35
Q
  1. What is a possible effect of laxatives during pregnancy?
A

Initiation of labor.

36
Q
  1. Discuss the use of laxatives during lactation.
A

The drug may be found in breast milk.