Cardiovascular - Diuretics Flashcards Preview

Pharmacy Pre-Reg 2020/2021 > Cardiovascular - Diuretics > Flashcards

Flashcards in Cardiovascular - Diuretics Deck (32)
Loading flashcards...
1

What are examples of loop diuretics and when are they used?

E.g. furosemide, bumetanide,

Acts on ascending limb of loop of henle

Used is HF - IV in acute, when there is odema or breathlessness in chronic

2

Give examples of thiazide and related diuretics, and when are they used?

Thiazide
Bendroflumethiazide
Cyclopenthiazide

Thiazide related
Indapamide
Metolazone
Chlortalidone
Xipamide

Act on the DCT
Used in hypertension and heart failure

3

Give an example of a potassium sparing diuretics and where does it act?

Amiloride

Acts on the collecting duct

4

Give examples of aldosterone antagonists and when are they used?

Spironolactone - adjunct in heart failure

Eplerenone - used in HF after MI, and in men who are experiencing oestrogen like side effects

5

Give an example of an osmotic diuretic and when is this used?

Mannitol
Used in cerebral odema

6

Give an example of a carbonic anhydrase inhibitor and when is this used?

Acetazolamide

Used in glaucoma and altitude sickness (unlicensed)

7

How do diuretics work?

Inhibit NaCl reasorption in the nephron, thereby inhibiting water reabsorption, so there is an increase in urine volume

8

What should a patient do if they are taking a diuretic and are experiencing diarrhoea or vomiting? Why?

Stop taking the diuretic for 1-2 days and increase fluid intake

To prevent dehydration, AKI, hypotension and worsening heart failure

9

What monitoring needs to be done for patients on diuretics?

Measure BP, electrolytes and renal function:
1-2 weeks after any change
Once treatment is stable, monitor every 6 months

10

What are more potent, loop or thiazide diuretics?

Loop

11

What has a longer duration of action, loop or thiazide diuretics?

Thiazide

12

What electrolyte and metabolic disturbances are associated with thiazides?

Hypokalaemia
Hyponatraemia
Hyperuricaemia
Hypercalcaemia
Increased glucose levels
Lipids

13

Which thiazides are preferred in
a) hypertension
b) heart failure
c) diabetes

a) indapamide
b) bendroflumethiazide
c) indapamide

14

Which thiazide has the smallest effect on glucose levels?

Indapamide

15

What conditions can thiazide and loops exacerbate?

Diabetes
Gout

16

Some diuretics can cause hypokalaemia. When is this especially dangerous?

When patients are also taking a cardiac glycoside e.g. digoxin
Patients who have severe CHD

Potassium sparing diuretics e.g. amiloride can be used

17

Why can chlortalidone be given on alternate days to control odema?

It had a longer duration of action

18

What diuretic is used in acute heart failure?

IV furosemide

19

Why should diuretics be given in the morning (or before 4pm)?

To prevent them from interfering with sleep due to diuresis

20

Can you give potassium sparing diuretics with potassium supplements?

No

21

Can potassium sparing diuretics be given alongside ACE Inhibitors?

No - increased risk of hyperkalaemia

22

What are the indications of spironolactone?

Adjunct in heart failure
Liver cirrhosis and acites
Primary hyperaldosteronism

23

What is the minimum eGFR for thiazides?

30ml/min/1.73m2

24

What is the effect of thiazides on diabetes?

Increase in glucose
Indapamide has the lowest effect on glucose

25

How can hypokalaemia affect the liver?

It can cause hepatic encephalopathy

26

What is the effect of loop diuretics on patients with an enlarged prostate?

Can cause urinary retention

(Although loops normally increase urine production)

27

Which diuretics can cause hypokalaemia

Loop
Thiazide

28

Which diuretics can cause hyperkalaemia

Potassium sparing

29

Should spironolactone be taken with or after food?

Yes

30

In what condition are aldosterone antagonists contraindicated in?

Addisons Disease