Diuretic Agents Flashcards
Indications for Use
Edema associated with congestive heart failure
Acute pulmonary edema
Liver disease/cirrhosis
Renal disease
Hypertension
Hyperkalemia
Carbonic Anhydrase Inhibitors
Adjunct drugs in the long-term management of open-angle glaucoma
Helpful for edema and high-altitude sickness
Not used very often
Cause hypokalemia; increase in digoxin toxicity may occur
Loop Diuretics
POTENT DIURETIC and acts directly on the ascending limb of the loop of Henle to inhibit chloride and sodium resorption
Increase renal prostaglandins, resulting in dilation of blood vessels and reduced peripheral vascular resistance
Useful in treating edema
Reduced BP, vascular resistance, central venous pressure, end-diastolic pressure
Indications for Loop Diuretics
Edema associated with heart failure or renal disease
Controls hypertension
Increases renal excretion of calcium in patients with hypercalcemia
Furosemide (Lasix)
Most commonly used loop diuretic
Used for pulmonary edema and HF edema, liver disease, nephrotic syndrome, ascites, hypertension
Osmotic Diuretics
Increase glomerular filtration rate and renal plasma flow to prevent kidney damage during acute renal failure
Reduces intracranial pressure or cerebral edema
Promotes excretion of toxic substances
NOT indicated for peripheral edema
Mannitol (Osmitrol)
Osmotic diuretic
IV infusion only
May crystallize when exposed to low temperatures
Use of a filter needle is required
Potassium-Sparing Diuretics
Work in collecting ducts and DCTs
Interfere with sodium-potassium exchange; causes HYPERKALEMIA
Competitively bind to aldosterone receptors
Block resorption of sodium and water usually induced by aldosterone
Spironolactone (Aldactone)
Potassium-sparing diuretic
Aldosterone-inhibiting diuretic
Promotes excretion of sodium and water and prevents potassium secretion
Thiazide Diuretic Indications
Hypertension (one of the most prescribed group of drugs for this)
Edema
Idiopathic hypercalciuria
Diabetes insipidus
Heart failure caused by diastolic dysfunction
Hydrochlorothiazide (Esidrix, HydroDIURIL)
Thiazide diuretic
Nursing Implications
Instruct patients to take medications in the morning
Monitor serum potassium levels
Teach to maintain proper nutritional and fluid volume status
Monitor for hyperkalemia
Interactions of Loop Diuretics
NSAIDs
Increase serum levels of uric acid, glucose, alanine aminotransferase, thiazide
Neurotoxic and nephrotoxic
Potassium-Sparing Diuretics Interactions
Lithium
ACE inhibitors
Potassium supplements
NSAIDs
