Diuretics

Question 1

Diuretics

Answer 1

Produce increased urine outflow; treatment of HTN move fluid assc with heart failure cirrhosis or kidney disease

Question 2

Every minute the kidney produces

Answer 2

125mL of filtrate… about 180 L/day; 99% of water, electrolytes, and nutrients t

Question 3

Small particles such as electrolytes, amino acids, drugs, glucose & waste products are filtered in

Answer 3

the glomeruli

Larger products such as protein and lipids remain in circulation

Question 4

Basic functions of the kidneys:

Answer 4

Cleansing and maintaining ECF volume and composition

acid-base balance

excretion of metabolic wastes

Question 5

Diuretics can cause:

Answer 5

Hypovolemia
Acid-base imbalances
Altered electrolyte levels

Question 6

Diuretics can cause the loss of electrolytes including:

Answer 6

Potassium

Sodium
Magnesium
Chloride
Bicarbonate

Question 7

Diuretic Classes

Answer 7

Loops
Thiazide
Osmotics
Potassium Sparing

Question 8

Loop Diuretics

K waste

Answer 8

block the reabsorption of sodium and chloride; Sodium & water are lost along with potassium

very potent/most affective/marked depletion

furosemide (Lasix)
bumetanide (Bumex)

Question 9

furosemide (Lasix)

bumetanide (Bumex)

Answer 9

for renal impaired
rapid movement of fluid
in morning

Question 10

furosemide (Lasix)
bumetanide (Bumex)
education

Answer 10

Assess vital signs, daily weights (report gain or loss >2lbs in 24 hours) & electrolytes; orthostatic hypotension

Question 11

furosemide (Lasix)
bumetanide (Bumex)
side effects

Answer 11

Ototoxicity

Dehydration
Hypotension
Electrolyte imbalances
Hyponatremia
Hypokalemia
Hyperglycemia

Question 12

furosemide (Lasix)
bumetanide (Bumex)
interactions

Answer 12

Digoxin-secondary to low potassium
Ototoxic drugs
Lithium-secondary to low sodium
Antihypertensive agents
NSAIDs-can counteract diuretic effect

Question 13

WARNING: furosemide (Lasix)

Answer 13

pushed SLOWLY, not to exceed 20mg/min;

to fast cause ringing and hearing loss;

Question 14

Potassium Supplements

Answer 14

Normal serum potassium levels are 3.5-5.0

Question 15

Diuretics: Thiazides

K waste

Answer 15

hydrochlorothiazide (HCTZ)
not as effective
treat hypertension & peripheral edema
First-line drugs for HTN
not immediate

Question 16

hydrochlorothiazide (HCTZ)

side effects

Answer 16

Electrolyte imbalances
Can cause hyperglycemia
Dehydration
only with normal renal function; not if BUN and Creatinine elevated

Question 17

Potassium-Sparing Diuretics

Answer 17

Spironolactone
Amiloride
Triamterene

weaker

if K greater than 5 stop

Question 18

Spironolactone

Answer 18

potassium retaining effects
Effects take up to 48 hours to develop
aldosterone antagonist

Question 19

Triamterene

Answer 19

Nonaldosterone antagonist
Inhibits sodium and potassium exchange
acts faster

Question 20

Triamterene
Spironolactone
adverse effects

Answer 20

life-threatening hyperkalemia, especially if given with an ACE inhibitors, ARBs, or direct renin inhibitor

Question 21

Potassium-Sparing Diuretics…

Answer 21

dont use with salt substitutes bc they have high K

Question 22

Osmotic diuretics

Answer 22

Inhibits passive reabsorption of water (causing diuresis)

no significant effect on the excretion of potassium

prevent kidney failure to decrease intracranial pressure and intraocular pressure

mannitol

Question 23

mannitol

Answer 23

emergency for intracranial pressure; side effects: edema

Question 24

Potassium Rich Foods

Answer 24

Good idea for people on potassium-wasting diuretics.

bananas and orange juice