diuretics Flashcards
(24 cards)
function of diuretics
- modify renal function to accelerate rate of urine formation
- increase excretion of water and electrolytes by inhibiting Na and H2O resorption within the nephron
- decrease reabsorption of na, cl, water, and other substances
- reduces extracellular fluid volume, plasma volume, and co
indications of diuretics
- alteration in renal
- cardiovascular, renal and hepatic conditions
- burns and trauma
- edema (peripheral, pulmonary, cerebral)
ae of diuretics
- hypotension
- potassium imbalances
types of diuretics
- loop
- thiazide
- postassium-sparing
- osmotic
- combination
loop diuretic drugs
- fureosemide
- bumetanide
- torsemide
loop diuretic moa
inhibits sodium and chloride reabsorption in the ascending loop of henle
uses of loop diuretics
- alone or in combo for htn treatment
- pulmonary edema
- chf
- ascites
- low GFR
loop diuretic implications
- don’t admin IVP to quickly, can develop ototoxicity, shown as tinnitus, no faster than 4mg/min
- monitor k levels for digoxin toxicity
loop diruetic ae
- electrolyte imbalances (na, k)
- fluid volume deficit
- digoxin toxicity
loop diuretics cautions
- sulfa allergy
- pregnancy
thiazide diuretic drugs
- hydrochlorothiazide
- metalazone
- chlorthalidone
thiazide diuretic uses
- first line treatment for htn
- long term management of heart failure
- slow onset, not for immediate results
- ineffective when gfr <30
thiazide diuretic caution and contraindications
- caution in liver patients, risk for thiazide induced (hyokalemic, hypochloremic) acidosis
- contraindicated in pregnancy, anuria, and sulfa allergies
thiazide diuretic implications
- monitor for hepatoencephalopathy by monitoring ammonia levels (stroke, confused, lethargic)
- monitor for signs of ototoxicity and dizziness
thiazide diuretic interactions
beta blockers can cause hyperglycemia, hyperlipidemia, hyperucermia
potassium sparing diuretic drugs
- spironolactone
- amiloride
- triamterene
potassium sparing diuretic uses
- heart failure
- ascites
- hypokalemia
- htn
- hyperaldosteronism
- slow onset, weak diuretic effect, 6 weeks for max effect
potassium sparing diuretic implications
- monitor for encephalopathy in liver
- use with ace inhibitor to reduce sx and help heart function
- monitor for digoxin toxicity, increases half life of digoxin
- monitor for lithium toxicitym reduces clearance of lithium
- educate no salt, low k level
- take with food, same time daily
- dont give if k levels is >5
osmotic diuretic drugs
mannitol (osmitrol)
osmotic diuretic moa
increases osmotic pressure of glomerular filtrate causing water to be drawn into the bloodstream from extracellular compartments… resulting in rapid diuresis or loss of water and electrolytes through the kidney
osmotic diuretic uses
- oliguria or anuria
- hypovolemic shock, trauma, dehydration
- increased intraocular pressure
- urinary excretion of toxic substances
- main use for increased intracranial pressure before or after neurosurgery
- not indicated for peripheral edma
osmotic diuretic implications
- if used to promote UOP, goal is >30 ml/hr
- check solution for crystals and dissolve before giving
- only give iv with filter
combination products
- Not indicated for initial therapy of edema or HTN because sometimes have to be titrated specifically for individual
- Can increase compliance
- Can prevent hypokalemia
- if inadequate diuretic effect, loop and thiazide can be taken together
nursing assessment for combination products
- Check electrolytes, kidney functions, VS, weight, UOP
- Assess for edema, N/V, abd pain, tenderness, lung sounds, respiration status
- Mental status, pupil reaction, heart rhythm
- Ascites
- Fatigue
