Diuretics

Question 1

What is the purpose of diuretics?

Answer 1

To decrease fluid retention or electrolyte imbalances due to retaining fluid
Usually used for: Renal failure, HTN, Chronic heart failure, and edema
Typically K WASTING, so should watch for hypokalemia

Question 2

What are some important points with Acetazolamide (Diamox)?

Answer 2

Is a Carbonic anhydrase inhibitor (CAI)
Used to treat Glaucoma and CHF
Can CAUSE motion sickness (w/ common SE being HA, dizziness and SOB)
Less potent than loop diuretics and Thiazide

Question 3

What are some important points with Furosemide (Lasix)?

Answer 3

Is a loop diuretic
Can cause HYPOkalemia (K wasting)
Should NOT be used with NSAIDs
Give with IV SLOWLY (bc can cause ototoxicity)
MUST check BP and K levels b4 giving
DONT use w/ NSAIDs

Question 4

What are some common points between diuretics?

Answer 4

Majority are K WASTING (So must know SS of hypokalemia)

All are excreted by the kidneys so must monitor renal function

Question 5

What are some important points with Hydrochlorothiazide (Hyrodiuril)?

Answer 5

Is a thiazide diuretic
Has the CEILING EFFECT after 50mg
- After 50mg the diuretic won’t work any better, but instead the risk of side effects and adverse effects get increased

Question 6

What is the ceiling effect? What medication has this effect?

Answer 6

Ceiling effect = After a certain dose, effectiveness of the medication doesn’t increase, there is just an increased chance of toxicity and adverse effects

Hydrochlorothiazide (Hyrodiuril), a thiazide diuretic, has this effect

Question 7

What are some important points with Metalazone (Zaroxolyn)?

Answer 7

Is a thiazide-like diuretic
Is EXTREMELY POTENT, so it’s usually only dosed about once a month or so
Can be used w/ loop diuretics for CHF pts

Question 8

What are some important points with Mannitol (Osmitrol)?

Answer 8

Is an osmotic diuretic
Increases renal BF
Can used be used 4 cerebral edema
- But DON’T use it if pt has an active brain bleed
MUST USE AN IV FILTER WHEN ADMINISTERING
- Crystalizes when exposed to low temps
- Inspect 4 crystallization b4 administering

Question 9

What are some important points with Spironolactone (Aldactone)?

Answer 9

Is an Aldosterone-Inhibiting Diuretic
Is K SPARING (where all the other diuretics on here are K WASTING)
- Monitor for HYPERkalemia
Given when pt ejection fraction UNDER 35 (50 and above is good EF)
Decreased UO = SIGN of RENAL FAILURE