DIURETICS

Question 1

Potassium sparing diuretics (drug names)

Answer 1

-spironolactone
-triamterene

Question 2

Potassium sparing diuretics (therapeutic actions)

Answer 2

-spironolactone: blocks aldosterone in the distal tubule, which results in the excretion of sodium

-triamterene: block potassium secretion through the tubule (so retaining potassium) This means we are excreting sodium.

Question 3

Potassium sparing diuretics (indications)

Answer 3

-adjuncts with thiazides or loop diuretics
-for those who need a diuretic, but are at risk for a hypokalemia
-hyperaldosteronism

Question 4

Potassium sparing diuretics (contraindications and interactions)

Answer 4

-Hyperkalemia and severe renal disease

-Interaction with aspirin

Question 5

Common adverse effects of potassium sparing diuretics

Answer 5

-muscle weakness
-Respiratory distress
-Decreased cardiac contractility
-ECG changes
-Urine: oliguria
-Reflexes

Question 6

Implementation of potassium sparing diuretics

Answer 6

Make sure patient doesn’t eat too many high potassium foods

Question 7

Implementation of potassium sparing diuretics

Answer 7

Make sure patient doesn’t eat too many high potassium foods

Question 8

Osmotic diuretic (drug names)

Answer 8

Mannitol

Question 9

Osmotic diuretic (therapeutic actions)

Answer 9

-Pulls water into the renal tubule without sodium loss
-only administer with IV (pulls fluid from extravascular space into the intravascular space)

Question 10

Osmotic diuretic (indications)

Answer 10

-increased ICP
-acute renal failure due to shock, overdose or trauma
-Decrease IOP before eye surgery or in acute glaucoma attacks

Question 11

Osmotic diuretic (contraindications)

Answer 11

-pre-existing, severe renal disease
-Pulmonary congestion and edema
-intercranial bleeding
-dehydration
-Heart failure

Question 12

Common adverse effects of osmotic diuretics

Answer 12

-Fluid and electrolyte imbalance
-Nausea and vomiting
-Hypotension
-Lightheaded and confusion
-Headache
-Heart failure & pulmonary edema

Question 13

Carbonic anhydrase inhibitors (drug names)

Answer 13

“Amide”
-acetazolamide

Question 14

Carbonic anhydrase inhibitors ( therapeutic actions)

Answer 14

-Block the effects of carbonic anhydrase; slow down the movement of hydrogen ions
-more sodium and bicarbonate are lost in the urine

Question 15

Carbonic anhydrase inhibitors ( indications)

Answer 15

-adjuncts to other diuretics
-glaucoma

Question 16

Carbonic anhydrase inhibitors (contraindications)

Answer 16

-Allergy to sulfonamides or thiazides

Question 17

Carbonic anhydrase inhibitors (caution and interactions)

Answer 17

• renal or hepatic disease
  -adrenocortical insufficiency
  -respiratory acidosis/COPD

-Interaction with aspirin

Question 18

Carbonic anhydrase inhibitors (common adverse effects)

Answer 18

-metabolic acidosis
-hypokalemia
-CNS effects, including confusion, drowsiness, and paresthesias of extremities

Question 19

Loop diuretics (drug names)

Answer 19

-bumetanide (very powerful)
-furosemide (safest)
-torsemide (very powerful)

Question 20

Loop diuretics (therapeutic actions)

Answer 20

-Blocks chloride pump, which blocks sodium and chloride rib absorption into circulation
-Large amount of sodium and chloride rich urine is excreted
-works very fast
-loop of henle

Question 21

Loop diuretics (indications)

Answer 21

-We give it for heart failure, pulmonary edema, edema related to heart failure, or renal/liver disease.
-HTN

Question 22

Loop diuretics (contraindications)

Answer 22

-electrolyte depletion
-Severe renal failure or liver failure

Question 23

Loop diuretics (caution and interactions)

Answer 23

-lupus
-hyperglycemia

-interactions with aminoglycosides (toxicity)
-anticoagulants
-digoxin (toxicity)
-anti-diabetic agents
-Lithium (toxicity)

Question 24

Common adverse effects of loop diuretics

Answer 24

-hypokalemia/hypocalcemia
-hyperglycemia
-ototoxicity/deafness
-hypotension/dizziness

Question 25

Thiazide/thiazide like diuretics (drug names)

Answer 25

-hydrochlorothiazide -chlorothiazide -chlorthalidone

Question 26

Thiazide/thiazide like diuretics (therapeutic actions)

Answer 26

-action is to block the chloride pump -keeps chloride in the sodium in the tubule to be excreted in the urine, thus preventing the reabsorption of both in the vascular system

Question 27

Thiazide/thiazide like diuretics (indications)

Answer 27

-edema associated with CHS liver or renal disease -Hypertension

Question 28

Thiazide/thiazide like diuretics (contraindications)

Answer 28

-allergy to sulfonamides -hypovolemia -Severe renal disease

Question 29

Thiazide/thiazide like diuretics (cautions, and interactions)

Answer 29

-Lupus -Liver disease -diabetes/glucose tolerance abnormalities -Interactions include digoxin(toxicity) -anti-diabetic agents -Lithium (toxicity)

Question 30

Adverse effects of thiazide diuretics

Answer 30

-Electrolyte and glucose balances(hypokalemia, hypercalcemia, and hyperglycemia) -fluid loss(dizzy, weak, and fatigued) -alkalinize urine (bladder infections)

Question 31

Diuretics implementation

Answer 31

-can be given with food or milk -Administer early in the day -administer diuretics with IV slowly and then switch to oral form as soon as possible -assess patient’s weight daily -assess electrolytes and dehydration

Question 32

Hypokalemia 6 L’s

Answer 32

-lethargy -leg cramps -limp muscles -Low shallow breathing -Lethal, cardiac dysrhythmias -lots of urine polyuria

Question 33

Diuretic agents actions

Answer 33

-Increase urine volume -increase sodium excretion -Prevent fluid retention