Diuretics

Question 1

What are thiazides used for?

Answer 1

Relieve oedema due to chronic heart failure and lower blood pressure in lower doses

Thiazides are effective in managing fluid retention and hypertension.

Question 2

In which condition are loop diuretics primarily used?

Answer 2

Pulmonary oedema due to left ventricular failure and chronic heart failure

Loop diuretics are potent diuretics effective in acute settings.

Question 3

What is the benefit of combining diuretics?

Answer 3

Effective in patients with oedema resistant to treatment with one diuretic

Combination therapy can enhance diuretic efficacy.

Question 4

What should be avoided when using vigorous diuresis with loop diuretics?

Answer 4

Acute hypotension and rapid reduction of plasma volume

Careful monitoring is essential during diuretic therapy.

Question 5

Name two thiazides.

Answer 5

Bendro and indapamide

These are commonly prescribed thiazide diuretics.

Question 6

How do thiazides affect sodium reabsorption?

Answer 6

Inhibit sodium reabsorption

This mechanism contributes to their diuretic effect.

Question 7

How quickly do thiazides act?

Answer 7

Within 1-2 hours

This rapid onset is beneficial for acute management.

Question 8

When should thiazides be administered?

Answer 8

Early in the day

This timing helps prevent disruption of sleep due to diuresis.

Question 9

What effect does a low-dose thiazide have in blood pressure management?

Answer 9

Produces a maximal or near-maximum effect of lowering blood pressure

Low doses are often sufficient for effective blood pressure control.

Question 10

What happens at higher doses of thiazides?

Answer 10

Leads to marked changes in plasma potassium, sodium, uric acid, glucose, and lipids with little effect on blood pressure

Higher doses have a risk of significant side effects.

Question 11

Which thiazide is normally preferred?

Answer 11

Indapamide

Indapamide is often chosen for its favorable side effect profile.

Question 12

Why is bendro no longer first line in blood pressure management?

Answer 12

It has been replaced by more effective options like indapamide

Treatment guidelines evolve as new evidence emerges.

Question 13

In which conditions should thiazides be avoided?

Answer 13

Hypokalemia, hyponatremia, hypercalcemia, and Addison’s disease

These conditions can be exacerbated by thiazide use.

Question 14

What is the danger of hypokalemia in heart failure?

Answer 14

It is dangerous and potassium supplements or potassium-sparing diuretics are used

Maintaining potassium levels is crucial in heart failure management.

Question 15

What can hypokalemia lead to in liver failure?

Answer 15

Encephalopathy

Electrolyte imbalances can have severe neurological consequences.

Question 16

List some other uses of thiazides.

Answer 16

Diabetes, gout, constipation, electrolyte imbalances, postural hypotension

Thiazides have multiple therapeutic applications beyond hypertension.

Question 17

What are some side effects of thiazides?

Answer 17

Diabetes, gout, constipation, electrolyte imbalances, postural hypotension

Awareness of side effects is important for patient monitoring.

Question 18

In which condition should thiazides be avoided?

Answer 18

Severe liver disease

Liver function impacts the safety of diuretic therapy.

Question 19

What are two examples of loop diuretics?

Answer 19

Furosemide and bromatinide

Loop diuretics are commonly used in clinical settings for various conditions.

Question 20

What condition can loop diuretics cause?

Answer 20

Pulmonary oedema

This is a serious condition that may arise from the use of loop diuretics.

Question 21

In which acute condition are loop diuretics used?

Answer 21

Acute heart failure

They help reduce fluid overload in heart failure patients.

Question 22

How can loop diuretics affect blood pressure treatment?

Answer 22

They can be added to achieve better control

This combination can help manage resistant hypertension.

Question 23

Do loop diuretics exacerbate diabetes?

Answer 23

Yes, but effects are less than thiazides

Monitoring is essential for diabetic patients on loop diuretics.

Question 24

What is the onset and duration of action for loop diuretics?

Answer 24

Act within 1 hour and completed within 6 hours

This allows for flexibility in dosing, such as twice a day without interrupting sleep.

Question 25

Name three contraindications for loop diuretics.

Answer 25

* Renal failure * Hyperkalemia * Hypernatremia * Liver cirrhosis ## Footnote These conditions can be worsened by loop diuretics.

Question 26

What auditory side effects can loop diuretics cause?

Answer 26

Tinnitus and deafness ## Footnote These side effects may be dose-dependent.

Question 27

What unusual urine color can furosemide and triantarine cause?

Answer 27

Blue urine ## Footnote This is a rare side effect associated with these medications.

Question 28

What can occur with loop diuretics in relation to potassium levels?

Answer 28

Hyperkalemia can occur ## Footnote This is particularly concerning in patients with existing potassium issues.

Question 29

Why can loop diuretics be dangerous in severe cardiovascular disease?

Answer 29

They can exacerbate fluid imbalance ## Footnote Caution is needed in these patients to prevent complications.

Question 30

What can be done to counteract potassium loss from loop diuretics?

Answer 30

Give potassium supplements or use potassium sparing diuretics ## Footnote This helps in maintaining potassium levels.

Question 31

Name a type of potassium sparing diuretic.

Answer 31

Aldosterone antagonist like spironolactone ## Footnote These diuretics help preserve potassium levels.

Question 32

What should not be given with potassium sparing diuretics?

Answer 32

Potassium supplements ## Footnote This combination can lead to severe hyperkalemia.

Question 33

What side effect can spironolactone cause?

Answer 33

Gynaecomastia ## Footnote This is a notable side effect in male patients.

Question 34

In which conditions can low doses of spironolactone be used?

Answer 34

* Heart failure * Resistant hypertension ## Footnote These conditions benefit from the diuretic's effects.

Question 35

For what syndrome is spironolactone also given?

Answer 35

Conns syndrome ## Footnote It helps manage hyperaldosteronism in this condition.

Question 36

In which condition is spironolactone contraindicated?

Answer 36

Addison's disease ## Footnote This is due to the risk of worsening adrenal insufficiency.