Loop Diuretics Flashcards

1
Q

Give two examples of loop diuretics?

A
  • Furosemide

- Bumetanide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the indications for the use of furosemide or bumetanide?

A
  • Pulmonary oedema due to heart failure

- Peripheral oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What causes of peripheral oedema are there where you would not use furosemide or bumetanide?

A
  • Venous stasis
  • Lymphoedema
  • Calcium channel blockers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What contraindications exist with furosemide and bumetanide?

A
  • Hypovolaemia/severe electrolyte disturbances
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What cautions are there for use of furosemide and bumetanide?

A
  • Renal impairment
  • Hepatic impairment
  • During pregnancy and breastfeeding
  • Impaired micturition (ejection of urine through the urethra)
  • Prostatic enlargement
  • Gout
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where do loop diuretics work on in the kidneys?

A
  • Thick ascending limb of the loop of henle in the renal tube
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What do loop diuretics inhibit in the loop of henle?

A
  • Na/K2Cl co transporter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What do loop diuretics inhibit the reabsorption of?

A
  • Sodium

- Resulting in diuresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why are loop diuretics very effective in causing diuresis?

A
  • Most sodium absorption occurs at this part of the loop of henle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What strange side effects can loop diuretics cause to happen when used in high doses?

A
  • Deafness due to an electrolyte change in the endolymph (semi circular canals of the inner ear)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do loop diuretics cause to happen systemically?

A
  • Pulmonary and systemic vasodilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does the pulmonary and systemic vasodilation cause?

A
  • Reduction in preload making treatment of pulmonary oedema even more effective
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When would loop diuretics be given intravenously?

A
  • During acute pulmonary oedema OR

- Resistant heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why should furosemide not be given quickly?

A
  • More likely to become ototoxic

- Slow infusion of 4mg/min should be used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How are loop diuretics normally given?

A
  • Orally

- Should be given at times of day when diuresis does not impact on life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What adverse reactions are caused by loop diuretics besides changes in blood metabolites?

A
  • Dehydration
  • Hyperglycaemia
  • Precipitation of gout
17
Q

What blood test should be closely monitored when on loop diuretics?

A
  • U’s and E’s
18
Q

What should loop diuretics NOT be prescribed with?

A

Aminoglycosides

19
Q

What can happen when loop diuretics are prescribed with aminoglycosides?

A
  • Acute renal failure

- Deafness

20
Q

What can the hypokaleamia caused by loop diuretics lead to with other medication?

A
  • Digoxin toxicity

- Anti-arrhythmic toxicity

21
Q

What other interactions do loop diuretics cause?

A
  • Reduce excretion of lithium that can lead to lithium toxicity
  • Interaction with theophylline will increase risk of hypokalaemia
22
Q

What should patients keep when on loop diuretics?

A
  • Fluid balance chart
23
Q

What may reduce loop diuretics efficacy in the long term?

A
  • Patient develops resistance to them (unknown cause)

- Higher dose required