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Flashcards in Loop Diuretics Deck (23)
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1

Give two examples of loop diuretics?

- Furosemide
- Bumetanide

2

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

- Pulmonary oedema due to heart failure
- Peripheral oedema

3

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

- Venous stasis
- Lymphoedema
- Calcium channel blockers

4

What contraindications exist with furosemide and bumetanide?

- Hypovolaemia/severe electrolyte disturbances

5

What cautions are there for use of furosemide and bumetanide?

- Renal impairment
- Hepatic impairment
- During pregnancy and breastfeeding
- Impaired micturition (ejection of urine through the urethra)
- Prostatic enlargement
- Gout

6

Where do loop diuretics work on in the kidneys?

- Thick ascending limb of the loop of henle in the renal tube

7

What do loop diuretics inhibit in the loop of henle?

- Na/K2Cl co transporter

8

What do loop diuretics inhibit the reabsorption of?

- Sodium
- Resulting in diuresis

9

Why are loop diuretics very effective in causing diuresis?

- Most sodium absorption occurs at this part of the loop of henle

10

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

- Deafness due to an electrolyte change in the endolymph (semi circular canals of the inner ear)

11

What do loop diuretics cause to happen systemically?

- Pulmonary and systemic vasodilation

12

What does the pulmonary and systemic vasodilation cause?

- Reduction in preload making treatment of pulmonary oedema even more effective

13

When would loop diuretics be given intravenously?

- During acute pulmonary oedema OR
- Resistant heart failure

14

Why should furosemide not be given quickly?

- More likely to become ototoxic
- Slow infusion of 4mg/min should be used

15

How are loop diuretics normally given?

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

16

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

- Dehydration
- Hyperglycaemia
- Precipitation of gout

17

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

- U's and E's

18

What should loop diuretics NOT be prescribed with?

Aminoglycosides

19

What can happen when loop diuretics are prescribed with aminoglycosides?

- Acute renal failure
- Deafness

20

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

- Digoxin toxicity
- Anti-arrhythmic toxicity

21

What other interactions do loop diuretics cause?

- Reduce excretion of lithium that can lead to lithium toxicity
- Interaction with theophylline will increase risk of hypokalaemia

22

What should patients keep when on loop diuretics?

- Fluid balance chart

23

What may reduce loop diuretics efficacy in the long term?

- Patient develops resistance to them (unknown cause)
- Higher dose required