Diuretics and Drugs for Electrolyte and Acid-Base Disorders Flashcards Preview

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Flashcards in Diuretics and Drugs for Electrolyte and Acid-Base Disorders Deck (37):
1

The kidneys regulate fluid volume, electrolytes, acids, and bases.
A)true
B)false

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2

They also secrete the enzyme renin, which helps to control blood pressure, and erythropoietin , a hormone that stimulates red blood cell production
A)true
B)false

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3

Renal failure is a decrease in the kidneys' ability to maintain electrolyte and fluid balance and to excrete waste products. If renal excretion is impaired, drugs will accumulate to high concentrations in the blood and tissues, resulting in toxicity.
A)true
B)false

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4

Because the kidneys excrete most drugs, the majority of medications will require a significant dosage reduction in patients with moderate to severe renal failure. The importance of this cannot be over emphasized: Administering the " average" dose to a patient in severe renal failure can kill a patient.
A)true
B) false

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5

Many patients with chronic renal failure will also have a deficiency of erythropoietin , a hormone secreted by the kidney.
A)true
B)false

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6

Erythropoietin serves as a primary signal to increase red blood cell production in the bone marrow.
A)true
B)false

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7

A synthetic form of erythropoietin, epoetin alfa (Epogen, Procrit) is effective in treating several disorders caused by a deficiency in red blood cells. Epoetin is some times given to patients undergoing cancer chemo therapy to counteract the anemia caused by antineoplastic agents. It is occasionally prescribed for patients prior to blood transfusions or surgery and to treat anemia in HIV infected patients .
A)true
B)false

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8

Epoetin alfa is usually administered three times per week until an increase in the number of red blood cells is achieved.
A)true
B)false

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9

Diuretics are used to treat hypertension, heart failure, and fluid retention disorders.
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B)false

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10

A diuretic is a drug that increases urine output. The goal of most diuretic therapy is to reverse abnormal flu id retention by the body. Excretion of excess fluid in the body is particularly desirable in the following conditions :
• Heart failure
• Kidney failure
• Pulmonary edema
• Liver failure or cirrhosis
• Hypertension (see C hapter 18 at> )

True

11

The most effective diuretics are the loop or high-ceiling diuretics. Drugs in this class act by blocking the reabsorption of sodium and chloride ions in the loop of Henle. When given IV, they have the ability to cause large amounts of fluid to be excreted by the kidney in a very short time.
A)true
B)false

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12

Loop diuretics are used to reduce the fluid accumulation associated with heart failure, hepatic cirrhosis, or chronic renal failure. Furosemide (Lasix) and torsemide (Demadex) are also ap- proved for HTN.
A)true
B)false

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13

Furosemide is the most frequently prescribed loop diuretic. Un like the thiazide diuretics, furosemide is able to increase urine output even when blood flow to the kidneys is diminished. Torsemide (Demadex) has a longer half-life than furosemide, which offers the advantage of once-a-day dosing. Bumetanide (Bumex) is 40 times more potent than furosemide but has a shorter duration of action
A)true
B)false

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14

The rapid excretion of large amounts of water caused by loop diuretics may produce adverse effects such as dehydration and electrolyte imbalances. Signs of dehydration include thirst, dry mouth, weight loss, and headache.
A)true
B)false

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15

Hypotension, dizziness, and even fainting can result from the rapid fluid loss. Potassium loss, or hypokalemia, may cause dysrhythmias, and thus potassium supplements may be indicated during loop diuretic therapy. Potassium loss is of particular concern to patients who are also taking digoxin (Lanoxin).

A)true
B)false

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16

Although rare, ototoxicity is possible. Because of the potential for serious adverse effects, the loop diuretics are normally reserved for patients with moderate to severe fluid retention, or when other diuretics have failed to achieve therapeutic goals.

A)true
B)false

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17

The thiazides comprise the largest, most frequently prescribed class of diuretics. These drugs act on the distal tubule to block sodium reabsorption and increase water excretion. Their primary use is for the treatment of mild to moderate HTN. They are less effective at producing diuresis than the loop diuretics and they are ineffective in patients with severe renal disease.
A)true
B)false

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18

All the thiazide diuretics are available by the oral route and have equivalent efficacy and safety profiles. Three drugs-chlorthalidone (Hygroton), indapamide (Lozol), and metolazone (Zaroxolyn)-are not true thiazides, although they are included with this drug class because they have similar mecha- nisms of action and adverse effects.
A)true
B)false

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19

Although less effective than the loop diuretics, potassium-sparing diuretics may help prevent hypokalemia.
A) true
B)false

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20

Potassium loss is a potentially serious adverse effect of the thiazide and loop diuretics. The therapeutic advantage of the potassium-sparing diuretics is that they are able to increase diuresis without adversely affecting blood potassium levels.
A)true
B)false

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21

Acetazolam ide (Diamox) is a carbonic anhydrase inhibitor used to decrease intraocular pressure in patients with glaucoma
A)true
B)false

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22

The osmotic diuretics also have very specific applications. Mannitol is used to maintain urine flow in patients with acute renal failure or during prolonged surgery. Mannitol can also be used to lower intraocular pressure in certain types of glaucoma. It is a very potent diuretic that is only given by the IV route. Osmotic diuretics are rarely drugs of first choice due to their potential toxicity
A)true
B)false

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23

Electrolytes are essential to many body functions, including nerve conduction, muscle contraction, and bone growth and remodeling. Too little or too much of an electrolyte may result in serious disease and must be quickly corrected.
A)true
B)false

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24

Treatment of alkalosis is directed toward addressing the underlying condi tion that is causing the excess bases to be retained. In mild cases, alkalosis may be corrected by administering sodium chloride concurrently with KCI. This combination increases the renal excretion of bicarbonate ion (a base), which indirectly increases the acidity of the blood. For acute patients, acidifying agents may be used. Hydrochloric acid and ammonium chloride are two drugs that can quickly lower the pH in patients with severe alkalosis.
A)true
B)false

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25

In patients with acidosis, the goal is to quickly reverse the level of acids in the blood. The treatment of choice for acute acidosis is to administer in fusions of sodium bicarbonate. Bicarbonate ion acts as a base to quickly neutralize acids in the blood and other body fluids. The patient must be carefully monitored during infusions because this drug can " over-correct" the acidosis, causing blood pH to turn alkaline.
A)true
B)false

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26

Causes of acidosis and alkalosis

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27

ACIDOSIS

RESPIRATORY ORIGINS OF ACIDOSIS
• Hypoventilation or shallow breathing
• Airway constriction
• Damage to respiratory center in medulla

METABOLIC ORIGINS OF ACIDOSIS
• Kidney failure
• Diabetes mellitus
• Excess alcohol ingestion
• Starvation
• Severe diarrhea

True

28

ALKALOSIS

RESPIRATORY ORIGIN OF ALKALOSIS
• Hyperventilation due to asthma, anxiety, or high altitude

METABOLIC ORIGINS OF ALKALOSIS
• Diuretics that cause potassium depletion
• Severe vomiting
• Ingestion of excess sodium bicarbonate
• Constipation for prolonged periods

True

29

Regarding Diuretics

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30

1.When taking diuretics, drink plenty of water if dry mouth or thirst develops, unless otherwise directed by a health care provider.

2. Take diuretics at least 2 hours before bedtime to avoid nighttime diuresis.

3. If diabetes is present, monitor blood sugar levels very closely when taking loop diuretics because these drugs may elevate blood glucose levels.

4. Do not take thiazide diuretics during pregnancy or when breast-feeding.

5. When taking loop or thiazide diuretics, increase intake of potassium-rich foods such as dark leafy vegetables, nuts, citrus fruits, bananas, and potatoes. If taking a potassium sparing diuretic, avoid these foods unless otherwise instructed by a health care provider.

6. Avoid caffeinated beverages w hen taking diuretics. The diuretic effect of the caffeine combined with the effects of these medications may cause dehydration.

Regarding Potassium Supplements

7. Because KCI tablets are irritating to the Gl mucosa, they should be taken with f ood. Do not crush or suck the tablets. If nausea or heartburn occurs, take antacids along with the KCI.


True

31

When taking diuretics don't drink soda or coffe or alcohol
A)true
B)false

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32

Loop diuretics the patient can loose potassium
A)true
B)false

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33

Potassium sparing and thiazides hold K AND Na
A)true
B)false

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34

KCI do not crush or soak and take with food
A)true
B)false

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35

Sodium and potassium are the main electrolytes in the body
A)true
B)false

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36

Pulmonary edema, HTN, liver and kidney failure Use diuretics
A)true
B)false

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37

Diuretics And Drugs For Electrolyte And Acid-Base Disorders

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