Thiazide and Thiazide-like Duuretics

Question 1

MOA

Answer 1

1. Inhibits Na+, K+, and Cl- reabsorption in the distal tube -> water loss
2. Relaxes / dilates peripheral arterioles

Question 2

Therapeutic effects

Answer 2

1. Excretion of H2O, Na+, K+, Cl-, without altering the pH

2. Peripheral arteriole relaxation -> decrease resistance -> decrease afterload (takes time)

Question 3

Indications

Answer 3

1. HTN

2. Fluid overload / edema

Question 4

Precautions

Answer 4

1. Impaired renal function
2. Pre-existing dehydration
3. Pre-existing electrolyte disturbances (hypokalemia)

Question 5

Contraindications

Answer 5

1. Severe renal failure

2. Untreated dehydration / electrolyte disturbance (hypokalemia)

Question 6

Side effects / adverse effects

Answer 6

1. Electrolyte disturbances = hypokalemia

2. Headache, dizziness

Question 7

Nursing Actions

Answer 7

Assessment:

BP, I/O, BUN / Cr, K+, Mg++

Question 8

Thiazide Example of Drugs

Answer 8

Hygroton or Diuril (chlorothiazide)
HydroDiuril (hydrochlorothiazide, HCTZ)*
*additive HTN agent

Question 9

Thiazide-like Example of Drugs

Answer 9

Zaroxolyn (metolazone) *usually added to something else - loop