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Diuretics are indicated for what 4 diagnosis?
- 1. HTN
- 2. HF
- 3. Renal Failure
- 4. Cirrhosis
Name the most common thiazide diuretic.
You can not take thiazides, loop diuretics, or carbonic anhydrase inhibitors if you're allergic to.....?
What is the drug that is not sulfa based that is a loop diuretic?
Ethacrynic Acid (Edecrin)
What is the most common loop diuretic?
What is the primary function of diuretics?
decrease sodium reabsorption (although this occurs at different sites along the nephron)
Thiazide diuretics works at both the _____ and ____.
Distal tubule and connecting segment
Which of the diuretics are the most potent?
Loop diuretics work at ______.
Thick ascending limb of Loop of Henle
Potassium sparing diuretics work at ______.
the aldosterone sensitive principal cells in cortical collecting tubule.
Reabsorption of up to ____ of Na in the distal tubule is inhibited by thiazide diuretics.
Thiazide diuretics are not as effective for the treatment of edema but they are mostly used for ____.
*long term therapy decreases peripheral vascular resistance
Thiazide diuretics cause the excretion of ____ and the reabsorption of _____.
_____% of filtered Na is reabsorbed in the Loop of Henle.
What is a common complications associated with loop diuretics relation to the inhibition of cotransporters in the inner ear?
What is the treatment of choice in hypercalcemia?
Loop diuretics and saline hydration
Loop diuretics promote the excretion of ____ , ____ and _____.
Carbonic Anhydrase Inhibitors work in what part of the nephron?
Why are carbonic anhydrase inhibitors (Diamox) considered a weak diuretic?
because most of Na is reclaimed in the loop and distal sites.
Carbonic anhydrase inhibitors promote the excretion of ____ and ____.
The lose of HCO3 from carbonic anhydrase inhibitors can lead to _____.
What are two kinds of potassium sparing diuretics?
- Sodium Channel Blockers
- Aldosterone Antagonists
How do sodium channel blockers work?
- Block Na reabsorption at the collecting duct
- Slow K secretion as well.
Aldosterone antagonists are often used in ___ and ___.
cirrhosis and ascites
*also used in CHF some
Which class of diuretics is routinely prescribed first line?
You should not prescribed more than ___mg of thiazide diuretics for patients with HTN.
What are the second line diuretics?
Loop diuretics are primarily used in ??
What is most important to monitor with patient who are taking diuretics?
patients should weigh themselves daily and record their edema and weight in a dairy to optimize treatment
Patients will have a decreased response to diuretics if their GFR is ____.
less than 30ml/min
Carbonic anhydrase inhibitors are used to treat ____ and ___.
Open-angle glaucoma and mountain sickness
What are the most common adverse effects seen with the administration of diuretics?
fluid and electrolyte imbalances
Aldosterone antagonists cause increased or decreased K levels???
Loops cause increased or decreased K levels???
When should you check serum electrolytes on a patient started on a diuretic?
- 1. at baseline
- 2. 1 week after starting med
- 3. 1 month after starting med
- 4. and at any dosage change (will check 2 weeks after dosage change)
What diuretics are safe in children?
Are these typically used?
- No --- use ACE, ARBs, and B blockers instead.
If at patient loses more than ___ to ___ lb. per day... they should be educated to call their provider immediately.
What is the hallmark sign of K+ disturbances?
- Muscle weakness for high and low K levels.
- Muscles weakness begins peripherally and progresses to the trunk and upper extremities.
Diuretics are in pregnancy category ___.
What are some s/s of hyperkalemia or hypokalemia?
- tingling in the hands or feet
- unusual tiredness or weakness
- leg cramps or muscle weakness
- abdominal pain
- heaviness in legs
- weak or slowed or irregular pulse
- low bp
What two classes of drugs are used to treat BPH?
- 1. Alpha 1 adrenergic antagonists (osin)
- 2. 5Alpha Reductase Inhibitors (asteride)
What is the common drug class of meds used to treat ED? examples are??
- PDE5 Inhibitors (afil)
- Sildenafil (Viagra)
- Tadalafil (Cialis)
Drugs used to treat BPH are also used to treat ____.
What is the only alpha blocker that is specific to the treatment of BPH (this drug is only indicated for BPH)?
When you suspect a patient of BPH, what is important to assess?
Digital rectal exam -- to estimate size and s/s of cancer
**should also check UA, Creatitine, BUN and PSA.
What is the MOA of alpha 1 adrenergic receptor blockers?
reduce sympathetic tone and relax the urethral stricture that causes BPH symptoms
They can also cause decrease BP!
If a patient does not have HTN.. what is the first line treatment for BPH?
alpa 1 selective antagonist
If a patient has HTN you should prescribe ____ as the first line treatment.
A long acting alpha 1 antagonist
Who do 5 alpha reductase inhibitors aid in treating BPH?
they shrink prostate
What class of meds are good for quick relief of BPH?? What class of meds are good for long term treatment of BPH??
- 1. alpha 1
- 2. 5 alpha reductase
Women of child bearing age should not handle ____.