Diuretic Drugs

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Diuretic Drugs
2013-11-12 11:05:57
Diuretic Drugs

PP pg 8-10
Show Answers:

  1. What is the action of Diuretic Drugs?
    • They accelerate the rate of urine formation.
    • Resulting in removal of sodium & water
    • (preventing reabsorption)
  2. In the nephron, where sodium goes, water follows.  If the water is NOT absorbed where does it go?
    Excreted as urine
  3. List the Diuretic drug classifications.
    • Potassium-losing diuretics
    • Thiazide & Thiazide-like diuretics
    • Loop diuretics
    • Carbonic Anhydrase Inhibitors (CAIs) 
    •     *K+ loosing diuretics
    • Osmotic Diuretics
    • K+ sparing diuretics
  4. What are the different K+ loosing diuretics?
    • Thiazide & Thiazide-like diuretics
    • Loop diuretics
    • Carbonic Anhydrase Inhibitors
    • Osmotic diuretics
  5. If your client has +3 pitting BLE edema & good kidney fxn, what drugs might they be put on?
    • Thiazide
    •      HCTZ, Diuril

    • Thiazide-like diuretics
    •      Hygroton, Mykrox
  6. What is the mechanism of action for the Thiazide/Thiazide-like diuretics?
    • Inhibit tubular resorption of Na+, Chloride, & K+ ions.
    • Dilate the arterioles by direct relaxation
  7. What are the a/e of Thiazides & Thiazide-like diuretics?
    • CNS: dizziness, HA, blurred vision, paresthesiase, <libido
    • CV: Hypotension
    • GI: Anorexia, N/V/D, constipation
    • Skin: Urticaria, photosensitivity
    • Metabolic: Hypokalemia, hyperglycemia, hyperuricemia (^uric acid levels in DM pts), Hypercalcemia, hypomagnesiumia, hypochloremia
  8. Loop diuretics are the strongest diuretics, name them.
    • Lasix
    • Bumetanide (Bumex)
    • Edecrin
  9. What is the mechanism of action with Loop Diuretics?
    • Act directly on the ascending limb of the loop of Henle to inhibit chloride & sodium reabsorption
    • Work fast!!
    • Potent diuresis & subsequent loss of fluid
    • <FV causes <BP
    • ^loss of K+ & Na+

  10. What are types of medical issues are Loop Diuretics used for?
    Edema, HTN
  11. What is an important factor to remember about Loop Diuretics?
    • <FV causes <BP
    • Loss of K+ & Na+
  12. What are the A/R of Loop Diuretics?
    • CNS: dizzness, HA, tinnitus, blurred vision
    • CV: Hypotension
    • GI: N/V/D
    • Hematologic: Agranulocytosis, neutropenia, <platelets
    • Metabolic: Hypokalemia, hyponatremia, <Ca+, <Mg, hyperglycemia, hyperuricemia, ^BUN & Creat.
  13. Name the K+ loosing Carbonic Anhydrase Inhibitor diuretics.
    • Acetazolamide (Diamox)
    • Methazolamide
    • Dichlorphenamide
  14. What is the mechanism of action for the K+ loosing diuretics Carbonic Ahnydrase Inhibitors?
    • Block the action of carbonic anhydrase, prevents exchange of H+ ions w/Na+ & water -> decreased resorption of water.
    • =ther is ^ excretion of bicarbonate, Na+, water, & K+, urine volume is ^.
  15. With the K+ loosing Carbonic Anhydrase Inhibitor drugs causeing ^ excretion of bicarbonate can lead to what severe issue?
    Metabolic acidosis.
  16. What are the A/E of Carbonic Anhydrase Inhibitors? (K+ loosing diuretics)
    • Metabolic Acidosis
    • Hypokalemia
    • Drowsiness, parasthesias, urticaria, photosensitivity, anorexia hematuria, melena
  17. What is the mechanism of action for the Osmotic Diuretic, Mannitol (Osmitrol)?
    • Pulls water into the renal tubules from the surrounding tissues.
    • Inhibits tubular resorption of water & solutes, producing a rapid diuresis.
  18. The rapid diuresis caused by the Osmotic drug Osmitrol is useful in what conditions?
    • <Intracranial pressure.
    •    NOT used for peripheral edema
    • ^glomerular filtration & renal plasma flow = helps to prevent kidney damage during acute renal failure.
    • <excessive intraocular pressure
  19. What are the A/E of the K+ loosing diuretic Osmitrol?
    • Convulsions, Thrombophlebitis, Pulmonary congestion
    • IV use only
  20. Name the K+ Sparing diuretics.
    • Amiloride (Midamor)
    • Spironolactone (Aldactone)
    • Triamterene (Dyrenium)
  21. What is the mechanism of action for K+ sparing drugs like  Spironolactone?
    • Interferes w/the Na/K+ exchange = Blocks the resorption of Na+ & water.
    • *allows K+ back in
  22. What are the indications for K+-sparing drugs like Spironolactone?
    • HTN, Hyperaldosteroinism, HF
    • **Reversing the K+ loss caused by K+-loosing drugs.**
    • Given w/K+ loosing drugs to balance K+
  23. What are the A/E of K+ Sparing drugs like Spironolactone?
    • CNS: dizziness, HA
    • GI: cramps, N/V/D
    • Urinary frequency, weakness, HTN
    • **Hyperkalemia**

  24. What are the nursing implications when a client is using Diuretics?
    • before admin: BP & K+ levels
    • Assess: baseline FV status, I&O, serum electrolyte values, Wt, VS (orthos)
    • Know foods ^in K: Bananas, oranges, dates, raisins, plums, fresh veg, potatoes, meat, fish, apricots, whole grain cereals, legumes
    • S/S of Hypokalemia: muscle weakness, constipation, irregular heart beat, lethargy
  25. What other information will the nurse teach the client taking diuretics?
    • Take in AM, change positions slowly, rise slowly
    • Keep log of: daily Wt for MD
    • ^K+ rich foods (not w/K+sparing drugs)
    • CALL MD: ^HR or syncope (dizziness/falling down), Wt gain of 2# or more/day, or 5# or more/week
    • Diabetics: blood glucose