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What are the effects of diuretics?
- Increase the renal excretion of water, sodium and other electrolytes.
- Act by increasing the amount of urine produce by the kidneys.
- Widely used in the treatment of hypertension and heart failure.
- Considered first line drugs bc they produce few side effects.
- Very effective in controlling mild to moderate hypertension.
- Electrolytes should be monitored.
what is hypovolemia?
Decreased volume of circulationg clood in the body. This equals to hypotension.
What is hyponatremia
what is hypokalemia?
what are the 4 important diuretic groups?
- High-ceiling (loop)
what is the most common rx drug of the high-celing (loop) group?
Furosemide (lasix) MA? TU? AE? and NI?
- MA: acts on the ascending loop of hence to block reabsorption— NACL is retained in the tubule and excreted in the urine.
- TU: renal disease, hypertension, congenital heart disease (CHD), lymphodema.
- AE: ototoxicity (cant hear), hypotension, dysrhythmia, hypokalemia, hyponatremia, dehydration, hypochloremia.
- NI: Check for electrolytes, dehydration, BP, HR, diet high in potassium, edemas
what is the most common use thiazide drug?
what is HCTZ MA? TU? AE? DI? NI?
- MA: Effect similar to high-ceiling loop diuretics (increase renal excretion of sodium, potassium, chloride, and water — elevate levels of uric acid and glucose) but the effect is considered lower than lasix. Not effective when urine flow is scant (barely sufficient or inadequate), which doesn’t happen with lasix (loop diuretics)
- TU: same as lasix + diabetes insipidus, and nephrotic syndrome.
- AE: same as high-ceiling (loop) diuretics + caution with pregnancy bc the drug enters the breast milk
- DI: digoxin, and NSAIDs
- NI: same as with lasix + check for glucose levels.
what are the 2 subdivitions of potassium-sparing diuretics?
Aldosterone antagonist and nonaldosterone antagonist
what is the most common aldosterone antagonist drug rx?
what is spironolactone MA? TU? AE? DI? NI?
- MA: Rarely used alone in therapy. Blocks aldosterone in the distal nephron. Retention of potassium. Increased excretion of sodium. Vasodilatation.
- TU: Hypertension (weak when used alone) Heart failure. Primary hyperaldosteronism Premenstrual syndrome. Polycystic ovary syndrome.
- AE:hyperkalemia- major side effect, dysthymias. Endocrine effectsGI disturbances
- DI: Thiazide and loop diuretics. Agents that raise potassium levels.
- NI: take with meal or snakes. Omit potassium supplements if on more that one type of diuretic. Avoid salt substitutes. Asses for signs of fluid and electrolytes balance.
what is the most common drug rx from the Osmotic group of diuretics?
What is Mannitrol (osmitrol) MA? TU? and AE?
- MA: MOST BE GIVEN IV. Promotes diuretics by creating osmotic force within lumen of the nephrons. (swell and draw fluid from high to low)
- TU: Prophylaxis of renal failure. reduction of intracranial pressure. reduction of intraocular pressure.
- AE: Edema (bc it works well in the head, but not in other parts of the body). Headache, nausea, vomiting, Fluid and electrolytes imbalance Weakness.