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What are the 2 major applications of diuretics?
- (1) treatment of hypertension
- 2) mobilization of edematous fluid (associated with heart failure, cirrhosis, and kidney disease).
- 3) In addition, because of their ability to maintain urine flow, diuretics are used to prevent renal failure.
What are the 4 major categories of diuretics?
- 1) high-ceiling (loop) diuretics (eg, furosemide);
- (2) thiazide diuretics (eg, hydrochlorothiazide);
- (3) osmotic diuretics (eg, mannitol); and
- (4) potassium-sparing diuretics.
How do diuretics work?
decrease reabsorption of sodium and water along the renal tubules of the nephron in the kidney
What is an example of a loop diuretic
What does lasix promote the excretion of
Lasix is used to treat:
- Hypertension (especially if renal disease is present)
- pulmonary edema
- Heart failure
- edema of hepatic, cardiac, or renal origin that has been unresponsive to less efficacious diuretics
What are the adverse effects of a loop diuretic
- ototoxicity (hearing impairment, rare)
Loop diuretics are in what pregnancy category
***Furosomide administration should occur no faster than 80mg/2min
What is an example of a thiazide diuretic?
How does HCTZ work?
- –Weak diuretic that acts in the distal tubule
- –Increases the excretion of sodium, chloride, potassium, and water
What is the principle difference between high-cieling diuretics and thiazides?
that the maximum diuresis produced by the thiazides is considerably lower than the maximum diuresis produced by the high-ceiling drugs.
What are the therapeutic uses of thiazide diuretics
- diabetes insipidus
What are the adverse effects of thiazide diuretics
- GI: nausea, vomiting
- CNS: dizziness, vertigo
- polyuria, nocturia
- CV: orthostatic hypotension
**thiazides should not be used during pregnancy
**should not be used if pt has pre existing renal disease because it can slow the GFR
If a pt is taking a thiazide diuretic, the nurse should
- monitor I & O
- BP and Pulse
- electrolyte levels
- glucose levels
What are the 2 sub categories of K-sparing diuretics?
aldosterone antagonists and nonaldosterone antagonists.
*** K-sparing diuretics have the weakest diuretic effect of the diuretics if given alone, but works synergistically with other diuretics
What is an example of an aldosterone antagonist diuretic?
spironolactone blocks the actions of aldosterone in the distal nephron.
What is an example of a nonaldosterone antagonist
triamterene and amiloride
How does Spironolactone work?
- works in the distal tubule to promote sodium and water excretion
- promotes re-absorption of Potassium
What are the therapeutic uses of Spironolactone?
- Heart failure
What are the adverse effects of Spironolactone?
- benign and malignant tumors
- Endocrine disorders (gynecomastia, menstrual irregularities, impotence, hirsutism, and deepening of the voice.)
What are the adverse effects of triamterene?
Relatively common side effects include nausea, vomiting, leg cramps, and dizziness.
What is an example of a Osmotic Diuretic
What are some therapeutic uses of Osmotic Diuretics
- Decrease in Intracranial Pressure
- Decrease of Intraocular pressure
- treatment of acute renal failure
What are the adverse effects of Mannitol?
- Serious fluid electrolyte imbalance
- may induce fluid overload
Carbonic Anhydrase inhibitors are used for?
•Used primarily in treating chronic, open-angle glaucoma
How does mannitol work?
Draws water into the vascular space through osmosis
Triamterene works where?
in the distal tubule of the kidney