Transition Drug Cards

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Transition Drug Cards
2011-10-20 17:48:50
Diuretic Agents

Diuretic Agents
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  1. Thiazide-
    Hydrochlorathiazide (Hydro-diuril),(HCTZ)
    • Derivatives of sulfonamides and inhibit tubular reabsorption of Na+ and Cl-.
    • Decreased libido photosensitivity, hyperuricemia, blood dyscrasias, jaundice.
    • PO, with food. Increased risk of Dig toxicity r/t potential change in serum K+ level. Risk of quinidine toxicity if taken with this med.
    • Edema of CHF, renal, cirrhosis, glucocorticoid, estrogen therapy, HTN, and diabetes insipidus.
    • Block the chloride pump keep the chloride and sodium in the tubule to be excreted in the urine, preventing the reabsorption of both in the vascular system.
  2. Loop Diuretics
    Furosemide (Lasix)
    • Potent diuretic, works on loop of Henle. Rapid onset. Inhibit reabsorption of Na+ and CL-.
    • Tinnitus, encephalopathy, photosensitivity, hyperglycemia, blood dyscrasias.
    • PO, IM, or IV. Allergy to sulfonimides?? Tinnitus, hearing loss, give with food. IV undiluted over 1-2 mins. Increased ototoxicity with aminoglycosides or cisplatin. Can increase risk of bleeding with anticoagulants. Decreased antihypertensive effects with indomethacin, ASA, or NSAIDS.
    • Edema of CHF, acute pulmonary edema, HTN, renal and liver disease.
    • Hypercalcemia.
    • Block the chloride pump in the ascending loop of henle causing reabsorption of sodium and chloride.
  3. Carbonic-Anhydrase Inhibitors
    Acetazolamide (Diamox)
    • Works on the proximal tubule of the nephron.
    • Hypokalemia, Acidosis, Metalic taste, leukopenia.
    • PO, IM, IV. PO must be with food. IM is very painful. Check for allergy to sulfonamides. Increased excretion of ASA and Lithium with these.
    • Adjunctive therapy of glacoma. Can be used for altitude sickness, seizures, and edema.
    • Inhibits carbonic anhydrase which decreases aqueous humor formation in the eye, intraoccular pressure and hydrogen secretion by the renal tubules. More sodium and bicarbonate are lost in the urine.
  4. Potassium sparing Diuretics
    Spironolactone (Aldactone)
    • Block aldosterone receptors. Excretion of Na+ but retain K+.
    • Hyperkalemia, gynecomastia (enlargement of the breast in male), photosensitivity. PO--with food. Watch for hyperkalemia. Avoid salt substitutes which contain K+. Decrease in diuretic effect if combined with ASA.
    • Edema, HTN, hyperaldostronism. Used frequently with Thiazides.
  5. Osmotic Diuretics
    Mannitol (osmitrol)
    • Osmotic diuretic-works on proximal, increased osmotic pressure of the glomular filtrate, inhibits reabsorption of water and lytes.
    • Convulsions, blurred vision, thrombophlebitis, tachycardia, pulmonary edema.
    • IV infusion or GU irrigant. Check neuro with ICP> Check eyes for IOP. Monitor renal function.
    • Acute renal failure, edema, GU irrigant. Increased ICP or IOP.
    • Elevates the osmolarity of the glomerular filtrate, leading to a loss of water, sodium, and chloride