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4 Cards in this Set
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Thiazides - Chlorthalidone (Hygroton) - Hydrochlorothiazide (Esidrix, Microzide) - Indapamide (Lozol) - Metolazone (Zaraoxolyn) |
Indications: - To decrease fluid volume - To increase excretion of water, sodium, potassium, and chloride - Inexpensive/effective - Useful in severe HTN - Effective orally - Enhances other antihypertensives
Adverse reactions: - Hypokalemia (dry mouth, thirst, weakness, drowsiness, lethargy, muscle aches, tachycardia) - Hyperuricemia - Glucose intolerance - Hypercholesterolemia - Sexual dysfunction
Nursing Implication: - Observe for postural hypotension; can be potentiated by (alcohol, barbiturates, narcotics) - Caution with renal failure, gout, client taking lithium - Hypokalemia increases risk for digitalis toxicity - Administer potassium supplements - Encourage intake of potassium-rich foods |
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Loop - Furosemide (Lasix) - Torsemide (Dermadex) - Bumetanide (Bumex) |
Indications: rapid action, potent for use when thiazides fail, cause volume depletion
Adverse reactions: hypokalemia, hyperuricemia, glucose intolerance, hypercholesterolemia, hypertriglyceridemia, sexual dysfuntion, weakness
Nursing Implication: - Volume depletion and electrolyte depletion are rapid - all nursing implications cited for thiazides |
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Potassium-Sparing - Spironolactone (Aldactone) - Amiloride (Midamor) - Triamterene (Dyrenium) - Eplerenone (Inspra) |
Indication: volume depletion without significant potassium loss
Adverse reaction: hyperkalemia, gynecomastia, sexual dysfunction
Nursing implication: - watch for hyperkalemia and renal failure in those treated with ACE inhibitors or NSAIDs - watch for increase in serum lithium levels - give after meals to decrease GI distress |
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Combination Thiazide and Postassium-Sparing - HCTZ and Triamterene (Maxidex) - HCTZ + Amiloride (Moduretic) - HCTZ + Spironolactone (Aldactazide) |
Indication: Decreases fluid volume while minimizing K+ loss
Adverse reactions: - Side effects of individual drug offset or minimized by its partner
Nursing implication: - caution client previously on loop or thiazide diuretic alone not to overdo k+ food now because k+- sparing component in new drug - follow scheduling doses to avoid sleep disruption |
