Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
59 Cards in this Set
- Front
- Back
|
What are the classes of diuretics
|
Thiazide
Thiazide-like Loop Carbonic-anhydrase Potassium-sparing Osmotic |
|
|
What are the indicated uses of diuretics?
|
Edema associated with H/FAcute Pulmonary edema
Liver disease Renal disease Hypertension Decrease fluid from intraocular pressure |
|
|
H/F comes from what?
|
Insufficient blood pumping to the kidneys. Causing activation of the renin-angiotenion sys. & resulting in increased bliid volume & Na+ retention.
|
|
|
Pulmonary edema (left-sided H/F)develops when?
|
Increased fluid volume backs in the lungs, pushing into capillaries,interferring with gas exchange.
|
|
|
Liver failure/cirrhosis occurs when?
|
In the presence of edema & ascites.
|
|
|
What causes edema & ascites?
|
Reduced plasma protein production.
Obstructed blood flow through the portal system |
|
|
What can happens if a patient stops taking water, while on diuretics?
|
Fluid rebound.
|
|
|
Thiazide & thiazide-like diuretics belong to a class of drugs called what?
|
Sulfonamides
|
|
|
What are the 5 thiazide diuretics
|
chlorothiazide
hydrochlorothiazide hyroflumethiazide methuchlothiazide |
|
|
What are the 3 thiazide-like diuretics
|
chlorthiazidone
indapamide metolazone |
|
|
What are the most used diuretics
|
Thiazide/thiazide-like
|
|
|
Thiazide/thiazide-like diuretics act to do what?
|
block the chloride pump
|
|
|
Thiazide/thiazide-like absorb where?
|
GI tract
|
|
|
Thiazbolizide/thiazide-like metabolize in what?
|
Liver
|
|
|
Where are Thiazide/thiazide-like excreted?
|
Urine
|
|
|
People with what allergies shouldn't take Thiazide/thiazide-like ?
|
Thiazides & sulfonamides
|
|
|
What are the contraindications of Thiazide/thiazide-like?
|
Allerty to thiazide & sulfonamides
Fluid & electrolyte imbalances Renal & liver disease Pregnancy & lactation |
|
|
What are the cautions of Thiazide/thiazide-like?
|
Gout
Systemic lupus Diabetes Hyperthyroidism |
|
|
What are the adverse effects of Thiazide/thiazide-like?
|
Abnormal nephron function
Hypokalemia Dcrease calcium excretion Altered glucose levels Alkalinized urine |
|
|
What are the most common adverse effects of thiazide/thiazide-like?
Thiazide/thiazide-like |
GI upset
CNS complications Hypokalemia |
|
|
What other drugs interact with Thiazide/thiazide-like?
|
Cholestyramine/colestipol
Digoxin Antidiabetic agents |
|
|
Why are loop diuretics called loop?
|
Because they work on the loop of Henle.
|
|
|
Loop diuretics are also referred to as what? And why?
|
High-ceiling diuretics, because they have a greater degree of diuresis.
|
|
|
What are the 4 loop diuretic available?
|
ethacrynic acid (Edercrin)
bumetanide (generic) furosemide (Lasix) torsemide (Demadex) |
|
|
What is most commonly used loop diuretic?
|
furosemide
|
|
|
What 2 loop diuretics are more powerful than Lasix?
|
Bumetanide & Torsemide
|
|
|
Loop diuretics are indicated for what?
|
Acute H/F
Hypertension Acute pulmonary edema Edema of H/F Renal/ liver disease |
|
|
What are the actions of loop diuretics?
|
Blocks chloride pump ascending from the loop of Henle. And reabsorption of Na & chloride.
|
|
|
Where are loops metabolized & where is it excreted?
|
Through the urine
|
|
|
What are the contraindications of loop diuretics?
|
Allery
Electrolyte depletion Anuria(absence of urine formation) Severe renal failure Hepatic coma Pregnancy & lactation |
|
|
What cautions should be taken with loop diuretics?
|
Systemic lupus
Gout Diabetics |
|
|
Adverse effects of loop diuretics are?
|
Fluid & electrolyte imbalances
Hypokalemia Alkalosis Hypocalcemia |
|
|
What are the drug interactions of loop diuretics?
|
Increase of ototoxicity if combined with
aminoglycosides anticoagulation indomethacin,ibuprofen, salicylaes, or NSAIDs |
|
|
What diuretic is relatively mild?
|
Carbonic Anhydrase
|
|
|
What 2 Carbonic Anhydrase diuretics currently available?
|
acetazolamide (Diamox)
methazolmide (generic) |
|
|
What is the pharmacokinetics of Carbonic Anhydrase diuretics?
|
Rapid absorption & widely distributed.
|
|
|
Where are Carbonic Anhydrase diuretics excreted?
|
Urine
|
|
|
What are the action of Carbonic Anhydrase diuretics?
|
Blocks effects of carbonic anhydrase,slowing down movement of hydrogen ions. Allowing more Na+ & biacarbonate lost in the urine.
|
|
|
Carbonic Anhydrase diuretic are indicated for what?
|
Glaucoma
Diuresis in H/F Mountain sickness Epilepsy |
|
|
Contraindications of Carbonic Anhydrase are what?
|
Allergy
angle closure glaucoma |
|
|
What are the cautions of Carbonic Anhydrase ?
|
Lactation
Fluid/electrolyte imbalances Renal & hepatic disease Adrenocortical insufficiency Respiratory acidosis COPD |
|
|
What are the adverse effects of Carbonic Anhydrase diuretics?
|
Related distribances in acid & base balance
Electrolyte imbalances Metabolic acidosis Hypokalemia Paresthesias of limbs Confusion Drowniness |
|
|
What are the drug interactions related to Carbonic Anhydrase diuretics?
|
Salicylates
Lithium |
|
|
What are the 3 available potassium-sparing diuretics?
|
amiloride (Midamor)
spironolactone (Aldactone) triamierene (Dyrenium) |
|
|
Action of the potassium-sparing diuretics are what?
|
Spares potassium, while still getting rid of Na+ & blocks actions of aldosterone in distal tubule.
|
|
|
Potassium-sparing diuretics are indicated for what?
|
Adjunct for edema of H/F
Liver/renal disease Hypertension Hypokalemia Hyperaldosteronism |
|
|
Potassium-sparing diuretics are metabolized where? And excreted where?
|
liver & urine
|
|
|
Explain the aborsption of potassium-sparing diuretics.
|
Is well absorbed protein bound & widely distributed.
|
|
|
What are the contraindications of potassium-sparing diuretics?
|
Allergy
Hyperkalemia Renal disease or anuria Taking amiloride or triamteren |
|
|
What cautions shoulith potassium-sparing diuretics?
|
Pregnancy & lactation
|
|
|
What adverse effect is common with potassium-sparing diuretics?
|
Hyperkalemia
|
|
|
What drug combined with potassium-sparing diuretics cause reaction?
|
Salicylates
|
|
|
What is the action of Osmotic diuretics?
|
Pulls water into renal tubule without Na+ loss.
|
|
|
What are the 2 mild Osmotic diuretics available?
|
glycerin (Osmoglyn)
isosorbide (Ismotic) |
|
|
What are the 2 stronger Osmotic diuretics?
|
mannitrol (Osmitrol
urea (Ureaphil) |
|
|
Osmotic diuretics are indicated for what?
|
Intracranial pressure reduction
Prevention of oliguric phase of renal failure Renal clearance of toxic substances Renal failure from shock, drug overdose and trauma |
|
|
Explain the pharmacokinetics of Osmotic diuretics?
|
Freely filteredat renal glomerulus, poor absorption by rental tubule or secretion by the tubule & resistance to metabolism
|
|
|
What are the contraindications of Osmotic diuretics?
|
Renal disease & anuria
Pulmonary congestion Intracranial bleeding Dehydration CHF |
|
|
What are the Osmotic diuretics cautions?
|
Pregnancy & lactation
|
