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5 types of DIURETICS |
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1.carbonic anhydrase inhibitors 2. loop diuretics 3.osmotic diuretics 4.potassium-sparing diuretics 5.thiazides&related diuretics |
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hypertension may be treated by giving an antihypertensive drug and what 2 types of diuretics? |
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loop diuretics & thiazides and related diuretics |
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CARBONIC ANHYDRASE INHIBITORS |
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-sulfonamides w/ nonbacteriostatic action.
-carbonic anhydrase enzyme makes free H ions. -excretes Na,K,bicarb,water. -decreases IOP *glaucoma |
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ACETAZOLAMIDE (Diamox) |
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Carbonic Anhydrase Inhibitor
*glaucoma,edema,epilepsy. onset 1-2hrs for8-12hrs |
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FUROSEMIDE (Lasix) |
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Loop Diuretic
*HTN,edema,cirrhosis,renal disease |
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LOOP DIURETICS |
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Lasix:^Na+Cl excretion>>inhibits reabsorption in distal&proximal tubules & in loop of Henle. Bumex:^excretion of Cl,some Na. acts on proximal tubule. |
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BUMETANIDE (Bumex) |
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Loop Diuretic (PO IV IM)
*CHF+pulmonary edema, cirrhosis, renaldisease. onset 30-60min for 4-6hrs |
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OSMOTIC DIURETICS |
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- ^ the density of the filtrate in the glomerulus, prevents selective reabsorption of water>>H2O,Na,Cl excretion ^ |
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MANNITOL (Osmitrol) |
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Osmotic Diuretic (IV)
*renal failure, IOP,cerebral edema,irrigation
contraindicated: active intracranial bleeding |
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POTASSIUM-SPARING DIURETICS |
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-saves K -Spironolactone:blocks aldosterone activity=blocks Na reabsorption@distaltubule>>Na+H2O excreted |
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SPIRONOLACTONE (Aldactone) |
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Potassium-Sparing Diuretics
*HTN,edema,cirrhosis,renal disease. men may develop gynecomastia |
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THIAZIDES & RELATED DIURETICS |
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-inhibits Na+Cl reabsorption in ascending LoopofHenle & early distal tubule>> Na,Cl,H2O excreted. preg: B |
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CHLOROTHIAZIDE (Diuril) |
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Thiazide & related diuretics (PO IV)
*HTN,edema,cirrhosis,corticosteroid & estrogen therapy |
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HYDROCHLOROTHIAZIDE (HydroDIURIL) |
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Thiazide & related diuretics
*HTN,edema,cirrhosis,corticosteroid & estrogen therapy |
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Uses of DIURETICS (4) |
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1.Edema(CHF, cirrhosis, corticosteroid/ estrogen therapy, cerebral). 2.HTN 3.Renaldisease 4.Glaucoma(^IOP) |
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Diuretics contraindications |
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hypersensitivity, electrolyte imbalances, sever kidney or liver dysfunction, and anuria. |
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use thiazide & loop diuretics cautiously in pts with... |
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liver disease, diabetes, lupus erythematosus, or diarrhea. sensitivity reaction to sulfonamides. |
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use potassium-sparing diuretics cautiously in pts with...contraindicated in pts with... |
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liver disease, diabetes, gout...
hyperkalemia & not recommended for children |
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NSAIDS & salicylates + potassium-sparing or loop diuretics = ... |
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decreased diuretic effectiveness |
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antidiabetic drugs + thiazides & related diuretics = ... |
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hyperglycemia |
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DIURETIC PREADMINISTRATION ASSESSMENT |
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-vital signs + weight + currentLab (serum electrolytes) -peripheral edema -pain -epilepsy: seizures -osmotic:disease+symptoms+I&O |
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DIURETIC ONGOING ASSESSMENT |
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-measure and record I&O -weight -frequent serum electrolyte, uric acid, liver & kidney function tests periodically |
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PT w/ EDEMA (chf) |
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-daily weight (-2lbs/day desirable) -record I&O q8hrs -vitals q4hrs -examine edema qd |
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PT w/ INCREASED INTRACRANIAL PRESSURE |
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-Mannitol IV check solution, low temp=crystallized -urine output qh, should be at least 30-50mL
-vitals q30-60min. -assess neurologic |
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diabetes mellitus + loop or thiazide diuretics = ... |
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blood glucose values may be elevated, urine may test positive for glucose. call DR. |
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