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