Diuretics

Question 1

Diuretics MOA

Answer 1

accelerate the rate of urine formation

Question 2

types of Diuretics

Answer 2

Carbonic anhydrase inhibitors (CAIs)
Loop diuretics
Osmotics
Potassium-sparing diuretics
Thiazide and thiazide-like diuretics

Question 3

CAI Indications

Answer 3

• long term management of OA glaucoma
• lower intraocular pressure befor eye surgery (when used with miotics)

also useful for
- edema (brain)
- high altitude sickness (high pressure in brain)

Question 4

CAI contraindications

Question 5

Acetazolamide drug class

Answer 5

Carbonic Anhydrase Inhibitor
(Diuretic)

Question 6

Furosemide (Lasix) drug class

Answer 6

Loop diuretic

Question 7

Torsemide drug class

Answer 7

Loop diuretic

Question 8

Bumetanide drug class

Answer 8

Loop diuretic

Question 9

Mannitol drug class

Answer 9

Osmotic diuretic

Question 10

Spironolactone drug class

Answer 10

Potassium sparing diuretic

Question 11

Chlorothiazide drug class

Answer 11

Thiazide/Thiazide like diuretic

Question 12

Hydrochlororthiazide (HCTZ) drug class

Answer 12

Thiazide/Thiazde like diuretic

Question 13

CAIs MOA

Answer 13

• Inhibit carbonic anhydrase which allows the exchange of H+ ions with sodium and water
• Less water is absorbed
• Urine volume increased

Question 14

Osmotic diuretics MOA

Answer 14

• Increase pressure
• water enters tubules from tissue
• minimal effect on Na
• vasodilation

Question 15

K sparing diuretics MOA (two kinds)

Answer 15

• inhibit Na/K channel pump that pulls K into the nephron
• more K stays in the blood
• more Na is excreted
• more water is excreted
  OR
• inhibit aldosterone that triggers Na/K exchange
• more K stays in the blood
• more Na is excreted
• more water is excreted

Question 16

Thiazide MOA

Answer 16

• Inhibit reabsorption of Na and Cl
• manage hypertension

Question 17

Loop diuretics MOA

Answer 17

• cause Na, Cl, water, and K excretions
• decreases preload

Question 18

Loop diuretics indications

Answer 18

• Edema d/t HF, cirrhosis
• Hypertension
• To excrete Ca

Question 19

Loop diuretics contraindications

Answer 19

• Hepatic coma
• Electrolyte imbalance

Question 20

Loop Diuretics AE

Answer 20

hypokalemia
hyperglycemia
SJS
neutropenia (and other deficiencies of the blood)
hyperuricemia

Question 21

Loop diuretics toxicity

Answer 21

• electrolyte loss/dehydration leading to CV collapse
• Neuro/nephrotoxic risk
• Increase blood uric acid and glucose levels

Question 22

Loop diuretics interactions

Answer 22

• Thiazide (metolazone): causing nephron blockage
• NSAIDS: reduce loop’s ability to decrease vascular resistance

Question 23

Loop diuretics Nursing Implications

Answer 23

• caution with elderly
• monitor for skin rx
• BP, ortho hypotn
• Hypokalemia
  Erythema multiforme

Question 24

S/S of hypokalemia

Answer 24

Anorexia
Nausea
Lethargy
Muscle weakness
Confusion
Hypotension

Question 25

Erythema multiforme

Answer 25

- hypersensitivity rx - triggered by infx (herpes) - target lesion - sometimes affects mucous membrane - acute

Question 26

Osmotic diuretics indications

Answer 26

- prevent kidney damage during acute KF - high ICP and cerebral edema - closed angle glaucoma

Question 27

Loop diuretics AE

Answer 27

convulsions thromboplebitis pulmonary congestion

Question 28

Mannitol Indications

Answer 28

swelling (eye and brain) kidney failure

Question 29

Mannitol Nursing Implications

Answer 29

can crystallize (discard) filter in IV line

Question 30

Potassium Sparing Diuretics Nursing Implications

Answer 30

monitor for K level >5.1 interacts with lithium, K supplements,

Question 31

Thiazides and Thiazide-like contraindications

Answer 31

creatine clearance <30-50mL/min

Question 32

Hydrochlorothiazide (HCTZ) Nursing implications

Answer 32

monitor BUN, creatine, K, glucose, dehydration and electrolytes do a thorough history and physical

Question 33

Carbonic Anhydrase Inhibitor (CAI) Nursing implications

Answer 33

monitor for digoxin toxicity if using together monitor electrolyte levels

Question 34

Normal serum potassium range

Answer 34

3.5-5.0mEq/L