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Diuretics
Pharmacology- Diuretic Meds
33
Nursing
Undergraduate 2
06/11/2012

Additional Nursing Flashcards

 


 

Cards

Term

furosemide (Lasix)


"Loop diuretics"


Routes and Pharmacokinetics

Definition

PO onset 60 mins, duration 8 hrs

IM rarely used

IV onset 5-10 mins, duration 2 hrs

 

Metabolized in liver, excreted in kidney

Term

furosemide (Lasix)


Uses

Definition

Pulmonary edema

CHF

Edema fro hepatic, cardiac or renal origins

HTN (adjunct therapy)

 

*note-can be used in the presence of renal impairment even tho it works in the kidney- does not change GFR

Term

furosemide (Lasix)


Adverse Effects

Definition

HYPOnatremia

HYPOchloremia

*HYPOkalemia* look at BMP

Dehydration (tugor, weight, I&O)

HYPOtension

Ototoxicity- can NOT give more than 20mg/min or pt will experience tinnitus

Term

furosemide (Lasix)


Drug Interactions

Definition

digoxin (Lanoxin)- can lead to digtoxicity in otherwise safe doses

 

Ototoxic drugs- additive effect

 

Potassium sparing diuretics- will balance out potassium levels when pt needs more lasix drugs

 

Anithypertensive drugs- additive effect

Term

furosemide (Lasix)


nursing interventions

Definition

Monitor I & O, hydration (thirsty, lips dry), daily weights


Monitor BUN (kidney function and hydration), Creatinine (kidney fnx)


Monitor BP


Monitor lytes ESP K+


Schedule oral doses early in day to prevent nocturia- risk for falls


IV doses give slowly at a rate not to exceed 20mg per minute in adults


IV piggyback 4mg per min

Term

furosemide (Lasix)


Teaching

Definition
change positions slowly
schedule dosing to reduce nocturia
monitor output esp in hot weather
eat high potassium foods
weigh daily & notify HCP if weight gain >2-3 lb in one day
Term

hydrochlorothiazide (HCTZ)


"Thiazide diuretics"


Definition
similar to loop diuretics...less potent, less diuresis

dependent of adequate renal function- increase GFR cant give to pt with renal impairment

act in the early segment of distal convoluted tubule

increases renal secretion of NA, CL and H2O

elevates plasma levels of uric acid and glucose- watch pt with DM and gout
Term

hydrochlorothiazide (HCTZ)


routes & pharmacokinetics

Definition

oral ONLY - onset 2 hrs, duration 6-12 hrs

dose 12.5-25 mg average

Term

hydrochlorothiazide (HCTZ)


Uses

Definition

essential HTN (first line drug)

 

edema in mild CHF

Term

hydrochlorothiazide (HCTZ)


adverse effects

Definition

hyponatremia

hypocholermia

hypokalemia

dehydration 

(^ same as lasix but less impact on BP, BMP, and I&O)

 

hypergylcemia in DM pts

hyperuricemia (gout pts)

caution with pregnancy and lactation

 

*dont take at night (especially elderly), can take with food

Term

hydrochlorothiazide (HCTZ)


drug interactions

Definition

digoxin (lanoxin)- can lead to digtoxicity in otherwise safe dose

ototoxic drugs- additive effect

potassium sparing diurectics- will balance out potassium levels when pt needs more

(^same as lasix)

NSAIDs may blunt diuretic effect

*natural licorice causes potassium loss*

Term

hydrochlorothiazide (HCTZ)


nursing interventions

Definition

monitor glucose in DM pts

Monitor uric acid levels

monitor for s/s gout, gouty arthritis

 

*may take with food to reduce GI upset

Term

spironolactone (Aldactone)

"Potassium- Sparing Diuretics"


uses

Definition

cause modest increase in UOP & substantial decrease in potassium excretion

 

this diuretic specifically works as an aldosterone antagonist (blocks aldosterone)

 

Used to treat certain patients with hyperaldosteronism (body produces too much aldosterone), low potassium levels, & in patients with edema caused by including heart, liver, or kidney disease. Spironolactone is used alone or with other medications to treat high blood pressure.

Term

spironolactone (Aldactone)


MOA

Definition

blocks action of aldosterone in distal nephron therefore retention of K and increase excretion of NA

 

scanty diuresis as it mostly occurs in loop

Term

spironolactone (Aldactone)


routes & pharmacokinetics

Definition

only oral: onset 24-48 hours duration 48-72 hours

Term

spironolactone (Aldactone)


uses

Definition

HTN

Edema

CHF

primary hyperaldosteronism

Term

spironolactone (Aldactone)


Adverse effects

Definition

hyperkalemia- watch that electrolytes dont get high

Term

spironolactone (Aldactone)


contraindications

Definition

renal failure/hyperkalema- already have high K

 

pregnancy/lactation/children

Term

spironolactone (Aldactone)


drug interaction

Definition

potassium supplements/salk substitues (made with KCl)

caution with ACE inhibitors

digoxin- increase effect

Term

spironolactone (Aldactone)


nursing intervention/teaching

Definition

monitor I&O, daily weights

MONITOR K!!!!!

monitor BP

 

may take with food to reduce GI upset

Term

mannitol (Osmitrol)

 

"osmotic diuretics"

 

Definition

freely filtered at glomerulus with minimal reabsorption


not metabolized to a significant degreee


acts by creating osmotic force within lumen of nephron w/out effect on electrolytes


Term

mannitol (Osmitrol)

 

route & pharmacokinetics

Definition

IV ONLY

onset 30-60 mins, duration 6-8 hrs

excreted intact in urine

Term

mannitol (Osmitrol)

 

uses

Definition

prophylaxis of renal failure

reduction of ICP (pulls fluid out of brain tissue)

reduction in IOP (for eye surgery)


Term

mannitol (Osmitrol)

 

Adverse effects

Definition

edema (extravascular)


transient volume expansin


electrolyte imbalances


dehydration

Term

mannitol (Osmitrol)

 

nursing interventions

Definition

use filter needle and inline filter for admin


monitor IV site


monitor fluid status (I&O, weights)


monitor VS, ICP, central venous pressure readings


monitor for eye pain, change in vision


monitor BUN and electrolytes

Term

potassium chloride

 

oral form?

Definition

can NOT be crushed

Term

potassium chloride

 

when should it be held?

Definition

hyperkalemia- CALL DOC!

Term

Sodium polystyrene sulfonate (Kayexalate)


what is it used for?

Definition

resin that gets rid of too much K

Term

Sodium polystyrene sulfonate (Kayexalate)


where does it work?


Definition

exchanges sodium for potassium

Term

Sodium polystyrene sulfonate (Kayexalate)


what route?

Definition

oral or rectal (may cause diarrhea)

Term

Sodium polystyrene sulfonate (Kayexalate)


contraindications?

Definition

CHF pts, if potassium isnt high

Term

Sodium polystyrene sulfonate (Kayexalate)


precautions?

Definition

telemetry- watch EKG

Term

Sodium polystyrene sulfonate (Kayexalate)


Adverse effects

Definition

may alter other drugs absorption

 

cant use if pt has fecal impactions

 

diarrhea, causes GI effects

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