Podcast
Questions and Answers
What is a potential side effect of thiazide and thiazide-like diuretics?
What is a potential side effect of thiazide and thiazide-like diuretics?
- Hyperkalemia
- Hypocalcemia
- Ototoxicity
- Hypokalemia (correct)
What is the primary site of action for loop diuretics?
What is the primary site of action for loop diuretics?
- Proximal tubule
- Loop of Henle (correct)
- Distal tubule
- Glomerulus
When are diuretics typically recommended to be administered?
When are diuretics typically recommended to be administered?
- In the evening
- In the morning (correct)
- At noon
- Before bedtime
Which class of diuretics is associated with inducing hyperuricemia?
Which class of diuretics is associated with inducing hyperuricemia?
Which diuretic class specifically causes an osmotic effect to lower intraocular pressure in glaucoma treatment?
Which diuretic class specifically causes an osmotic effect to lower intraocular pressure in glaucoma treatment?
What side effect is commonly associated with potassium-sparing diuretics?
What side effect is commonly associated with potassium-sparing diuretics?
Which diuretic class is primarily used to treat edema by increasing urine output?
Which diuretic class is primarily used to treat edema by increasing urine output?
What could be a special use of carbonic anhydrase inhibitors?
What could be a special use of carbonic anhydrase inhibitors?
What is the primary effect of thiazide diuretics on potassium levels?
What is the primary effect of thiazide diuretics on potassium levels?
Which diuretic is primarily associated with increased calcium excretion?
Which diuretic is primarily associated with increased calcium excretion?
What common side effect is shared by both thiazide and loop diuretics?
What common side effect is shared by both thiazide and loop diuretics?
What mechanism do thiazide diuretics use to exert their effects in the kidney?
What mechanism do thiazide diuretics use to exert their effects in the kidney?
Which diuretic would be least likely to cause hyperuricemia?
Which diuretic would be least likely to cause hyperuricemia?
Which of the following conditions can thiazide diuretics potentially exacerbate due to their side effect profile?
Which of the following conditions can thiazide diuretics potentially exacerbate due to their side effect profile?
What is the prototype drug for loop diuretics?
What is the prototype drug for loop diuretics?
What is a potential outcome of decreased calcium excretion due to thiazide diuretics?
What is a potential outcome of decreased calcium excretion due to thiazide diuretics?
Which electrolyte imbalance should a nurse assess for when a patient is on diuretics?
Which electrolyte imbalance should a nurse assess for when a patient is on diuretics?
What should a nurse monitor to evaluate the effectiveness of diuretic therapy?
What should a nurse monitor to evaluate the effectiveness of diuretic therapy?
Which of the following foods should be provided to a patient on most diuretics?
Which of the following foods should be provided to a patient on most diuretics?
What nursing diagnosis is related to the effect of diuretics?
What nursing diagnosis is related to the effect of diuretics?
Which vital sign change may indicate a need for caution when administering diuretics?
Which vital sign change may indicate a need for caution when administering diuretics?
What is an important assessment to perform before administering diuretics?
What is an important assessment to perform before administering diuretics?
What precaution should be taken when administering IV diuretics?
What precaution should be taken when administering IV diuretics?
What is the role of Spironolactone in diuretic therapy?
What is the role of Spironolactone in diuretic therapy?
Which of the following conditions requires careful assessment when a patient is prescribed diuretics?
Which of the following conditions requires careful assessment when a patient is prescribed diuretics?
What is a common side effect associated with the use of Carbonic Anhydrase Inhibitors like Acetazolamide?
What is a common side effect associated with the use of Carbonic Anhydrase Inhibitors like Acetazolamide?
Which diuretic is primarily associated with causing hypocalcemia?
Which diuretic is primarily associated with causing hypocalcemia?
Which of the following is a potassium-sparing diuretic?
Which of the following is a potassium-sparing diuretic?
How does Mannitol contribute to diuresis in the nephron?
How does Mannitol contribute to diuresis in the nephron?
What dietary restriction should patients on Carbonic Anhydrase Inhibitors observe?
What dietary restriction should patients on Carbonic Anhydrase Inhibitors observe?
Which medication blocks potassium secretion in the distal tubule?
Which medication blocks potassium secretion in the distal tubule?
What is a potential consequence of using diuretics that cause electrolyte imbalances?
What is a potential consequence of using diuretics that cause electrolyte imbalances?
Study Notes
Diuretics - Overview
- Increase urine production by kidneys
- Five main classes: Thiazides, Loop diuretics, Potassium-sparing, Carbonic Anhydrase inhibitors, Osmotic diuretics
- General Indications:
- Treatment of edema: increases urine output to flush out excess fluid
- Treatment of CHF: sodium loss associated with water loss
- Treatment of Hypertension: sodium loss in the kidney results in water loss
Diuretic Class Comparison
- Carbonic Anhydrase Inhibitor: Proximal tubule - Acidosis side effect
- Thiazide and Thiazide-like: Proximal tubule - Hyperuricemia, Hypokalemia side effects
- Loop diuretics: Loop of Henle - Hypokalemia, Ototoxicity side effects
- Potassium-Sparing: Distal tubule - Hyperkalemia side effect
- Osmotic: Glomerulus - Hypovolemia and hypotension side effects
Special Uses
- Carbonic Anhydrase Inhibitor: Mountain sickness, Meniere’s disease
- Thiazide and thiazide-like: Nephrolithiasis due to calcium stones, Hypocalcemia
- Loop diuretics: Hypercalcemia
- Potassium Sparing: CHF taking digoxin
- Osmotic diuretic: Increased ICP, Lithium toxicity
Thiazides and Thiazide-like
- Prototype: Hydrochlorothiazide
- Block chloride pump → sodium and chloride stay in the distal tubule and exit in urine
- Potassium also flushes out, leading to Hypokalemia
- Other side effects: Decreased calcium excretion (hypercalcemia), Decreased uric acid secretion (hyperuricemia), Hyperglycemia
Loop Diuretics
- Prototype: Furosemide
- High-ceiling diuretics: Block chloride pump in ascending loop of Henle → prevents sodium and chloride reabsorption
- Potassium also excreted together with sodium and chloride (Hypokalemia)
- Side effects: Hypokalemia, Bicarbonate loss (increased calcium excretion → hypocalcemia), Ototoxicity
Potassium Sparing
- Prototype: Spironolactone (aldosterone antagonist)
- Triamterene and Amiloride block potassium secretion in distal tubule, leading to sodium loss and potassium retention
- Side effects: Hyperkalemia
Osmotic Diuretics
- Prototype: Mannitol (sugar not absorbed in nephron → osmotic pull of water → diuresis)
- Side Effects: Hypovolemia - nurse should warm solution to allow crystals to dissolve
Carbonic Anhydrase Inhibitors
- Prototype: Acetazolamide
- Carbonic Anhydrase catalyzes sodium bicarbonate formation
- Enzyme blockage slows hydrogen and bicarbonate movement into tubules
- Sodium is lost in urine
- Side Effects: Metabolic acidosis (bicarbonate loss), Hypokalemia
Nursing Process and The Diuretics
- Assessment:
- Reason for drug administration
- Allergy history to sulfonamides (contraindicated for thiazides)
- Fluid and electrolyte balance
- Other conditions: Gout, diabetes, pregnancy, lactation
- Vital signs
- Special electrolyte and laboratory examinations
- Symptoms of body weakness (indicates hypokalemia)
- Nursing Diagnosis:
- Fluid volume deficit related to diuretic effect
- Alteration in urinary pattern
- Potential for injury (ototoxicity, hypotension)
- Knowledge deficit
- Implementation:
- Administer IV drug slowly
- Safety precautions for dizziness/hypotension
- Provide potassium-rich foods for most diuretics, except spironolactone
- Skin care, oral care, and urinary care
- Monitor daily weight to evaluate therapy effectiveness
- Monitor urine output and cardiac rhythm
- Evaluation:
- Resolution of edema
- Decreased congestion
- Normal BP
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Description
Explore the different classes of diuretics and their specific uses. Learn about the mechanisms of action, indications for treatment, and potential side effects for each class, including Thiazides, Loop diuretics, Potassium-sparing, Carbonic Anhydrase inhibitors, and Osmotic diuretics. This quiz is essential for understanding renal pharmacotherapy.
