Diuretics Overview and Class Comparison
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Diuretics Overview and Class Comparison

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Questions and Answers

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?

  • Proximal tubule
  • Loop of Henle (correct)
  • Distal tubule
  • Glomerulus

    • 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?

    <p>Thiazides</p> Signup and view all the answers

    Which diuretic class specifically causes an osmotic effect to lower intraocular pressure in glaucoma treatment?

    <p>Osmotic diuretics</p> Signup and view all the answers

    What side effect is commonly associated with potassium-sparing diuretics?

    <p>Hyperkalemia</p> Signup and view all the answers

    Which diuretic class is primarily used to treat edema by increasing urine output?

    <p>Loop diuretics</p> Signup and view all the answers

    What could be a special use of carbonic anhydrase inhibitors?

    <p>Managing glaucoma</p> Signup and view all the answers

    What is the primary effect of thiazide diuretics on potassium levels?

    <p>Potassium flushing out</p> Signup and view all the answers

    Which diuretic is primarily associated with increased calcium excretion?

    <p>Loop diuretics</p> Signup and view all the answers

    What common side effect is shared by both thiazide and loop diuretics?

    <p>Hypokalemia</p> Signup and view all the answers

    What mechanism do thiazide diuretics use to exert their effects in the kidney?

    <p>Inhibit the chloride pump in the ascending loop of Henle</p> Signup and view all the answers

    Which diuretic would be least likely to cause hyperuricemia?

    <p>Potassium-sparing diuretics</p> Signup and view all the answers

    Which of the following conditions can thiazide diuretics potentially exacerbate due to their side effect profile?

    <p>Nephrolithiasis due to calcium stones</p> Signup and view all the answers

    What is the prototype drug for loop diuretics?

    <p>Furosemide</p> Signup and view all the answers

    What is a potential outcome of decreased calcium excretion due to thiazide diuretics?

    <p>Hypercalcemia</p> Signup and view all the answers

    Which electrolyte imbalance should a nurse assess for when a patient is on diuretics?

    <p>Hypokalemia</p> Signup and view all the answers

    What should a nurse monitor to evaluate the effectiveness of diuretic therapy?

    <p>Daily weight</p> Signup and view all the answers

    Which of the following foods should be provided to a patient on most diuretics?

    <p>Spinach</p> Signup and view all the answers

    What nursing diagnosis is related to the effect of diuretics?

    <p>Fluid volume deficit</p> Signup and view all the answers

    Which vital sign change may indicate a need for caution when administering diuretics?

    <p>Hypotension</p> Signup and view all the answers

    What is an important assessment to perform before administering diuretics?

    <p>Assess for allergy history</p> Signup and view all the answers

    What precaution should be taken when administering IV diuretics?

    <p>Administer slowly to avoid complications</p> Signup and view all the answers

    What is the role of Spironolactone in diuretic therapy?

    <p>It is a potassium-sparing diuretic.</p> Signup and view all the answers

    Which of the following conditions requires careful assessment when a patient is prescribed diuretics?

    <p>Chronic kidney disease</p> Signup and view all the answers

    What is a common side effect associated with the use of Carbonic Anhydrase Inhibitors like Acetazolamide?

    <p>Metabolic acidosis</p> Signup and view all the answers

    Which diuretic is primarily associated with causing hypocalcemia?

    <p>Indapamide</p> Signup and view all the answers

    Which of the following is a potassium-sparing diuretic?

    <p>Triamterene</p> Signup and view all the answers

    How does Mannitol contribute to diuresis in the nephron?

    <p>By creating an osmotic pull for water</p> Signup and view all the answers

    What dietary restriction should patients on Carbonic Anhydrase Inhibitors observe?

    <p>High potassium foods</p> Signup and view all the answers

    Which medication blocks potassium secretion in the distal tubule?

    <p>Amiloride</p> Signup and view all the answers

    What is a potential consequence of using diuretics that cause electrolyte imbalances?

    <p>Ototoxicity</p> Signup and view all the answers

    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.

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