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Questions and Answers
Which diuretic works by inhibiting sodium and chloride reabsorption in the ascending limb of the loop of Henle?
Which diuretic works by inhibiting sodium and chloride reabsorption in the ascending limb of the loop of Henle?
- Loop diuretics (correct)
- Thiazide diuretics
- Potassium-sparing diuretics
- Osmotic diuretics
What is the drug of choice for producing rapid effects and significant diuresis?
What is the drug of choice for producing rapid effects and significant diuresis?
- Osmotic diuretics
- Loop diuretics (correct)
- Thiazide diuretics
- Potassium-sparing diuretics
Which diuretic is effective in patients with low glomerular filtration rate (GFR)?
Which diuretic is effective in patients with low glomerular filtration rate (GFR)?
- Loop diuretics (correct)
- Thiazide diuretics
- Potassium-sparing diuretics
- Osmotic diuretics
Which diuretic is the drug of choice for long-term management of hypertension and heart failure edema?
Which diuretic is the drug of choice for long-term management of hypertension and heart failure edema?
Which diuretic competes for aldosterone-sensitive Na+/K+ channel at the distal tubule of the nephron to decrease sodium and water reabsorption and potassium excretion?
Which diuretic competes for aldosterone-sensitive Na+/K+ channel at the distal tubule of the nephron to decrease sodium and water reabsorption and potassium excretion?
Which diuretic is referred to as 'potassium sparing'?
Which diuretic is referred to as 'potassium sparing'?
Which diuretic produces rapid diuresis by increasing the solute load (osmotic pressure) of the glomerular filtrate?
Which diuretic produces rapid diuresis by increasing the solute load (osmotic pressure) of the glomerular filtrate?
Loop diuretics inhibit sodium and chloride reabsorption in the descending limb of the loop of Henle.
Loop diuretics inhibit sodium and chloride reabsorption in the descending limb of the loop of Henle.
Thiazide diuretics are the drug of choice for rapid effects and significant diuresis.
Thiazide diuretics are the drug of choice for rapid effects and significant diuresis.
Osmotic diuretics work by increasing the solute load of the glomerular filtrate.
Osmotic diuretics work by increasing the solute load of the glomerular filtrate.
Furosemide (Lasix) is contraindicated in patients with hepatic impairment.
Furosemide (Lasix) is contraindicated in patients with hepatic impairment.
Hydrochlorothiazide is a stronger diuretic compared to furosemide (Lasix).
Hydrochlorothiazide is a stronger diuretic compared to furosemide (Lasix).
Spironolactone (Aldactone) is commonly used to treat hypertension and hyperaldosteronism.
Spironolactone (Aldactone) is commonly used to treat hypertension and hyperaldosteronism.
Mannitol (Osmitrol) is primarily used to reduce intraocular pressure before ophthalmic surgery.
Mannitol (Osmitrol) is primarily used to reduce intraocular pressure before ophthalmic surgery.
Match the following diuretics with their descriptions:
Match the following diuretics with their descriptions:
Match the following diuretics with their indications for use:
Match the following diuretics with their indications for use:
Match the following diuretics with their adverse effects:
Match the following diuretics with their adverse effects:
Match the following diuretics with their correct descriptions:
Match the following diuretics with their correct descriptions:
Match the following diuretics with their contraindications:
Match the following diuretics with their contraindications:
Match the following diuretics with their adverse effects:
Match the following diuretics with their adverse effects:
Match the following diuretics with their primary uses:
Match the following diuretics with their primary uses:
Which diuretic is commonly used to treat hypertension and hyperaldosteronism?
Which diuretic is commonly used to treat hypertension and hyperaldosteronism?
Which diuretic works by inhibiting sodium and chloride reabsorption in the ascending limb of the loop of Henle?
Which diuretic works by inhibiting sodium and chloride reabsorption in the ascending limb of the loop of Henle?
Which diuretic is the drug of choice for rapid effects and significant diuresis?
Which diuretic is the drug of choice for rapid effects and significant diuresis?
Which diuretic is commonly used to treat hypertension, ascites, hypokalemia, and hyperaldosteronism?
Which diuretic is commonly used to treat hypertension, ascites, hypokalemia, and hyperaldosteronism?
Which diuretic should be used with caution in patients with renal failure and hepatic disease?
Which diuretic should be used with caution in patients with renal failure and hepatic disease?
Which diuretic is contraindicated in patients with sulfonamide allergy and pregnancy?
Which diuretic is contraindicated in patients with sulfonamide allergy and pregnancy?
Which diuretic is primarily used to reduce intracranial pressure for neurosurgery and intraocular pressure before ophthalmic surgery?
Which diuretic is primarily used to reduce intracranial pressure for neurosurgery and intraocular pressure before ophthalmic surgery?
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Study Notes
Diuretics
- Diuretics are drugs that treat excess fluid in the body by increasing urine formation and output.
- Indications for diuretic administration: edema, heart failure, renal disease, hepatic disease, hypertension, and increased intracranial pressure.
Renal Physiology
- The nephron is the functional unit of the kidney, and diuretic drugs work on different sites of the nephron.
Loop Diuretics
- Prototype: furosemide (Lasix)
- Mechanism of action: inhibit sodium and chloride reabsorption in the ascending limb of the loop of Henle
- Uses: rapid diuresis, effective in patients with low GFR
- Cautions: chronic renal failure, hepatic impairment, sulfonamide allergy, pregnancy
- Adverse effects: hyponatremia, hypokalemia, excess fluid loss, ototoxicity
Thiazide Diuretics
- Prototype: hydrochlorothiazide
- Mechanism of action: decrease reabsorption of sodium, water, chloride, and bicarbonate in the distal convoluted tubule
- Uses: long-term management of hypertension and heart failure edema
- Cautions: hepatic impairment, sulfonamide sensitivity, renal failure, anuria, pregnancy
- Adverse effects: hearing impairment, tinnitus, dizziness, ototoxicity
Potassium-Sparing Diuretics
- Prototype: spironolactone (Aldactone)
- Mechanism of action: competes for aldosterone-sensitive Na+/K+ channel at the distal tubule to decrease sodium and water reabsorption and potassium excretion
- Uses: heart failure, ascites, hypokalemia, hypertension, hyperaldosteronism
- Cautions: renal failure, hepatic disease, potassium-rich foods
- Adverse effects: deepening of the voice, gynecomastia, menstrual irregularities, and testicular atrophy
- Black box warning: tumorigenic
Osmotic Diuretics
- Prototype: mannitol (Osmitrol)
- Mechanism of action: increases the solute load (osmotic pressure) of the glomerular filtrate, pulling water from extravascular sites into the bloodstream
- Uses: managing oliguria or anuria, reducing ICP for neurosurgery, reducing IOP before ophthalmic surgery, excreting toxic substances
Caring for Patients on Diuretics
- Assessment: baseline fluid excess, contraindications, and timing of administration
- Interventions: education on salt and potassium intake, monitoring for adverse effects, and assessing therapeutic outcomes
- Evaluation: weighing patients, intake/output monitoring
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