6 Questions
Loop diuretics can cause __________ that manifests as tinnitus, hearing impairment, deafness, vertigo, and a sense of fullness in the ears.
ototoxicity
Loop diuretics should be avoided in postmenopausal osteopenic women, in whom increased Ca2+ excretion may have deleterious effects on _______ metabolism.
bone
Increased Na+ delivery to the distal tubule, particularly when combined with activation of the renin– angiotensin system, leads to increased urinary K+ and H+ excretion, causing a __________ alkalosis.
hypochloremic
What are some of the adverse effects of overzealous use of loop diuretics?
Serious depletion of total-body Na+, hyponatremia, extracellular fluid volume depletion, hypotension, reduced GFR, circulatory collapse, thromboembolic episodes, hepatic encephalopathy, hypochloremic alkalosis, hypokalemia, cardiac arrhythmias, hypomagnesemia, hypocalcemia, ototoxicity, hyperuricemia, hyperglycemia, increased plasma levels of LDL cholesterol and triglycerides while decreasing plasma levels of HDL cholesterol, skin rashes, photosensitivity, paresthesias, bone marrow depression, and GI disturbances.
What are the contraindications to the use of loop diuretics?
Severe Na+ and volume depletion, hypersensitivity to sulfonamides (for sulfonamide-based loop diuretics), and anuria unresponsive to a trial dose of loop diuretic.
What drug interactions may occur when loop diuretics are coadministered with other medications?
Aminoglycosides, carboplatin, paclitaxel, and others (synergism of ototoxicity), anticoagulants (increased anticoagulant activity), digitalis glycosides (increased digitalis-induced arrhythmias), lithium (increased plasma levels of Li+), propranolol (increased plasma levels of propranolol), sulfonylureas (hyperglycemia), cisplatin (increased risk of diuretic-induced ototoxicity), NSAIDs (blunted diuretic response and salicylate toxicity with high doses of salicylates), probenecid (blunted diuretic response), thiazide diuretics (synergism of diuretic activity of both drugs, leading to profound diuresis), and amphotericin B (increased potential for nephrotoxicity and intensification of electrolyte imbalance).
Test your knowledge on the adverse effects of loop diuretics and their impact on fluid and electrolyte balance. Learn about the risks of overusing these medications and the potential consequences of total-body sodium depletion. Explore the associated symptoms such as hyponatremia, hypotension, and thromboembolic episodes, and understand how liver disease can exacerbate these effects. Increase your understanding of how to manage electrolyte imbalances and prevent serious complications. Take the quiz now and become an expert on
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