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Questions and Answers
What is the primary mechanism of action of loop diuretics?
What is the primary mechanism of action of loop diuretics?
- They promote water reabsorption in the distal convoluted tubule.
- They block reabsorption of sodium and chloride in the loop of Henle. (correct)
- They enhance sodium reabsorption in the kidneys.
- They increase potassium retention in the kidneys.
Which of the following conditions is Furosemide commonly indicated for?
Which of the following conditions is Furosemide commonly indicated for?
- Congestive heart failure (correct)
- Hypokalemia
- Hypertension without fluid overload
- Chronic kidney disease stage 1
What is a major adverse effect associated with the use of loop diuretics like Furosemide?
What is a major adverse effect associated with the use of loop diuretics like Furosemide?
- Weight gain
- Increased thirst
- Hyperkalemia
- Hypochloremia (correct)
Which electrolyte imbalance is particularly concerning in patients taking loop diuretics?
Which electrolyte imbalance is particularly concerning in patients taking loop diuretics?
What should patients be instructed to monitor while taking Furosemide?
What should patients be instructed to monitor while taking Furosemide?
Which of the following drugs may interact with loop diuretics leading to increased risk of toxicity?
Which of the following drugs may interact with loop diuretics leading to increased risk of toxicity?
Why is Furosemide useful in patients with renal impairment?
Why is Furosemide useful in patients with renal impairment?
What is an essential baseline data point to collect before starting treatment with a loop diuretic?
What is an essential baseline data point to collect before starting treatment with a loop diuretic?
What is a significant risk associated with using loop diuretics in patients taking digoxin?
What is a significant risk associated with using loop diuretics in patients taking digoxin?
Which symptom indicates a possible case of dehydration in patients on loop diuretics?
Which symptom indicates a possible case of dehydration in patients on loop diuretics?
Which of the following should patients be advised to do if they experience postural hypotension?
Which of the following should patients be advised to do if they experience postural hypotension?
What is the recommended approach to minimize potassium loss in patients using loop diuretics?
What is the recommended approach to minimize potassium loss in patients using loop diuretics?
Which group of patients is particularly at risk for dysrhythmias when using loop diuretics with digoxin?
Which group of patients is particularly at risk for dysrhythmias when using loop diuretics with digoxin?
What effect can loop diuretics have on patients who are pregnant?
What effect can loop diuretics have on patients who are pregnant?
What symptom might suggest an adverse reaction to loop diuretics?
What symptom might suggest an adverse reaction to loop diuretics?
Why is careful dosage adjustment important for patients on loop diuretics?
Why is careful dosage adjustment important for patients on loop diuretics?
What is one mechanism by which blood pressure can drop?
What is one mechanism by which blood pressure can drop?
What should be monitored routinely in patients taking digoxin and a diuretic?
What should be monitored routinely in patients taking digoxin and a diuretic?
What is a potential consequence of taking a potassium-sparing diuretic and consuming potassium-rich foods?
What is a potential consequence of taking a potassium-sparing diuretic and consuming potassium-rich foods?
In order to minimize postural hypotension, what advice should be given to patients?
In order to minimize postural hypotension, what advice should be given to patients?
What unique effect is associated with loop diuretics?
What unique effect is associated with loop diuretics?
Why might patients taking digoxin be advised to also take a diuretic?
Why might patients taking digoxin be advised to also take a diuretic?
Which of the following might indicate the need for potassium supplementation?
Which of the following might indicate the need for potassium supplementation?
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Study Notes
Loop Diuretics
- Mechanism of action: Loop diuretics act in the ascending limb of the loop of Henle, blocking the reabsorption of sodium (Na) and chloride (Cl) ions. This prevents the passive reabsorption of water.
- Indications: Loop diuretics are used for:
- Pulmonary edema:
- Edema of hepatic, cardiac, and renal origin:
- Hypertension that cannot be controlled with other diuretics:
- Adverse Effects:
- Hyponatremia
- Hypochloremia
- Dehydration:
- Loss of potassium:
- Hypokalemia:
- Hypotension:
- Drug Interactions:
- Digoxin: Loop diuretics can increase the risk of digoxin toxicity, especially in patients with low potassium levels.
- Patient Education:
- Patients should be taught to monitor their blood pressure and notify the prescriber if it drops substantially.
- Patients should be educated about postural hypotension and advised to sit or lie down if dizziness or lightheadedness occurs.
- Patients should be informed of the potential for dehydration and its signs, including dry mouth, unusual thirst, oliguria, and excessive weight loss.
- Patients should consume potassium-rich foods, consider potassium supplements, or use a potassium-sparing diuretic to minimize potassium loss.
- Patients should be warned about the risk for ototoxicity, which is unique to loop diuretics.
- Follow-up & Monitoring:
- Baseline data: Weight, vital signs, and electrolytes should be monitored regularly.
- Clinical Pearls:
- Furosemide (Lasix) is the most frequently prescribed loop diuretic.
- Loop diuretics can produce diuresis even with low glomerular filtration rate (GFR).
- Use caution in patients with cardiovascular disease, renal impairment, diabetes mellitus, or a history of gout.
- To minimize the risk for dehydration, start with low doses, adjust the dosage carefully, and monitor weight loss daily.
- Combining loop diuretics with digoxin increases the risk of dysrhythmias.
- The risk for digoxin toxicity is increased when patients are hypokalemic.
- Loop diuretics can cause a substantial drop in blood pressure.
Furosemide (Lasix)
- Onset: 60 minutes
- Duration: 8 hours
- Availability: 20mg, 40mg, 80mg tablets
- Doses/Day: 1-2 doses
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