Diuretics and Fluid Electrolytes 2024 PDF

FLUID VOLUME & ELECTROLYTES 2024 TYSAK: Terms such as Hypertonic (solution is greater concentration than plasma) Isotonic (solutions is same concentration as plasma) Hypotonic (solutions is less concentration than plasma) ELECTROLYTE IMBALANCES: Potassium imbalance: pg. 720 Treat low potassium—has “...

FLUID VOLUME & ELECTROLYTES 2024 TYSAK: Terms such as Hypertonic (solution is greater concentration than plasma) Isotonic (solutions is same concentration as plasma) Hypotonic (solutions is less concentration than plasma) ELECTROLYTE IMBALANCES: Potassium imbalance: pg. 720 Treat low potassium—has “potassium” in the name; used to prevent problems and to treat problems. Prototype: potassium chloride, oral and IV Treat high potassium—do not eat foods or take medicines with K in them Use sodium polystyrene sulfonate or dialysis DIURETICS (Therapy for Fluid Volume Excess) (Ch. 34) 2022 Review 680 Terms—nephron, glomerulus of Anatomy Physiology: and Urine is formed by filtrations, reabsorption (99%) and tubular Physiology secretion. Kidneys maintain fluid and electrolyte balance and acid-base balance. Sites of Sodium Absorption and Diuretic Action—see Fig. 34.2 Generally speaking, diuretics block Na and Cl reabsorption, so more urine is excreted because if Na excretion increases, the water follows. Can have a profound effect. Terms to know—polyuria, oliguria, dysuria, anuria Major Classification of Diuretics Thiazide diuretic, pg. 686 furosemide hydrochlorothiazide --blocks Na & Cl Blocks Na & Cl in early reabsorption in loop of Henle distal convoluted tubule --Na excretion increases, and Less potent so more water follows suitable for outpatient --PO: 60 min. use. IV: 5 min. Often first drug Loop diuretic, pg. 682 Prototype Mechanism of Action and Pharmaco kinetics Therapeutic uses Adverse effects Drug Interactions Other information Potassium- 689 sparing diuretic spironolactone Inhibits the Na-K pump. K is not in the tubule, so it’s not secreted, but Na remains in tubule and is excreted Called potassiumsparing diuretic Hypertension Edema Heart Failure (HF) Pulmonary edema Hyponatremia, Hypochloremia, Dehydration. Hypotension Hypokalemia Ototoxicity Hypertension Edema ------Hyponatremia, Hypochloremia, Dehydration Hypokalemia Hyperkalemia Digoxin—because K depleted Aspirin—takes place of ASA, so increases ASA in system Lithium--electrolyte Same as loop Other diuretics Caution if renal impaired, CV or hepatic disease; Category C Caution if renal or hepatic disease. Drugs differ in onset, peak & duration Triamterene— similar, directly inhibits Na/K exchange Dizziness, h/a, diarrhea and endocrine effects Osmotic diuretic, 691 mannitol Completely different mechanism. No effect on Na & K. Creates osmotic force. Prevents renal failure. Reduces ICP & decreases IOP Edema, n/v, headache Lithium