Diuretics

Osmotic diuretics

100

Lab value that determines how well the kidneys are functioning 

Glomerular Filtration Rate(GFR)

200

Prototype medication

Mannitol

300

Diuretic of choice for what condition?

Increased cranial Pressure

400

Cautions 

Renal disease, anuria, pulmonary congestion, Intracranial bleeding, dehydration, HR all exacerbate 

500

Function of Osmotic diuretics

Pull water into renal tubule without sodium loss

Thiazide & Thiazide like diuretics

100

What are the prototype medications?

Thiazide: Hydrochlorothiazide (generic) 

Thiazide like :chlorthalidone

200

Thiazide/thiazide like diuretics are used to treat what?

Edema of HF, Renal, Liver disease

300

Mild diuretic, 1st choice for HTN

Hydrochlorothiazide

400

Most common AE

Fluid/electrolyte imbalance

Hypotension (hold for low, systolic less than 100)

Hypokalemia - muscle cramps, arrhythmias

500

Drug-drug interaction

Digoxin - Hypokalemia, Toxicity

Lithium - Hyponatremia, toxicity

Loop diuretics

100

Prototype medication 

Furosemide 

200

AE of loop diuretics

Hypokalemia, 

hypocalcemia, 

hypotension and dizziness

Ototoxicity and deafness

300

Less powerful diuretic, great for at home use 

Furosemide

400

Indications for loop diuretics

Rapid and Extensive Diuresis up to 20 pounds 

Acute HF,

 Acute Pulmonary Edema

Edema associated w/ HF, renal/liver disease,HTN

500

Associated labs 

HCT, BUN, Specific gravity increase

Osmotic

100

Prototype medication

Mannitol

200

What are three indications for Mannitol?

reduction of intracranial pressure before or after neurosurgery, 

reduction of intraocular pressure before certain types of ophthalmic surgery

Prevent AKI 

300

What routes can Mannitol be administered? 

IV 

400

Double Jeopardy: 

A patient reports a drug allergy to sulfonamides. Which diuretic drug class should the nurse question if ordered for the patient?

500

Double Jeopardy

This diuretic's maximal effects may take up to 6 weeks to occur. 

Potassium sparing diuretics

100

Prototype medication 

Spironolactone

200

Indication 

Patients who are at risk for developing hypokalemia

300

Side effects of Potassium sparing diuretics

Gynecomastia

testicular atrophy

Menstrual irregularities

elevated potassium levels

400

What is the black box warning associated with Spironolactone?

Investigations have shown that the drug is tumorigenic with chronic toxicity in rats; unnecessary use should be avoided.

500

Spironolactone causes the loss of what, and the retention of what?

loss of sodium and water 

retention of potassium