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Diuretics are drugs that primarily increase the excretion of sodium. To some extent, they also increase the volume of urine produced by the kidneys. By blocking the absorptive capacity of cells lining the renal tubules for sodium, intravascular volume and the eventual leaking of fluid from capillaries is reduced and prevented. It is used in the management of diseases like glaucoma, hypertension, and edema in heart failure, liver failure, and renal diseases. Diuretics: Generic and Brand NamesHere is a table of commonly encountered diuretic agents, their generic names, and brand names:
Disease Spotlight: Edema, Hypertension, and GlaucomaEdema is the accumulation of fluids in the interstitial spaces. It can be typically seen in patients with heart failure (HF), cirrhosis and other liver diseases, and renal diseases.
Hypertension is persistent higher-than-normal blood pressure and is primarily idiopathic (no known cause). When not acted upon promptly, this can lead to multiple organ failure and severe cardiovascular complications. Diuretic agents are used in management of hypertension to reduce blood pressure by decreasing circulating fluid volume and sodium. Glaucoma is an eye disease that is characterized by increased intraocular pressure (IOP), which is the pressure inside the eyes. When not acted upon promptly, high IOP can damage optic nerve and cause irreversible blindness. Diuretic agents are used in the management of glaucoma by enhancing the osmotic pull to effectively remove some fluid in the eye, decreasing the IOP. Thiazide and Thiazide-like Diuretics
Therapeutic Action
Indication
Children
Adults
Older adults
Pharmacokinetics
Contraindications and Cautions
Adverse Effects
Interactions
Loop Diuretics
Therapeutic Action
Indications
Children
Adults
Pregnant women
Older adults
Pharmacokinetics
Contraindications and Cautions
Adverse Effects
Interactions
Carbonic Anhydrase Inhibitors
Therapeutic Action
Indications
Children
Adults
Pregnant women
Older adults
Pharmacokinetics
Contraindications and Cautions
Adverse Effects
Interactions
Potassium-Sparing Diuretics
Therapeutic Action
Indications
Children
Adults
Pregnant Women
Older adults
Pharmacokinetics
Contraindications and Cautions
Adverse Effects
Interactions
Osmotic Diuretics
Therapeutic Action
Indications
Children
Adults
Pregnant women
Older adults
Pharmacokinetics
Contraindications and Cautions
Adverse Effects
Here are important nursing considerations when administering this drug: Nursing AssessmentThese are the important things the nurse should include in conducting assessment, history taking, and examination:
Nursing DiagnosesHere are some of the nursing diagnoses that can be formulated in the use of this drug for therapy: Implementation with RationaleThese are vital nursing interventions done in patients who are taking diuretics:
EvaluationHere are aspects of care that should be evaluated to determine effectiveness of drug therapy:
Practice Quiz: Diuretic AgentsQuiz time! Take our 5-item quiz about diuretic agents! Questions 1. Most diuretics’ effect in the body is __________. A. loss of sodiumB. loss of potassiumC. loss of calcium D. retention of potassium 2. What is the only potassium-sparing diuretics that can be used in children? A. FurosemideB. SpironolactoneC. Amiloride D. Triamterene 3. A patient receiving diuretics should alert the nurse if she feels the following: A. insomnia D. all of the above 4. What is the first loop diuretic introduced? A. FurosemideB. BumetanideC. Torsemide D. Ethacrynic acid 5. A patient admitted for cerebral swelling complained of feeling light-headed and nauseous while receiving mannitol. What should the nurse do? A. Document, withdraw, and notify doctor.B. Decrease mannitol flow.C. Provide comfort measures. D. Increase mannitol flow. Answers and Rationale 1. Answer: A. loss of sodium. Most diuretics prevent cells lining the renal tubules from reabsorbing an excessive proportion of the sodium ions in the glomerular filtrate. 2. Answer: B. Spironolactone. Potassium-sparing diuretics include spironolactone, amiloride, and triamterene. Both amiloride and triamterene are not for use in children. Use of spironolactone in children would require careful monitoring of electrolytes. 3. Answer: C. muscle weakness. This is a sign of hypokalemia and would require prompt intervention. Other signs and symptoms of hypokalemia include arrhythmia and muscle cramps. 4. Answer: A. Furosemide
5. Answer: A. Document, withdraw, and notify doctor. A sudden drop in fluid level is one of the most potentially fatal adverse effects of mannitol. Manifestations include hypotension, lightheadedness, nausea, and confusion. Recommended ResourcesRecommended resources and reference books. Disclosure: Includes Amazon affiliate links. See AlsoHere are other nursing pharmacology study guides:
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Nervous System Drugs Cardiovascular System Drugs References and SourcesReferences and sources for this pharmacology guide for Diuretics:
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