Diuretic Drugs
TERMS
□ acetazolamide (Diamox)
□ furosemide (Lasix)
□ hydrochlorothiazide (Esidrix, Hydro DIURIL)
□ mannitol (Osmitrol)
□ spironalactone (Aldactone)
QUICK LOOK AT THE CHAPTER AHEAD
Diuretics work to prevent resorption of water and sodium and speed up urine formation. Diuretics are classified according to their sites of action, diuretic potency, and chemical structure. Diuretics decrease blood volume, venous pressure, arterial pressure, pulmonary and peripheral edema, and cardiac output.1 They are indicated for clients with fluid overload and are used to treat hypertension, congestive heart failure (CHF), edema, and ascites.
Table 43-1 Diuretic Drugs | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
DIURETIC DRUGS CLIENT TEACHING
Avoid concurrent use of OTCs and herbal remedies without consulting with health care provider.
Eat high potassium foods, except when taking potassium-sparing diuretics.
Change positions gradually to prevent orthostatic hypotension.
Monitor weight and notify health care provider of a weight gain of 5 or more pounds in a week.
Monitor and report symptoms of hypokalemia such as irregular heart rate, lethargy, or muscle weakness or cramping to health care provider.
Follow up with laboratory and health care provider visits as indicated.
Clients with diabetes mellitus need to monitor blood sugar levels as loop and thiazide diuretics can increase blood sugar.
Notify health care provider of symptoms of fluid volume loss or hypotension, such as palpitations.
Maintain fluid balance and notify health care provider if experiencing vomiting or diarrhea.
Avoid alcohol, exercising in hot weather, barbiturates, or opioids to prevent orthostatic hypotension.
Take diuretics in the morning.
Clients taking cardiac glycosides with a diuretic should report symptoms of cardiac glycoside toxicity, such as visual changes, bradycardia, nausea, or anorexia.
Wear sunscreen or protective clothing to prevent photosensitivity.
Eat high potassium foods, except when taking potassium-sparing diuretics.
Change positions gradually to prevent orthostatic hypotension.
Take diuretics in the morning.
ACTIONCarbonic Anhydrase Inhibitors (CAIs)
Inhibit the enzyme carbonic anhydrase found in the eyes, kidneys, and other parts of the body
Work primarily in the proximal tubule of the nephron and also decrease the aqueous humor in the eye2
Loop Diuretics
Potent diuretics that act mainly in the ascending limb of the loop of Henle. They have a rapid onset of action and inhibit reabsorption of sodium and chloride.
Osmotic Diuretics
Work in the proximal tubule and increase osmotic pressure of glomerular filtrate, which inhibits tubular reabsorption of water and electrolytes3
Also decrease intraocular pressure
Potassium-Sparing Diuretics
Block aldosterone receptors and work in the collecting ducts and distal convoluted tubules and interfere with sodium-potassium exchange. The result is excretion of sodium, but a retention of potassium.
Thiazide and Thiazide-Like Diuretics
Thiazides are chemical derivatives of sulfonamides that inhibit tubular reabsorption of sodium and chloride ions in the ascending loop of Henle and in the early distal tubule.4
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
