Other potassium sparing other diuretics examples

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Unformatted text preview: ent diuretics • Spironolactone – actually inhibits aldosterone – has no effect on adrenalectomized person • Used either: – In combination with a thiazide, or – When other diuretics are toxic or ineffective • Cautions: – potassium retention (and hyperkalemia) – gynecomastia (enlarged breasts). Other Potassium Sparing Other Diuretics • Examples: – Triamterene (Dyrenium®) and similar drug amiloride (Midamor®) • Mechanism – has effects antagonistic to aldosterone – works independent of amount of aldosterone in system • Used in combination with thiazide. Dyazide® = triamterene and Dyazide Hydrochlorothiazide. • Elevates blood urea with chronic administration • May elevate blood glucose • Caution: – potassium retention (causing hyperkalemia) Osmotic Diuretics Osmotic • Examples: – Parenteral = Mannitol, urea – Oral = glycerin, isosorbide • Used to: – Withdraw water from overhydrated cells • especially in brain or eye – Maintain high volume of urine – Prevent renal failure following hemolytic reaction, shock, hemorrhage, or surgery – Helps eliminate drug overdose such as barbiturates or salicylates • Does not extract abnormal amounts of fluid from body – Not for edema because does not eliminate sodium ion – Caution: • CHF, pulmonary edema, severe hypertension. • Problem: Potential for circulatory overload & transient increase in BP Objective 7: Objective Identify some common causes, symptoms, and treatments of selected fluid and electrolyte disturbances. Chiefly Replacement Therapy Chiefly • Water and Sodium - regulated together in most cases • Water very important: – Loss of 20-25% = death – More intracellular (55%) than extracellular (45%) What regulates fluid What movement between intracellular and extracellular compartments? Metabolism and the Sodium Pump! Dehydration Dehydration • Causes – decreased ADH secretion (diabetes insipidus) – high protein diet (produces urea which carries water out via kidney) – vomiting – diarrhea – fistula drainage • Corrected by: – 0.9% NaCl or 5% Dextrose (oxidized to yield H20) • Maximum usually 2-3 liters/day • Caution - must have normal kidney function Overhydration Overhydration • Causes – excessive fluids • especially if impaired renal or cardiac function – sweating (loss of Na+) followed by drinking H20 – increased ADH or ADH-like substan...
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This document was uploaded on 02/07/2014.

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