Box 51 2 Hormone Like Treatment for HF Nesiritide Natrecor Acts like

Box 51 2 hormone like treatment for hf nesiritide

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Box 51-2 Hormone-Like Treatment for HF Nesiritide (Natrecor) Acts like natriuretic hormone Causes decreased sodium reabsorption from the distal tubules Leads to dilute urine or increased volume Hormone is usually released in response to fluid overload or hemodilution In HF, reduces volume and cardiac workload Given IV, acutely decompensated HF with dyspnea at rest or with minimal activity
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Carbonic Anhydrase Inhibitors Acetazolamide (Diamox) Methazolamide (generic)
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins QuestionHow do carbonic anhydrase inhibitors work? A. Slow down the reabsorption of sodiumB. Speeds up creation of sodium bicarbonateC. Balances acidic and alkaline solutes in urineD. Slows down the movement of hydrogen ions
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins AnswerD. Slows down the movement of hydrogen ionsRationale: Diuretics that block the effects of carbonic anhydrase slow down the movement of hydrogen ions. As a result, more sodium and bicarbonate are lost in the urine.
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Carbonic Anhydrase Inhibitors (cont.) Actions Block the effects of carbonic anhydrase; slow down the movement of hydrogen ions More sodium and bicarbonate are lost in the urine Indications Adjuncts to other diuretics Glaucoma decreased aqueous humor secretion
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Carbonic Anhydrase Inhibitors (cont.) Pharmacokinetics Rapidly absorbed and widely distributed Excreted in the urine Contraindications Allergy to drug, sulfonamides, or thiazides Angle closure glaucoma Pregnancy some associated with fetal abnormalities
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Carbonic Anhydrase Inhibitors (cont.) Caution Lactation Fluid or electrolyte imbalances Renal or hepatic disease Adrenocortical insufficiency Respiratory acidosis COPD
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Carbonic Anhydrase Inhibitors (cont.) Adverse Effects Related to disturbances in acid-base balance and electrolyte balances Metabolic acidosis Hypokalemia Paresthesias of extremities, confusion, drowsiness Drug-to-Drug Interactions Salicylates and lithium increased excretion of these two drugs
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Prototype Carbonic Anhydrase Inhibitors
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Potassium-Sparing Diuretics Amiloride (Midamor) Spironolactone (Aldactone) Triamterene (Dyrenium)
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Potassium-Sparing Diuretics (cont.) Actions Cause a loss of sodium while retaining potassium Aldactone - Blocks the actions of aldosterone in the distal tubule Amiloride & triamterene block potassium secretion through the tubule
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