Copyright 2013 Wolters Kluwer Health Lippincott Williams Wilkins Thiazide and

Copyright 2013 wolters kluwer health lippincott

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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Thiazide and Thiazide-Like Diuretics (cont.) Adverse Effects (cont.) Decreased calcium excretion Decreased uric acid secretion Altered blood glucose levels, increased with long- term use Urine will be slightly alkalinized Drug-to-Drug Interactions Cholestyramine or colestipol decreased thiazide absorption Digoxin increase risk of dig toxicity Antidiabetic agents decreased effectiveness of these agents
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Thiazide and Thiazide-Like Diuretics (cont.) Drug-to-Drug Interactions Lithium increased risk of lithium toxicity if these drugs are combined
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Prototype Thiazide and Thiazide-Like Diuretics
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Loop Diuretics Furosemide ( Lasix ) Most commonly used; less powerful than new drugs; larger margin of safety for home use Bumetanide ( Bumex ) and Torsemide ( Demadex ) New drugs; more powerful than Lasix Ethacrynic acid ( Edecrin ) First loop diuretic introduced, used less frequently in the clinical setting
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Loop Diuretics (cont.) Actions Block the chloride pump in the ascending loop of Henle Similar effect in the descending loop of Henle & the distal convoluted tubule This decreases reabsorption of sodium and chloride Indications Acute CHF Acute pulmonary edema Edema associated with CHF Edema associated with renal or liver disease Hypertension
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Loop Diuretics (cont.) Pharmacokinetics Metabolized and excreted primarily through the urine Contraindications Allergy Electrolyte depletion Anuria - Severe renal failure Hepatic coma Pregnancy and lactation
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Loop Diuretics (cont.) Caution SLE, gout, and diabetes mellitus Adverse Effects Related to the imbalance in electrolytes and fluid Hypokalemia Alkalosis Hypocalcemia Hypotension & dizziness
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Loop Diuretics (cont.) Adverse Effects (cont.) Hyperglycemia with long-term use Ototoxicity & deafness usually reversible when drug is stopped
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Loop Diuretics (cont.)Drug-to-Drug InteractionsAminoglycosides or cisplatine increased risk of ototoxicity Anticoagulation increased anticoagulant effectIndomethacin, ibuprofen, salicylates, or NSAIDs decreased loss of sodium and decreased antihypertensive effect if combine with these medications
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Prototype Loop Diuretics
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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