Thiazide and Thiazide Like Diuretics 5 Thiazide and Thiazide Like Diuretics 5

Thiazide and thiazide like diuretics 5 thiazide and

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Thiazide and Thiazide-Like Diuretics #5 Thiazide and Thiazide-Like Diuretics #5 Adverse Effects (cont.) o Decreased calcium excretion o Altered blood glucose levels o Urine will be slightly alkalinized Drug-to-Drug Interactions o Cholestyramine or colestipol o Digoxin o Antidiabetic agents
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Prototype Thiazide and Thiazide-Like Diuretics Prototype Thiazide and Thiazide-Like Diuretics
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Question #1Question #1What is the action of thiazide diuretics? A. Blocks the chloride pumpB. Blocks the sodium pumpC. Blocks the potassium pumpD. Blocks the carbonic anhydrase pump
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Answer to Question #1 Answer to Question #1 A. Blocks the chloride pump Rationale: Thiazide and thiazide-like diuretics act to block the chloride pump. Chloride is actively pumped out of the tubule by cells lining the ascending limb of the loop of Henle and the distal tubule.
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Loop Diuretics #1 Loop Diuretics #1 Furosemide ( Lasix ) o Most commonly used; less powerful than new drugs; larger margin of safety for home use Bumetanide ( Bumex ) and Torsemide ( Demadex ) o New drugs; more powerful than Lasix Ethacrynic acid ( Edecrin ) o First loop diuretic introduced, used less frequently in the clinical setting
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Loop Diuretics #2 Loop Diuretics #2 Actions o Block the chloride pump in the ascending loop of Henle o This causes reabsorption of sodium and chloride Indications o Acute CHF o Acute pulmonary edema o Edema associated with CHF o Edema associated with renal or liver disease o Hypertension
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Loop Diuretics #3 Loop Diuretics #3 Pharmacokinetics o Metabolized and excreted primarily through the urine Contraindications o Allergy o Electrolyte depletion o Anuria o Severe renal failure o Hepatic coma o Pregnancy and lactation
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Loop Diuretics #4 Loop Diuretics #4 Caution o SLE, gout, and diabetes mellitus Adverse Effects o Related to the imbalance in electrolytes and fluid o Hypokalemia o Alkalosis o Hypocalcemia
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Loop Diuretics #5 Loop Diuretics #5 Drug-to-Drug Interactions o Aminoglycosides or cisplatine o Anticoagulation o Indomethacin, ibuprofen, salicylates, or NSAIDs
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Prototype Loop Diuretics Prototype Loop Diuretics
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Carbonic Anhydrase Inhibitors #1 Carbonic Anhydrase Inhibitors #1 These drugs are used as adjuncts to other diuretics when a more intense diuresis is needed o Acetazolamide ( Diamox ) o Methazolamide (generic).
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