Copyright 2017 Wolters Kluwer All Rights Reserved Loop Diuretics cont Loop

Copyright 2017 wolters kluwer all rights reserved

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Copyright © 2017 Wolters Kluwer • All Rights Reserved Loop Diuretics (cont.) Loop Diuretics (cont.) Drug-to-Drug Interactions Aminoglycosides or cisplatine risk of ototoxicity Anticoagulation risk of bleeding Indomethacin, ibuprofen, salicylates, or NSAIDs anti-HTN effect
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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 Carbonic Anhydrase Inhibitors These drugs are used as adjuncts to other diuretics when a more intense diuresis is needed Acetazolamide ( Diamox ) Methazolamide (generic).
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Carbonic Anhydrase Inhibitors Carbonic Anhydrase Inhibitors 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
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Carbonic Anhydrase Inhibitors (cont.) Carbonic Anhydrase Inhibitors (cont.) Pharmacokinetics Rapidly absorbed and widely distributed Excreted in the urine Contraindications Allergy Angle closure glaucoma
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Carbonic Anhydrase Inhibitors (cont.) Carbonic Anhydrase Inhibitors (cont.) Caution Lactation Fluid or electrolyte imbalances Renal or hepatic disease Adrenocortical insufficiency Respiratory acidosis COPD
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Carbonic Anhydrase Inhibitors (cont.) Carbonic Anhydrase Inhibitors (cont.) Adverse Effects Related to disturbances in acid and base balance and electrolyte balances Metabolic acidosis Hypokalemia Paresthesias of extremities, confusion, drowsiness Drug-to-Drug Interactions Salicylates and lithium
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Prototype Carbonic Anhydrase Inhibitors Prototype Carbonic Anhydrase Inhibitors
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Potassium-Sparing Diuretics Potassium-Sparing Diuretics Not as powerful as the loop diuretics, but they retain potassium instead of wasting it. Amiloride ( Midamor ) Spironolactone ( Aldactone ) Triamterene ( Dyrenium )
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Potassium-Sparing Diuretics Potassium-Sparing Diuretics Actions Cause a loss of sodium while retaining potassium Block the actions of aldosterone in the distal tubule Indications Adjuncts with thiazide or loop diuretics Patients who are at risk for hypokalemia Pharmacokinetics Well absorbed, protein bound, and widely distributed Metabolized in the liver and excreted in the urine
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Potassium-Sparing Diuretics (cont.) Potassium-Sparing Diuretics (cont.) Contraindications Allergy Hyperkalemia, renal disease, or anuria Patients taking amiloride or triamterene Caution Pregnancy and lactation Adverse Effects Hyperkalemia Drug-to-Drug Interactions Salicylates anti-HTN & diuretic effect, risk of hyperkalemia, Na and water retention.
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Prototype Potassium-Sparing Diuretics Prototype Potassium-Sparing Diuretics
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