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Thiazide diuretic drugs
chlorothiazide (Diuril)
hydrochlorothizide (HydroDIURIL) HCTZ
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Thiazide Diuretic information?
- action: works on distal convoluted tubule
- indications: edema, HTN
- contraindications: anuria, severe renal failure, pregnancy
- adverse reactions: hypotension, hypokalemia, hyperglycemia in the diabetic
- interactions: w/ digoxin=cardiac arythimia, w/ lithium= lithium toxicity
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Loop diretics
- furosemide (lasix)
- bumetanide (bumex)
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Loop diuretic info?
- action: loop of Henle
- indications; htn,chf, cirrhosis
- contraindications; anuria, electrolyte imbalance, infancy and pregnancy
- adverse reactions; dehydration, postural hypotension, dizziness, hypokalemia
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potassium-sparing diuretics?
- spironolactone (aldactone)
- triamterene (dyrenium)
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Potassium-sparing diuretic info?
- action; distal tubule and collecting duct
- indications; chf, htn, hyperaldosteronism
- contraindications; severe kidney disease, hyperkalemia
- adverse reactions; hyperkalemia, gynecomastia in males
- drug interactions; dont use salt substitute, increase hyperkalemia if taken with ace inhibitors or indocin
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osmotic diuretic drugs?
mannitol (osmitrol)
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osmotic diuretic info?
- action; proximal convoluted tubule
- indication; cerebral edema
- contraindications; severe chf, intracranial bleeding
- adverse reactions; tachycardia, blurred vision
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carbonic anhydrase inhibitors drugs?
acetazolamide (diamox)
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carbonic anyhdrase inhibitor info?
- actions; proximal convoluted tubule, decrease production of aqueous humor
- indication; treats glaucoma
- contraindications; narrow-angle glaucoma, addisons disease (too much cortisol)
- adverse reactions; numbness and tingling, photosensitivity
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What are diuretic nursing implications?
- teach to take oral diuretic in the am
- check bp, I&O, weight, degree of edema
- report worsening edema
- enc fluids unless restricted
- teach to rise slowly due to low bp
- check bs for thiazide hyperglacemia
- k+ level (norm 3.5-5.0)
- check for signs of hypokalemia(muscle weakness, leg cramps, cardiac arrhythmias
- enc k+ rich foods
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sulfonamide drugs?
trimethoprim/sulfamethoxazole (bactrim, septra)
sulfisoxazole (gantrisin)
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sulfonamide drug info?
- action: bacteriostatic
- indications; treats uti
- contraindications; strep a
- adverse reactions: skin rash, photosensitivity, blood disorder
- interactions; decrease effect of digoxin, oral contraceptives, incerease effect of coumadin, oral hypoglycemics
- NI; monitor temp, push fluids, avoid direct sunlight, avoid caffeine/ makes uti sx worse
- entire med unless rash, fallow up c&s
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urinary antiseptic drugs
- methenamine (mandelamine)
- nitrofurantoin (macrodantin)
- ciprofloxacin (cipro)
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urinary antiseptic info?
- action: bactericidal, bacteriostatic
- indications; acute and chronic uti that are resistant to sulfonamides
- contraindications; anuria, renal failure, pregnancy
- adverse reactions; n/v, diarrhea, skin rash, ha, crystalluria, macrodantin=brown urine, pulmonary reactions
- NI; monitor temp, push fluids to prevent crystals, entire med, fallow up c&S
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urinary analgesic drugs?
phenazopyridine (pyridium)
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urinary analgesic info?
- action; topical analgesic effect on urinary tract
- indications; relieves painful urination
- contraindications; renal or hepatic disease
- adverse reactions; bright orange urine
- NI; take 2-3 days
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cholinergic drugs?
bethanechol (urecholine)
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Cholinergic info?
- indications; urinary retention after surgery, treats neurogenic bladder
- adverse reactions; hypotension, sweating, increase salivation
- contraindications; urinary obstruction
- NI; palpate for distension
- monitor abilty to void
- treat overdose with atropine
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Urinary antispasmodic drugs?
- oxybutynin (ditropan)
- tolterodine tartrate (detrol)
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urinary antispasmodic info?
- action; relaxes bladder smooth muscles
- indications; bladder spasms,urinary urgency, stress incontinence
- contraindications; urinary obstruction, glaucoma
- adverse reactions; dry mouth, constipation, decrease sweating
- interactions; don't take with anticholinergics or cns depressants
- NI; palpate for distention, monitor ability to void
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