T4 diuretics, fluids & electrolytes

What is checked to see kidney function

glomerular filtration rate

Carbonic anhydrase inhibitors (CAIs)

Loop diuretics

Osmotic diuretics

Potassium-sparing diuretics

Thiazide & thiazide-like diuretics

Types of diuretics

What are 3 loop diuretics

furosemide - Lasix

bumetanide - Bumex

torsemide - demadex

What is the most potent diuretic

furosemide - Lasix

what are the indications for furosemide - Lasix

HTA HF pulmonary edema

furosemide - Lasix administration

PO: onset 30 - 60 min Peak: 1- 2 hr

IV: onset 5 min Peak: 30 min

furosemide - Lasix adverse effects

Hypokalemia dehydration ototoxicity electrolyte imbalance

furosemide - Lasix contraindictions

anuria, kidney impairment, preg

what drug do you inject over 1 - 2 min to reduce ototoxicity (hearing loss)

furosemide - Lasix

What drug is hydrochlorothiazide (HCTZ) / Demadex

thiazide diuretic

HCTZ - Demadex indications

HTA HF nephrotic syndrome edema

HCTZ - Demadex administration

PO: onset 2hr peak: 4-6hr

HCTZ - Demadex adverse effects

Electrolyte imbalance hypokalemia dehydration erectile dysfunction

HCTZ - Demadex contraindictions

pt w/ decreased GFR, sulfonamide allergy, renal issues

spironolactone - Aldactone is what diuretic

potassium - sparing

spironolactone - Aldactone indications

HF, inadequate renal function, ascites

spironolactone - Aldactone administration

PO: onset, peak and duration 24-48 hr, max effect in 6 wks

spironolactone - Aldactone adverse effects

dizziness, H/A, gynecomastia (breasts in men), testicular atrophy

spironolactone - Aldactone contraindictions

pt w/ decreased GFR, anuria, avoid potassium rich food

What diuretic can be used w/ other diuretics BUT HCTZ

spironolactone

what drug is an osmotic diuretic

mannitol - Osmitrol

what drug is useful for peripheral edema d/t it not promoting sodium excretion

mannitol - Osmitrol

what drug causes rapid diuresis and pulls water from extravascular sites into the bloodstream

mannitol - Osmitrol

mannitol - Osmitrol indications

anuria, reduce ICP and intraocular pressure

mannitol - Osmitrol administration

IV: onset 1-3 hrs, drug not absorbed

mannitol - Osmitrol adverse effects

seizures

mannitol - Osmitrol contraindications

severe renal disease (anuria), intracranial bleeding

mannitol - Osmitrol considerations

drug may form crystals when exposed to low temp

use a filtered IV tubing

Hypertonic

Sodium loss, sweating

Hypotonic

Water loss, renal disease

Isotonic

V/D, water and sodium loss

What IV solution is hypertonic

3% NaCl

what IV solution is hypotonic

0.5% NaCl

What IV solution is isotonic

0.9% NaCl

What solution is isotonic and for ppl who lost fluid (ex blood)

crystalloid solution

What solutions replenish water & electrolytes and contain large molcules

colloids

What is the thrombolytic antidote

fresh frozen plasma

what IV do you give with blood

0.9 NaCl / normal saline

What do you not give while doing a blood transfusion

lactated ringer, albumin, detoxrose

Blood infusion must be started within ______ of leaving the blood bank. Blood must be completely infused within _____.

30 min, 4hrs

Oral meds should be give _______ prior to staring infusion. BE in the room w/ the pt for the 1st _____.

30 min, 15 min

Hypokalemia

< 3.5 mEq

Hyperkalemia

> 5.5 mEq

Hyponatremia

low sodium

< 135 mEq/L

Hypernatremia

high sodium

> 145 mEq/L