DIURETICS


Actions and Uses:

The ability to lower blood pressure and the ability to decrease edema in heart failure, renal, and liver disorders. There are five categories of diuretics that are effective in the removal of water and sodium: 1. Thiazide 2. Loop 3. Osmotic 4. Carbonic anhydrase inhibitor 5. Potassium-sparing These drugs can be used alone or in combination, to control blood pressure and edema.


Side effects and adverse reactions:

Thiazide: electrolyte imbalances such as hypercalcemia, hyperuricemia, and hypomagnesaemia.

Loop: electrolyte and fluid imbalances such as hypokalemia, hyponatremia, and hypochloremia.

Osmotic: fluid and electrolyte imbalance, pulmonary edema from rapid shift of fluids, nausea, vomiting, tachycardia from rapid fluid loss, and acidosis.

Carbon-Anhydrase Inhibitors: fluid and electrolyte imbalance, metabolic acidosis, nausea, vomiting, anorexia, confusion, orthostatic hypotension, and crystalluria.

Potassium-Sparing Diuretic: hyperkalemia. Caution must be used when due to high potassium excretion in urine.



Nursing Implications:

Monitor vital signs and serum electrolytes.



Reference:

Kee, J.L. Hayes, E.R. & McCuistion, L.E. (2009). Pharmacology A Nursing Approach (6th Edition) (pages 645-654). St. Louis: Saunders Elsevier.


Edited by Candice Hester