PHARMACOTHERAPY OF RENAL FAILURE
Diuretics are used to treat what four conditions? (Hint: think heart and kidneys.) - Renal
Failure
Heart Failure
Accumulation of Edema
& HTN
**Name the three primary adverse effects r/t diuretics.** - Electrolyte Imbalance
Dehydration
Hypotension
Which type of diuretics are the most effective? - Loop diuretics.
How do LOOP diuretics work? - LOOP diuretics block sodium reabsorption in the
LOOP of Henle. (water follows Na+ out of body...)
Loop diuretics can only be administered parenterally. True/False? - False! Loop
diuretics can be administered both orally and parenterally.
(loOP diuretics - both the letters O and P are in the word loOP.)
Furosemide (lasix) = Loop diuretic - Cruella de Vil was obsessed with FUR, and she
was LOOPY af: FURosemide - LOOP diuretic.
Furosemide can't be given to patients with a potassium level above 5.1mEq/L or higher.
True/False? - False! Furosemide cannot be given to patients with a K+ level at
3.4mEq/L or LOWER.
Potassium range is 3.5-5.0 mEq/L. 3.4 or lower is Hypokalemia: Lasix will cause further
potassium depletion in patients.
**Can be administered with potassium supplements to prevent this.
Nursing considerations for Furosmeide (Lasix) include all of the following except...
a) Monitor vital signs & BP
b) Administer early in the day; esp. if pt. is taking it at home.
c) Administer with sodium supplements
, d) Observe older adults carefully
e) Ensure ready access to the bathroom - c) Administer with sodium supplements.
Exp: Lasix is a loop diuretic; these diuretics work by getting RID of sodium. In fact,
administering any sort of supplement is not included in Nursing Considerations...
Actual Nursing Considerations:
a) Monitor vital signs & BP - risk for hypotension
b) ***Administer early in the day; esp. if pt. is taking it at home.***
c) Establish Safety precautions.
d) Observe older adults carefully - they need assistance to restroom due to increased
risk of falls
e) Ensure ready access to bathroom - see reasoning above
What are some significant adverse effects to watch out for with Furosemide (loop
diuretics)? - **Ototoxicity**
Hyperuricemia
Metabolic alkalosis
Tachycardia
Hypovolemia
Two important contraindications for Lasix.
(Hint: we went over one already.) - **Severe fluid/electrolyte depletion**
Anuria
Name the three cousins of furosemide (lasix).
(Hint: generic names usually end in "-ide", trade names usually end in "-ex".) - 1)
Bumetanide (Bumex)
2) Torsemide (Demadex) - twice as potent; given IV
3) Ethacrynic acid (Edecrin)
For pts. allergic to Sulfonamide (antibiotic);
its the only loop diuretic not Sulfonamide
based.
**Causes the most severe ototoxicity.**
(Pic: Ethel is that sad third wheel on the left.
Ethel has more in common with ethacrynic
acid than her crappyfriends standing next to
her.)
Menial Hint: There are four letters in the word Loop for loop diuretics - there are four
loop diuretics we learned about. - 1) FurosemIDE
2) BumetanIDE
3) TorsemIDE
4) Ethacrynic acid...