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Drug Adverse Effects Nursing Implications Monitor(labs): 4. & 5. Furosemide Bumetanide Torsemide Drug Class Mechanism of Action 1. diuretic Acts on the thick segment of the ascending limb of the 2 (which part of the nebron 2) to block reabsorption of sodium and chloride. . 3 (can cause dig. Toxicity in patients taking digoxin) Nursing Implications: • Should not be administered if K+ is less than .6. mEq. • Hypotension (dizziness) Indications: Edema, HTN, HF, short- term treatment of hyperkalemia • Can cause ototoxicity if given IV push too fast • Always check (which vital sign) 8. before administering. daily at • Patient should check their 9. the same time before meals. • Can cause postural hypotension. • NSDAIDS reduce effectiveness of loop diuretics • Severe 7 (fluid volume deficit) Route of Administration IM, PO, IV ***High-dose therapy administer by continuous via 10 infusion Monitor Labs: 13 & Spironolactone* Amiloride 11. diuretic Works on the distal tubule Na+ - channel inhibitor Triamterene Eplerenone Monitor Vitals: 14. (sitting and supine), pulse, & respirations • 12. (dangerous electrolyte) • Metabolic acidosis • Gynecomastia (aldosterone antagonists) . Gastric problems including peptic ulcer If patient has edema, record sites and extent of edema Teach: • Patient taking Spironolactone may cause 15. _irregularities and 15. • Avoid foods high in 16. Acetazolamide Dichlorphenamide* Methazolamide Carbonic anhydrase inhibitors • Advise patients to take these drugs with or after meals if GI upset occurs. • Employed primarily to lower intraocular pressure (IOP) and not to increase urine production." Prevent the action • Hypokalemia of carbonic • Metabolic acidosis anhydrase, • Blurred vision thereby • Photophobia decreasing the • Burning and stinging of production of the eye aqueous humor Blocks sodium and Hypokalemia water • Hyponatremia reabsorption in • Hyperglycemia in the distal diabetics convoluted tubule Drug interactions 17. diuretic hydrochlorothiazide Chlorothiazide Monitor labs: Potassium & 20. Chlorthalidone Nursing Implications: • Monitor (Vital signs): 21. frequently First-line therapy for 18. Therapeutic use: . Can potentiate digitalis toxicity. Edema, HTN, diabetes insipidus • 19. can reduce diuretic efficacy ******Do not use if renal function is impaired • Beta-blockers can potentiate hyperglycemia & hyperlipidemia Mannitol* 23. diuretic Elevates blood plasma osmolality, resulting in enhanced flow of • Headache, nausea, vomiting. • Edema • Fluid & electrolyte imbalance Therapeutic Uses: Administer: 24. .22 water from tissues, including the brain and cerebrospinal fluid, into interstitial fluid and plasma. **Mannitol has no significant effect on the excretion of potassium and other electrolytes. 22. • 22. Nursing: Use a_25 needle when withdrawing mannitol from the vial and use an in-line filter to prevent cryst