lOMoARcPSD|50207110
Generic: metolazone Trade: Zaroxolyn
Pharmocologic: Thiazide diuretic Therapeutic: Antihypertensive/Diuretic
Dosage: PO (Adults): Hypertension—2.5– 5 mg/day; edema 5– 20 mg/day
ACTION: INDICATIONS:
Increases excretion of sodium and HTN, fluid retention (edema) in pt w/ CHF o
water by inhibiting sodium reabsorption nephrotic disorder
in the distal tubule. Promotes excretion CONTRAINDICATIONS:
of chloride, potassium, magnesium, and Severe liver disease, unable to pass urine, Usin
bicarbonate. May produce arteriolar metolazone during pregnancy could cause side
effects in the newborn baby, such as blood cell
dilation.
problems, or jaundice (yellowing of the skin or
SIDE EFFECTS: eyes). <18 years of age, sulfonamides allergy
Dizziness, drowsiness, depressed mood,
muscle or joint pain, numbness or tingly, NURSING CONSIDERATIONS:,
nausea, stomach pain, loss of appetite, Monitor for S/S of dehydration (thirst,
diarrhea, constipation, dehydration, weakness, muscle cramping, hypotension,
electrolyte imbalance, orthostatic tachycardia), Monitor BP, I&O, and daily
hypotension, digoxin toxicity, ED weight, and assess feet, legs, and sacral are
for edema daily. Instruct pt to change
positions slowly to avoid dizziness and falls,
LAB TEST CONSIDERATION: Instruct pt to take the last dose in the
Monitor electrolytes (especially potassium), afternoon to avoid nocturia, May cause ↑
blood glucose, BUN, and serum creatinine and serum cholesterol, LDL, and triglyceride
uric acid levels.
concentrations.
Downloaded by Samuel Gero ()
, lOMoARcPSD|50207110
Generic: furosemide Brand: Lasix Pharmacologic: LOOP DIURETIC Therapeutic: Diuretics
PO (Adults): 20– 80 mg/day as a single dose initially, may repeat in 6– 8 hr dose by 20– 40 mg q 6– 8
hr until desired response.
MODE OF ACTION: INDICATIONS:
Inhibits NaCl reabsorption in the ascending Tx of edema due to CHF, hepatic or renal
loop of Henle, thereby ↑ the excretion of failure and HTN.
sodium & potassium. May have peripheral
vasodilatory effects. CONTRAINDICATIONS:
Allergy to sulfonamides/thiazides, anuria.
SIDE EFFECTS: Pregnancy Category C.
Electrolyte imbalances (primarily hypokalemia),
orthostatic hypotension, ototoxicity (usually NURSING CONSIDERATIONS:
reversible), dehydration, increased BUN, Instruct pt to change positions slowly, consume hig
hyperglycemia, blood dyscrasias, BMS, K+ foods or prescribed K+ supplements ut dict, us
photosensitivity. Commonly ↓serum K+. May sunscreen. Watch EKG for arrhythmias, especially
↓serum NA, calcium, and magnesium with altered K+ levels. Instruct pt to take the last
concentrations. May also cause↑ BUN, serum dose in the afternoon to avoid nocturia. Monitor fo
glucose, creatinine, and uric acid levels. S/S of dehydration (thirst, weakness, muscle
cramping, hypotension, tachycardia). Assess fluid
LAB TEST CONSIDERATIONS: status. Monitor daily weight, I&O, amount and
location of edema, lung sounds, skin turgor, and
Monitor electrolytes, renal/hepatic function, mucous membranes. Monitor BP and pulse before
glucose, and uric acid levels before and and during administration. Assess patient for
periodically throughout therapy. tinnitus and hearing loss. Assess patients receivin
digoxin for anorexia, nausea, vomiting, muscle
Downloaded by Samuel Gerocramps, paresthesia, and confusion.
()
, lOMoARcPSD|50207110
Generic: bumetanide Trade: Bumex Pharmacologic: Loop diuretics Therapeutic: Diuretics
Usual adult dosage: 0.2-5 mg/day Available: IM, PO, IV
MODE OF ACTION: INDICATIONS:
Inhibits NaCl reabsorption in the ascending Tx of edema due to CHF, hepatic or renal failu
loop of Henle, thereby increasing the & HTN. Unlabeled Use: Reversal of oliguria in
excretion of sodium and potassium. May preterm neonates.
have peripheral vasodilatory effects. CONTRAINDICATIONS:
Therapeutic Effects: Diuresis and Allergy to sulfonamides, anuria. Pregnancy
subsequent mobilization of excess fluid category C
(edema, pleural effusions).
NURSING CONSIDERATIONS:
SIDE EFFECTS: Instruct pt to change positions slowly, consum
Electrolyte imbalances (primarily hypokalemia), high K+ foods or prescribed K+ supplements u
orthostatic hypotension, ototoxicity (usually dict, use sunscreen. Watch EKG for
reversible), dehydration, increased BUN, arrhythmias, especially with altered K+ levels.
hyperglycemia, blood dyscrasias, BMS, Instruct pt to take the last dose in the afternoon
photosensitivity, Steven Johnson syndrome to avoid nocturia. Monitor the blood pressure f
effectiveness, monitor I&O q shift and weight
daily. Monitor for S/S of dehydration (thirst,
weakness, muscle cramping, hypotension,
LAB TEST CONSIDERATIONS: tachycardia). Advise pt w/ DM to monitor blood
Monitor electrolytes, renal and hepatic function,
glucose closely. Assess patient for tinnitus and
glucose, and uric acid levels before and periodically
during therapy. May cause ↑NA, K+, calcium, and
hearing loss. Assess patients receiving digoxi
magnesium concentrations. May also cause ↓BUN, for anorexia, nausea, vomiting, muscle cramps
paresthesia, and confusion.
Downloaded by Samuel Gero ()
glucose, creatinine, and uric acid levels.
, lOMoARcPSD|50207110
Generic: amiloride Pharmacologic: Potassium-sparing diuretics Therapeutic: Diuretic
Usual dosage: 5-20 mg po/day
MODE OF ACTION: INDICATIONS:
Inhibition of sodium resorption in the kidney,
Primary hyperaldosteronism, mgmt. of edema
saving potassium and hydrogen ions. associated w/ CHF, cirrhosis and nephrotic
Therapeutic Effects: Weak diuretic and syndrome. Mgmt of essential HTN. Tx hypokalem
antihypertensive response (counteracts K+ loss caused by other diuretics).
SIDE EFFECTS: CONTRAINDICATIONS:
Hyperkalemia, agranulocytosis, muscle Kidney problems, unable to urinate, or
cramps dizziness, HA, gynecomastia hyperkalemia. Pregnancy category C.
(males), breast tenderness, deepening of
voice, increased hair growth (females),
NURSING CONSIDERATIONS:
hyponatremia. May cause ↑serum
magnesium, uric acid, BUN, creatinine, K+ Check BP before administration, Monitor for S/S
and urinary calcium excretion levels. May of dehydration (thirst, weakness, muscle
cramping, hypotension, tachycardia), Monitor
also cause ↓NA levels
intake & output Q shift, Weigh pt QD, have the p
LAB TEST CONSIDERATIONS: change positions slowly to avoid dizziness and
Evaluate K+ levels before and routinely falls, Instruct the pt to take the last dose in the
during therapy. Withhold drug and notify health afternoon to avoid nocturia, Monitor the BP for
care professional if patient becomes effectiveness, Monitor EKG for signs
hyperkalemic. Monitor BUN, serum creatinine, hyperkalemia (tented T waves). Teach pt to avo
and electrolytes before and periodically during NACL substitutes and high K+ foods.
therapy. Downloaded by Samuel Gero ()
Generic: metolazone Trade: Zaroxolyn
Pharmocologic: Thiazide diuretic Therapeutic: Antihypertensive/Diuretic
Dosage: PO (Adults): Hypertension—2.5– 5 mg/day; edema 5– 20 mg/day
ACTION: INDICATIONS:
Increases excretion of sodium and HTN, fluid retention (edema) in pt w/ CHF o
water by inhibiting sodium reabsorption nephrotic disorder
in the distal tubule. Promotes excretion CONTRAINDICATIONS:
of chloride, potassium, magnesium, and Severe liver disease, unable to pass urine, Usin
bicarbonate. May produce arteriolar metolazone during pregnancy could cause side
effects in the newborn baby, such as blood cell
dilation.
problems, or jaundice (yellowing of the skin or
SIDE EFFECTS: eyes). <18 years of age, sulfonamides allergy
Dizziness, drowsiness, depressed mood,
muscle or joint pain, numbness or tingly, NURSING CONSIDERATIONS:,
nausea, stomach pain, loss of appetite, Monitor for S/S of dehydration (thirst,
diarrhea, constipation, dehydration, weakness, muscle cramping, hypotension,
electrolyte imbalance, orthostatic tachycardia), Monitor BP, I&O, and daily
hypotension, digoxin toxicity, ED weight, and assess feet, legs, and sacral are
for edema daily. Instruct pt to change
positions slowly to avoid dizziness and falls,
LAB TEST CONSIDERATION: Instruct pt to take the last dose in the
Monitor electrolytes (especially potassium), afternoon to avoid nocturia, May cause ↑
blood glucose, BUN, and serum creatinine and serum cholesterol, LDL, and triglyceride
uric acid levels.
concentrations.
Downloaded by Samuel Gero ()
, lOMoARcPSD|50207110
Generic: furosemide Brand: Lasix Pharmacologic: LOOP DIURETIC Therapeutic: Diuretics
PO (Adults): 20– 80 mg/day as a single dose initially, may repeat in 6– 8 hr dose by 20– 40 mg q 6– 8
hr until desired response.
MODE OF ACTION: INDICATIONS:
Inhibits NaCl reabsorption in the ascending Tx of edema due to CHF, hepatic or renal
loop of Henle, thereby ↑ the excretion of failure and HTN.
sodium & potassium. May have peripheral
vasodilatory effects. CONTRAINDICATIONS:
Allergy to sulfonamides/thiazides, anuria.
SIDE EFFECTS: Pregnancy Category C.
Electrolyte imbalances (primarily hypokalemia),
orthostatic hypotension, ototoxicity (usually NURSING CONSIDERATIONS:
reversible), dehydration, increased BUN, Instruct pt to change positions slowly, consume hig
hyperglycemia, blood dyscrasias, BMS, K+ foods or prescribed K+ supplements ut dict, us
photosensitivity. Commonly ↓serum K+. May sunscreen. Watch EKG for arrhythmias, especially
↓serum NA, calcium, and magnesium with altered K+ levels. Instruct pt to take the last
concentrations. May also cause↑ BUN, serum dose in the afternoon to avoid nocturia. Monitor fo
glucose, creatinine, and uric acid levels. S/S of dehydration (thirst, weakness, muscle
cramping, hypotension, tachycardia). Assess fluid
LAB TEST CONSIDERATIONS: status. Monitor daily weight, I&O, amount and
location of edema, lung sounds, skin turgor, and
Monitor electrolytes, renal/hepatic function, mucous membranes. Monitor BP and pulse before
glucose, and uric acid levels before and and during administration. Assess patient for
periodically throughout therapy. tinnitus and hearing loss. Assess patients receivin
digoxin for anorexia, nausea, vomiting, muscle
Downloaded by Samuel Gerocramps, paresthesia, and confusion.
()
, lOMoARcPSD|50207110
Generic: bumetanide Trade: Bumex Pharmacologic: Loop diuretics Therapeutic: Diuretics
Usual adult dosage: 0.2-5 mg/day Available: IM, PO, IV
MODE OF ACTION: INDICATIONS:
Inhibits NaCl reabsorption in the ascending Tx of edema due to CHF, hepatic or renal failu
loop of Henle, thereby increasing the & HTN. Unlabeled Use: Reversal of oliguria in
excretion of sodium and potassium. May preterm neonates.
have peripheral vasodilatory effects. CONTRAINDICATIONS:
Therapeutic Effects: Diuresis and Allergy to sulfonamides, anuria. Pregnancy
subsequent mobilization of excess fluid category C
(edema, pleural effusions).
NURSING CONSIDERATIONS:
SIDE EFFECTS: Instruct pt to change positions slowly, consum
Electrolyte imbalances (primarily hypokalemia), high K+ foods or prescribed K+ supplements u
orthostatic hypotension, ototoxicity (usually dict, use sunscreen. Watch EKG for
reversible), dehydration, increased BUN, arrhythmias, especially with altered K+ levels.
hyperglycemia, blood dyscrasias, BMS, Instruct pt to take the last dose in the afternoon
photosensitivity, Steven Johnson syndrome to avoid nocturia. Monitor the blood pressure f
effectiveness, monitor I&O q shift and weight
daily. Monitor for S/S of dehydration (thirst,
weakness, muscle cramping, hypotension,
LAB TEST CONSIDERATIONS: tachycardia). Advise pt w/ DM to monitor blood
Monitor electrolytes, renal and hepatic function,
glucose closely. Assess patient for tinnitus and
glucose, and uric acid levels before and periodically
during therapy. May cause ↑NA, K+, calcium, and
hearing loss. Assess patients receiving digoxi
magnesium concentrations. May also cause ↓BUN, for anorexia, nausea, vomiting, muscle cramps
paresthesia, and confusion.
Downloaded by Samuel Gero ()
glucose, creatinine, and uric acid levels.
, lOMoARcPSD|50207110
Generic: amiloride Pharmacologic: Potassium-sparing diuretics Therapeutic: Diuretic
Usual dosage: 5-20 mg po/day
MODE OF ACTION: INDICATIONS:
Inhibition of sodium resorption in the kidney,
Primary hyperaldosteronism, mgmt. of edema
saving potassium and hydrogen ions. associated w/ CHF, cirrhosis and nephrotic
Therapeutic Effects: Weak diuretic and syndrome. Mgmt of essential HTN. Tx hypokalem
antihypertensive response (counteracts K+ loss caused by other diuretics).
SIDE EFFECTS: CONTRAINDICATIONS:
Hyperkalemia, agranulocytosis, muscle Kidney problems, unable to urinate, or
cramps dizziness, HA, gynecomastia hyperkalemia. Pregnancy category C.
(males), breast tenderness, deepening of
voice, increased hair growth (females),
NURSING CONSIDERATIONS:
hyponatremia. May cause ↑serum
magnesium, uric acid, BUN, creatinine, K+ Check BP before administration, Monitor for S/S
and urinary calcium excretion levels. May of dehydration (thirst, weakness, muscle
cramping, hypotension, tachycardia), Monitor
also cause ↓NA levels
intake & output Q shift, Weigh pt QD, have the p
LAB TEST CONSIDERATIONS: change positions slowly to avoid dizziness and
Evaluate K+ levels before and routinely falls, Instruct the pt to take the last dose in the
during therapy. Withhold drug and notify health afternoon to avoid nocturia, Monitor the BP for
care professional if patient becomes effectiveness, Monitor EKG for signs
hyperkalemic. Monitor BUN, serum creatinine, hyperkalemia (tented T waves). Teach pt to avo
and electrolytes before and periodically during NACL substitutes and high K+ foods.
therapy. Downloaded by Samuel Gero ()
