c. Loop Diuretics. The primary agent of loop diuretics is furosemide (LasixR).
Loop diuretics act by blocking reabsorption of sodium in the ascending Loop of Henle.
(1)
Specific indications for loop diuretic use.
(a) Pulmonary edema.
(b) Congestive heart failure.
(2)
Administration and dosage of loop diuretics. Follow this procedure:
(a) Given an oral dosage of 40 mg one to two times a day. LasixR may
be given up to maximum dose of 120 mg three times a day.
(b) IV dosage is 20 to 40 mg. The diuretic acts 5 minutes after IV
administration. The duration of action is about 2 hours.
d. Thiazide Diuretics. These diuretics are often classified as
benzothiadiazides. The primary agents are hydrochlorothiazide (HCTZ, Oretic ,
EsidrixR) and chlorothiazide (DiurilR). The diuretic acts in the distal tubule.
(1)
Specific indications for thiazide diuretics.
(a)
Less severe edematous states.
(b) Hypertension.
(2)
Administration and dosage. Proceed as follows:
(a) This diuretic is usually administered orally.
(b) The duration of action is 6 to 12 hours, depending on the agent
used.
e. Potassium-sparing Diuretics. The primary agents of this type of diuretic are
spironolactone (AldactoneR) and triamterene (DyreniumR). A potassium-sparing diuretic
acts in the distal tubule. A specific indication for this class of diuretic is excessive
potassium loss. DO NOT use if patient suffers from hyperkalemia. Spironolactone
(AldactoneR) is given in the dosage of 25mg 4 times per day by mouth. Triamterene
(DyreniumR) is given in the dosage 100 mg every day by mouth.
f. Combination type Diuretics. The primary agent is thiazide with a
potassium-sparing diuretic. Other agents are hydrochlorothiazide and spironolactone
(Aldactazide ). Fixed dose combinations may be more convenient in patient
management.
MD0580
4-8