NURS 1141 Exam 2 Questions With Complete Solutions
Drug Class: Thiazide Diuretics
Metolazone (Zaroxolyn)
Hydrochlorothiazide (Microzide) MOA
Acts primarily on the distal tubule of the kidney to block the
reabsorption of sodium and chloride ions from the tubule.
The sodium and chloride ions that are not reabsorbed are passed
into the collecting ducts, taking molecules of water with them,
resulting in a diuresis.
Metolazone (Zaroxolyn) Info
- Metolazone (Zaroxolyn) helps with diuresis resistance
-Remains effective for creatinine clearance as low as 10 mL/min
-Available PO only
- Most effective if given 30 min before IV Loop diuretics
Drug Class: Thiazide Diuretics
Metolazone (Zaroxolyn)
Hydrochlorothiazide (Microzide) Uses
- The treatment of edema associated with heart failure, renal
disease, hepatic disease, pregnancy, obesity, premenstrual
,syndrome, and administration of adrenocortical steroids.
- May be 1st choice for hypertension
- The antihypertensive properties of thiazides result from a
direct vasodilatory action on the peripheral arterioles
- Thiazide diuretics tend to lose their diuretic action after about
6 weeks of therapy, but the antihypertensive properties continue.
- Thiazide diuretics also tend to lose their diuretic effect when
creatinine clearance is less than 30 mL/min.
Drug Class: Thiazide Diuretics
Metolazone (Zaroxolyn)
Hydrochlorothiazide (Microzide) Therapeutic Outcomes
Diuresis with reduction of edema and improvement in symptoms
related to excessive fluid accumulation, and reduction in
elevated blood pressure.
Drug Class: Thiazide Diuretics
Metolazone (Zaroxolyn)
Hydrochlorothiazide (Microzide) Nursing Implications
- Baseline vitals, lung sounds, weight, degree of edema, lab
studies, patient's mental status, strength, tremors, general
appearance
,- Pt's with DM require baseline glucose
- Check for symptoms of acute gout, or reduction in hearing, if
present notify HCP
Drug Class: Thiazide Diuretics
Metolazone (Zaroxolyn)
Hydrochlorothiazide (Microzide) Dosage and Administration
- Administer with food or milk to reduce gastric irritation.
- Do NOT administer after midafternoon to prevent nocturia.
Drug Class: Thiazide Diuretics
Metolazone (Zaroxolyn)
Hydrochlorothiazide (Microzide) Common Side Effects
Cardio: Orthostatic Hypotension
Drug Class: Thiazide Diuretics
Metolazone (Zaroxolyn)
Hydrochlorothiazide (Microzide) Serious Side Effects
Cardio: Hypotension
GI: Gastric irritation, nausea, vomiting, constipation
Dermatologic: Photosensitivity
, Metabolic/ Renal: Electrolyte imbalance, hypokalemia,
dehydration, hypomagnesemia, hypercalcemia, hyperuricemia
Endocrine: Hyperglycemia
Hypersensitivity: Hives, pruritus, rash
Drug Class: Thiazide Diuretics
Metolazone (Zaroxolyn)
Hydrochlorothiazide (Microzide) Drug Interactions
Digoxin
Corticosteroids
Lithium
NSAIDs
Hypertensive agents
Oral hypoglycemic agents, Insulin
Drug Class: Potassium-Sparing Diuretics Example
Spironolactone (Aldactone)
Triamterene (Dyrenium)
Drug Class: Potassium-Sparing Diuretics
Spironolactone (Aldactone) MOA
Blocks the sodium-retaining, potassium-excreting, magnesium-
excreting properties of aldosterone
which
Drug Class: Thiazide Diuretics
Metolazone (Zaroxolyn)
Hydrochlorothiazide (Microzide) MOA
Acts primarily on the distal tubule of the kidney to block the
reabsorption of sodium and chloride ions from the tubule.
The sodium and chloride ions that are not reabsorbed are passed
into the collecting ducts, taking molecules of water with them,
resulting in a diuresis.
Metolazone (Zaroxolyn) Info
- Metolazone (Zaroxolyn) helps with diuresis resistance
-Remains effective for creatinine clearance as low as 10 mL/min
-Available PO only
- Most effective if given 30 min before IV Loop diuretics
Drug Class: Thiazide Diuretics
Metolazone (Zaroxolyn)
Hydrochlorothiazide (Microzide) Uses
- The treatment of edema associated with heart failure, renal
disease, hepatic disease, pregnancy, obesity, premenstrual
,syndrome, and administration of adrenocortical steroids.
- May be 1st choice for hypertension
- The antihypertensive properties of thiazides result from a
direct vasodilatory action on the peripheral arterioles
- Thiazide diuretics tend to lose their diuretic action after about
6 weeks of therapy, but the antihypertensive properties continue.
- Thiazide diuretics also tend to lose their diuretic effect when
creatinine clearance is less than 30 mL/min.
Drug Class: Thiazide Diuretics
Metolazone (Zaroxolyn)
Hydrochlorothiazide (Microzide) Therapeutic Outcomes
Diuresis with reduction of edema and improvement in symptoms
related to excessive fluid accumulation, and reduction in
elevated blood pressure.
Drug Class: Thiazide Diuretics
Metolazone (Zaroxolyn)
Hydrochlorothiazide (Microzide) Nursing Implications
- Baseline vitals, lung sounds, weight, degree of edema, lab
studies, patient's mental status, strength, tremors, general
appearance
,- Pt's with DM require baseline glucose
- Check for symptoms of acute gout, or reduction in hearing, if
present notify HCP
Drug Class: Thiazide Diuretics
Metolazone (Zaroxolyn)
Hydrochlorothiazide (Microzide) Dosage and Administration
- Administer with food or milk to reduce gastric irritation.
- Do NOT administer after midafternoon to prevent nocturia.
Drug Class: Thiazide Diuretics
Metolazone (Zaroxolyn)
Hydrochlorothiazide (Microzide) Common Side Effects
Cardio: Orthostatic Hypotension
Drug Class: Thiazide Diuretics
Metolazone (Zaroxolyn)
Hydrochlorothiazide (Microzide) Serious Side Effects
Cardio: Hypotension
GI: Gastric irritation, nausea, vomiting, constipation
Dermatologic: Photosensitivity
, Metabolic/ Renal: Electrolyte imbalance, hypokalemia,
dehydration, hypomagnesemia, hypercalcemia, hyperuricemia
Endocrine: Hyperglycemia
Hypersensitivity: Hives, pruritus, rash
Drug Class: Thiazide Diuretics
Metolazone (Zaroxolyn)
Hydrochlorothiazide (Microzide) Drug Interactions
Digoxin
Corticosteroids
Lithium
NSAIDs
Hypertensive agents
Oral hypoglycemic agents, Insulin
Drug Class: Potassium-Sparing Diuretics Example
Spironolactone (Aldactone)
Triamterene (Dyrenium)
Drug Class: Potassium-Sparing Diuretics
Spironolactone (Aldactone) MOA
Blocks the sodium-retaining, potassium-excreting, magnesium-
excreting properties of aldosterone
which
