NUR2474 Pharmacology Module 5 Quiz Review
Nur2474 pharmacology module 5 quiz review Test tips:
Before answering the question, identify key words (what does the question really ask).
Be cautious of negatively worded questions! They are easy, but often misinterpreted due to not paying
attention to them.
Topics review:
1. Diuretics mechanism of action (including effects on electrolytes)
a. Diuretics work by preventing kidney reabsorption of sodium and chloride therefore preventing
absorption of water.
i. Hypovolemia
ii. Acid-base imbalance
iii. Electrolyte imbalance
2. Diuretics intended use
a. Cleansing of ECF and maintenance of ECF volume and composition
b. Maintenance of acid-base balance
c. Excretion of metabolic wastes and foreign substances
d. Increase amount of salt and water expelled from the body as urine
e. Can also be used to treat hypertension, edema, diabetes insipidus, CHF
3. Review furosemide (mechanism of action, side and adverse effects, administration, monitoring,
food/drug interactions)
a. Mechanism of action
i. Loop Diuretic
ii. Acts on ascending loop of Henle to block reabsorption
b. Side/adverse effects
i. Hyponatremia
ii. Hypochloremia
iii. Dehydration
iv. Hypotension
1. Loss of volume
2. Relaxation of venous smooth muscle
v. Hypokalemia
vi. Ototoxicity
vii. Hyperglycemia
viii. Hyperuricemia (excess of uric acid in blood)
ix. Use in pregnancy
x. Impact on lipids, calcium, and magnesium
c. Administration
i. Rapid onset
1. PO- 60 minutes
2. IV- 5 minutes
ii. Administer in the morning
1. Make you pee a lot, interfere with sleep pattern
d. Monitoring
i. Monitor blood sugar levels
ii. Monitor electrolytes
iii. EKG
iv. Dehydration
v. Fall risk due to hypotension
, vi. Furosemide and gentamicin (antibiotic) should not be mixed due to acoustic damage
—tinnitus
vii. Kidney function
1. Creatinine
a. 0.84 to 1.21 mg/dl
2. Creatinine clearance:
a. Men—110 to 150 ml/min
b. Women—100 to 130 ml/min
3. Bun
a. 10-20 mg/dl
e. Food/drug interactions
i. Digoxin
ii. Ototoxic drugs
iii. Potassium-sparing diuretics
iv. Lithium
v. Antihypertensive agents
vi. NSAIDs
vii. Gentamicin
4. Types of Diuretics
a. Loop Diuretics
i. Furosemide (Lasix): potassium wasting. will help you get ride of fluid in the lungs. Used
to treat pulmonary, edematous states (swollen from fluid), hypertension. Interacts with
potassium sparring diuretics because loop diuretics make you lose potassium and
potassium-sparring diuretics make you save potassium.
ii. Must give potassium with this type of diuretic.
iii. (Pink frothy sputum is a side effect if patient has pulmonary edema)
b. Thiazide Diuretics
i. Benzothiazide diuretics are not as potent as loop diuretics but produce similar effects and
have similar side effects. Not as effective if patient has poor urine flow such as a patient
with damaged kidneys.
ii. Side effects: hyponatremia, hypochloremia, dehydration, hypokalemia, use cautiously in
pregnancy and lactation, hyperglycemia, hyperuricemia. Ototoxicity. (not mix with other
ototoxic drugs)
iii. Hydrochlorothiazide: Most widely used. Peaks in 4 to 6 hours. Used for HTN, edema,
and Diabetes insipidus. Same side effects as above. Also impacts lipids, calcium, and
magnesium.
c. Osmotic Diuretics: promotes diuresis by creating osmotic force within lumen of the nephron.
Given parenterally (IV). Treats renal failure, reduces intracranial and intraocular pressure.
i. Mannitol:
1. Side effects: edema, headache, nausea, vomiting, fluid, and electrolyte
imbalance.
d. Potassium-sparing Diuretics: increase in urine production. Substantial decrease in potassium
excretion. Do not increase potassium with this medication. Stay away from potassium rich foods.
Nur2474 pharmacology module 5 quiz review Test tips:
Before answering the question, identify key words (what does the question really ask).
Be cautious of negatively worded questions! They are easy, but often misinterpreted due to not paying
attention to them.
Topics review:
1. Diuretics mechanism of action (including effects on electrolytes)
a. Diuretics work by preventing kidney reabsorption of sodium and chloride therefore preventing
absorption of water.
i. Hypovolemia
ii. Acid-base imbalance
iii. Electrolyte imbalance
2. Diuretics intended use
a. Cleansing of ECF and maintenance of ECF volume and composition
b. Maintenance of acid-base balance
c. Excretion of metabolic wastes and foreign substances
d. Increase amount of salt and water expelled from the body as urine
e. Can also be used to treat hypertension, edema, diabetes insipidus, CHF
3. Review furosemide (mechanism of action, side and adverse effects, administration, monitoring,
food/drug interactions)
a. Mechanism of action
i. Loop Diuretic
ii. Acts on ascending loop of Henle to block reabsorption
b. Side/adverse effects
i. Hyponatremia
ii. Hypochloremia
iii. Dehydration
iv. Hypotension
1. Loss of volume
2. Relaxation of venous smooth muscle
v. Hypokalemia
vi. Ototoxicity
vii. Hyperglycemia
viii. Hyperuricemia (excess of uric acid in blood)
ix. Use in pregnancy
x. Impact on lipids, calcium, and magnesium
c. Administration
i. Rapid onset
1. PO- 60 minutes
2. IV- 5 minutes
ii. Administer in the morning
1. Make you pee a lot, interfere with sleep pattern
d. Monitoring
i. Monitor blood sugar levels
ii. Monitor electrolytes
iii. EKG
iv. Dehydration
v. Fall risk due to hypotension
, vi. Furosemide and gentamicin (antibiotic) should not be mixed due to acoustic damage
—tinnitus
vii. Kidney function
1. Creatinine
a. 0.84 to 1.21 mg/dl
2. Creatinine clearance:
a. Men—110 to 150 ml/min
b. Women—100 to 130 ml/min
3. Bun
a. 10-20 mg/dl
e. Food/drug interactions
i. Digoxin
ii. Ototoxic drugs
iii. Potassium-sparing diuretics
iv. Lithium
v. Antihypertensive agents
vi. NSAIDs
vii. Gentamicin
4. Types of Diuretics
a. Loop Diuretics
i. Furosemide (Lasix): potassium wasting. will help you get ride of fluid in the lungs. Used
to treat pulmonary, edematous states (swollen from fluid), hypertension. Interacts with
potassium sparring diuretics because loop diuretics make you lose potassium and
potassium-sparring diuretics make you save potassium.
ii. Must give potassium with this type of diuretic.
iii. (Pink frothy sputum is a side effect if patient has pulmonary edema)
b. Thiazide Diuretics
i. Benzothiazide diuretics are not as potent as loop diuretics but produce similar effects and
have similar side effects. Not as effective if patient has poor urine flow such as a patient
with damaged kidneys.
ii. Side effects: hyponatremia, hypochloremia, dehydration, hypokalemia, use cautiously in
pregnancy and lactation, hyperglycemia, hyperuricemia. Ototoxicity. (not mix with other
ototoxic drugs)
iii. Hydrochlorothiazide: Most widely used. Peaks in 4 to 6 hours. Used for HTN, edema,
and Diabetes insipidus. Same side effects as above. Also impacts lipids, calcium, and
magnesium.
c. Osmotic Diuretics: promotes diuresis by creating osmotic force within lumen of the nephron.
Given parenterally (IV). Treats renal failure, reduces intracranial and intraocular pressure.
i. Mannitol:
1. Side effects: edema, headache, nausea, vomiting, fluid, and electrolyte
imbalance.
d. Potassium-sparing Diuretics: increase in urine production. Substantial decrease in potassium
excretion. Do not increase potassium with this medication. Stay away from potassium rich foods.
