Diuretics and Medications for Urinary System Disorders

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Diuretics and Medications for Urinary System
Disorders

• Unit 27

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Objectives

• State two vital functions of the kidney
• Describe the symptoms, diagnosis, and treatment
  regimen for cystitis
• Describe interstitial cystitis
• State the action, usual dosage, and adverse
  reactions of selected drugs used for urologic
  disorders

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Urinary System

• Composed of two kidneys, two ureters, one
  bladder, and one urethra
• Million or more functional units called nephrons
  which are the site of filtration and reabsorption
• Two vital functions are performed
• 1. urine is produced for excretion
• 2. water and electrolytes are regulated

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Diseases of the Urinary System

• Type 2 diabetes is the leading cause of chronic
  kidney failure
• Other conditions include
• Kidney stones
• Polycystic kidney disease
• Cancer
• UTIs-urinary tract infections
• Cystitis (bladder infections)

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Warning Signs of Disease

• More frequent urination
• Blood in the urine (hematuria)
• Edema around eyes, in the hands and feet
• Pain in the small of the back, below the ribs
• High blood pressure

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Diuretics

• Function by decreasing reabsorption of NaCl by
  the kidneys, increasing the amount of salt and
  water excreted in the urine
• This action further reduces the amount of fluid
  retained within the body and prevents edema

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Classification of Diuretics

• Classified according to site and mechanism of
  action
• 1. Thiazide diuretics
• 2. Loop diuretics
• 3. Potassium-sparing diuretics
• 4. Osmotic diuretics
• 5. Carbonic anhydrase inhibitor diuretics

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Diuretic Uses

• CHF
• Hypertension
• Renal failure
• Diabetes
• Glaucoma
• PMS

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Thiazide Diuretics

• Act by inhibiting sodium and chloride
  reabsorption in the distal tubule of the kidney
• Ex. Diuril
• Warning observe patient for evidence of fluid or
  electrolyte imbalance
• Thiazides may increase blood sugar in diabetic
  patients

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Loop Diuretics

• Act by inhibiting the reabsorption of sodium and
  chloride in the proximal and distal tubules and
  in the ascending loop of Henle
• Watch for fluid imbalances
• May increase blood sugar in diabetic patients

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Potassium-Sparing Diuretics

• Act by causing increased amounts of sodium and
  water to be excreted, while potassium is retained
• Action occurs in the distal tubule
• Uses edema, CHF, cirrhosis of the liver,
  hypertension

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Osmotic Diuretics

• Act by increasing the osmolality of the plasma
  and tubular fluid, increasing excretion of water,
  chloride, sodium, and potassium.
• Uses prevent acute renal failure during trauma
  or prolonged surgery prevent increased cerebral,
  cerebrospinal, or ocular pressures during trauma

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Carbonic Anhydrase Inhibitor Diuretics

• Act to promote the reabsorption of sodium and
  bicarbonate from the proximal tubules
• Block the action of the enzyme carbonic
  anhydrase, promoting the excretion of water,
  sodium, and potassium

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Urinary Tract Antibacterials

• Sulfonamides primary drug of choice
• Sulfonamides are classified according to the
  length of time they remain in the body.
• Three groupings of sulfonamides
• 1. short
• 2. intermediate
• 3. long

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Sulfonamides

• Act by causing a bacteriostatic effect against
  both gram positive and gram negative bacteria
• Prevent the growth of microorganisms by
  inhibiting the production of dihydrofolic acid in
  the bacterial cells
• Uses acute, recurrent UTIs
• Warnings Allergies!

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