Carbonic anhydrase inhibitors
Carbonic anhydrase inhibitors include acetazolamide (Diamox), dichlor-
phenamide (Darnide, Oratrol), and methazolamide (Neptazane).
Potassium-sparing diuretics
Potassium-sparing diuretics include amiloride HCl (Midamor); spironolactone
(Aldactone), and triamterene (Dyrenium). Combination diuretics include:
amiloride HCl and hydrochlorothiazide (Moduretic); spironolactone and
hydrochlorothiazide (Aldactazide), and triamterene and hydrochlorothiazide
(Dyazide, Maxzide).
THIAZIDE DIURETICS
Thiazides influence the distal convoluted renal tubule beyond the loop of
Henle to promote sodium, chloride, and water excretion. Thiazides are used in
the treatment of hypertension and peripheral edema, but are not effective for
immediate diuresis and should be used mainly with patients with normal
kidney function.
Thiazides cause a loss of sodium, potassium, and magnesium and promote
calcium reabsorption. They affect glucose tolerance and should be used with
caution in clients with diabetes mellitus. Monitor laboratory tests for electrolytes
and glucose.
Side effects and adverse reactions of thiazides are electrolyte imbalances,
hyperglycemia, hyperuricemia (elevated serum uric acid level), and hyperlipi-
demia (elevated blood lipid levels). They affect the metabolism of carbohydrates.
Other side effects include dizziness, headaches, nausea, vomiting, constipa-
tion, and rarely urtacaria (hives) and blood dyscrasias.
A list of thiazides diuretic drugs is provided in the Appendix. Detailed tables
show doses, recommendations, expectations, side effects, contraindications, and
more; available on the book’s Web site (see URL in Appendix).
LOOP OR HIGH-CEILING DIURETICS
Loop or high-ceiling diuretics act on the ascending loop of Henle by inhibiting
chloride transport of sodium into the circulation. Sodium, potassium, calcium,
CHAPTER 19 Cardiac Circulatory Medications^361