Presentation
The book presents core drug knowledge using prototypes of different drug classes and emphasizes core patient variables that influence the patient's response to therapy. [books.google.com]
Image Collections Hundreds of image-rich slideshow presentations visually engage and challenge readers while expanding their knowledge of both common and uncommon diseases, case presentations, and current controversies in medicine. [reference.medscape.com]
They present a case of poisoning with phenobarbital (a long-acting barbiturate), in a 22-year-old woman, showing this same effect. [jamanetwork.com]
Entire Body System
- Epilepsy
Carbonic anhydrase inhibitors are also used to treat epilepsy, altitude and motion sickness. THIAZIDE DIURETICS These were originally synthesized as carbonic anhydrase inhibitors. [uky.edu]
- Pseudotumor
[…] elimination Eyes: ↓ production of aqueous humor Brain: ↓ CSF production Side effects Hyperammonemia with paresthesias Proximal renal tubular acidosis → hyperchloremic, non- anion gap metabolic acidosis Hypokalemia Sulfa allergy Indications Acute glaucoma Pseudotumor [amboss.com]
- Surgical Procedure
Administer by IV infusion using an administration set with a filter. a b When used in surgical procedures to prevent oliguric acute renal failure, administration may be initiated before or immediately following surgery and may be continued postoperatively [drugs.com]
Gastrointestinal
- Constipation
Symptoms of potassium loss include: Tiredness Weakness Numbness Tingling Muscle cramps Constipation Vomiting Fast heartbeat (tachyarrhythmia) Patients should contact their physicians if they have any of the following side effects from diuretics, most [drugs.nmihi.com]
A06 — DRUGS FOR CONSTIPATION A — ALIMENTARY TRACT AND METABOLISM B05BC01 — Mannitol B05BC — Solutions producing osmotic diuresis B05B — I.V. [drugbank.ca]
- Loss of Appetite
Side effects Potential side effects of diuretics The most common side effect associated with diuretics is potassium loss. With the exception of potassium-sparing versions, all diuretics may cause a loss of potassium. [drugs.nmihi.com]
Cardiovascular
- Orthostatic Hypotension
Transplantation, Mannitol 1 3 Terminated Treatment Acute Ischemic Stroke (AIS) 1 3 Terminated Treatment Dopamine Beta Hydroxylase Deficiency / Multiple Systems Atrophy / Parkinson's Disease (PD) / Progressive autonomic failure / Symptomatic Neurogenic Orthostatic [drugbank.ca]
Skin
- Skin Rash
Reactions include dermatitis, skin rash, photo-dermatitis (light reactions on skin), hemolytic anemia (breakdown of the red blood cells), thrombocytopenia (low platelet counts) and acute necrotizing pancreatitis. [news-medical.net]
Eyes
- Blurred Vision
vision Hypernatremia Hyperkalemia Hypotension Mannitol when given with Acetazolamide and NSAIDS, may cause acute renal failure. [health-conditions.com]
* CNS: headache, blurred vision, dizziness, disorientation, convulsions. * GI: nausea, vomiting. Toxicity and Overdosage * Extension of adverse reactions. [skepticfiles.org]
vision Confusion or nervousness Diarrhea, stomach cramps or pain Loss of appetite Difficult or painful urination Muscle twitches or spasms Joint pain Fever or chills Erectile dysfunction (impotence) or decreased desire for sex Headache or ringing in [drugs.nmihi.com]
Musculoskeletal
- Osteoporosis
Diuretics (specifically the carbonic anhydrase inhibitors) are used as adjunctive treatment of chronic simple (open-angle) glaucoma and secondary glaucoma Thiazide diuretics have off–label (non- FDA -approved) uses for osteoporosis in postmenopausal women [rxlist.com]
These drugs have been shown to reduce calcium excretion, meaning they are attractive options for patients with kidney stones or osteoporosis. [drugs.nmihi.com]
Neurologic
- Headache
Toxicity: Volume expansion effects -- increased extra cellular fluid volume and hyponatremia may cause pulmonary edema, complicating congestive heart failure Headache, nausea, vomiting -- commonly observed Dehydration and hypernatremia: fluid loss leads [pharmacology2000.com]
[…] pressure Oligria/Anuria CONTRAINDICATIONS OF MANNITOL: Patient with severe dehydration Hypersensitivity Heart Failure Anuria Active cerebral hemorrhage (who undergoes craniotomy) SIDE EFFECTS & ADVERSE EFFECTS: Dehydration Dizziness Nausea Vomiting Headache [health-conditions.com]
Headache Nausea and vomiting Dehydration and loss of free water Hypernatremia or increased sodium levels Further Reading Diuretic - What is a Diuretic? What Are Diuretics Used For? Diuretic Mechanism [news-medical.net]
Overview Snapshot A 32-year-old previously healthy man develops headache, fatigue, vomiting, and shortness of breath about 12 hours after arriving to Mt. Everest Base Camp. Over the next day, he develops mild difficulty walking, and confusion. [medbullets.com]
* CNS: headache, blurred vision, dizziness, disorientation, convulsions. * GI: nausea, vomiting. Toxicity and Overdosage * Extension of adverse reactions. [skepticfiles.org]
- Confusion
[…] or lightheadedness, especially after getting up from a sitting or lying position Less common side effects of diuretics may include: Allergic reaction Fainting (syncope) Increased sensitivity to sunlight, causing severe sunburn or rash Blurred vision Confusion [drugs.nmihi.com]
Over the next day, he develops mild difficulty walking, and confusion. He is seen by a physician who administers a medication and advises him to rest. His symptoms improve over the next 24-48 hours. [medbullets.com]
When individuals present with fluid imbalance (depletion) due to diuretics, adverse events such as: dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, confusion, seizures, muscular fatigue, hypotension, oliguria [rxlist.com]
- Dizziness
Obtain blood and urine specimen for laboratory analysis Observe for any change in consciousness, dizziness, fatigue, postural hypotension Monitor for fluid intake by measuring intake, output and daily weight. [health-conditions.com]
Elderly use issues Older adults have a higher frequency and intensity of side effects, such as lightheadedness, dizziness and fainting (syncope). [drugs.nmihi.com]
* CNS: headache, blurred vision, dizziness, disorientation, convulsions. * GI: nausea, vomiting. Toxicity and Overdosage * Extension of adverse reactions. [skepticfiles.org]
The product has been associated with side effects such as dizziness, headache, cough, rash, asthenia, fatigue, impotence, edema/swelling, among other adverse events. [google.ch]
- Vertigo
There was no significant relationship between normalization of ECoG findings and improvement of vertigo. [jstage.jst.go.jp]
Currently, the Products are mainly used by ENT doctors for the treatment of patients with Meniere’s disease, which is characterised by repetitive attacks of severe rotatory vertigo with ear ringing and hearing loss and which has also been designated as [eisai.com]
Urogenital
- Polyuria
POLYURIA after the release of obstructive uropathy is a clinical entity of considerable medical interest. [nejm.org]
The result is usually polyuria leading to dehydration if not managed in a timely and appropriate manner. [nataliescasebook.com]
In addition, the polyuria expected during osmotic diuresis phase was not evident in our case probably as a result of extra renal water loss by diarrhea and febrile state, and by AKI. [scielo.br]
Workup
Serum
- Hyponatremia
Hyponatremia initially, as blood volume is increased. When excess diuresis occurs, hyponatremia turns to hypernatremia. 2. Precipitation of CCF, if increased blood volume, it worsens. [howmed.net]
Side effects Metabolic imbalances Hypokalemia, hypomagnesemia, hypocalcemia ;, hypochloremia, hyponatremia (moderate) Metabolic alkalosis Hyperuricemia / gout Hyperglycemia Ototoxicit y (potentially permanent hearing damage) Dehydration / hypovolemia [amboss.com]
Toxicity: Volume expansion effects -- increased extra cellular fluid volume and hyponatremia may cause pulmonary edema, complicating congestive heart failure Headache, nausea, vomiting -- commonly observed Dehydration and hypernatremia: fluid loss leads [pharmacology2000.com]
Ashraf N et al: Thiazide-induced hyponatremia associated with death or neurologic damage in outpatients. Am J Med 1981; 70: 1141. 3. Brater DC: Determinants of the overall response to furosemide: pharmacokinetics and pharmacodynamics. [skepticfiles.org]
#6 from what I remember - most diuretics are not used in anuric states (except for a couple). specifically to osmotic diuretic agents: I think in anuric states - the osmotic risks would be hyponatremia, hyperkalemia, volume overload and the increased [forums.studentdoctor.net]
Treatment
CF) 1 3 Completed Treatment Relapsing Remitting Multiple Sclerosis (RRMS) 1 3 Completed Treatment Renal Cancers 1 3 Completed Treatment Wheezing 1 3 Not Yet Recruiting Treatment Ciguatoxin 1 3 Recruiting Other Asthma Bronchial 1 3 Recruiting Treatment [drugbank.ca]
These situations include the treatment of pulmonary edema, hypertensive crises and poisonings. Salt diuretics are used also for the treatment of cardiac failure [3]. [dopinglinkki.fi]
Two medical therapies exist but they are only short-term treatments, which means pain and disorders will be relieved only temporarily. These two treatments are able to only control communicating hydrocephalus. [sophysa.com]
Treatment must be stopped if encephalopathy develops. Spironolactone can also be used to treat malignant ascites. [patient.info]
: Osmotic diuretic treatment of refractory edema. Circulation, Vol. XVII, 6: 1013, 1956. [journals.sagepub.com]
Etiology
Rhabdomyolysis: a review of clinical presentation, etiology, diagnosis, and management. Pediatr Emerg Care. 2008 Apr. 24(4):262-8. [Medline]. Lima RS, da Silva Junior GB, Liborio AB, Daher Ede F. Acute kidney injury due to rhabdomyolysis. [emedicine.medscape.com]
DISCUSSION This report illustrates a case of hypernatremia of multifactorial etiology in the intensive care unit (ICU). [scielo.br]
Pathophysiology
· Presents new chapters on pathogenesis and pathophysiology of diabetic nephropathy and genetic basis of glomerular and structural kidney disorders.. · Provides expanded coverage of the pathophysiology and management of chronic kidney disease. [books.google.ro]
This thoroughly updated Third Edition covers newly approved drugs, has separate chapters on drugs affecting fungal and viral infections, and includes more pathophysiology information. [books.google.com]
The syndrome of rhabdomyolysis: Pathophysiology and diagnosis. Eur J Intern Med. 2007 Mar. 18(2):90-100. [Medline]. Kilfoyle D, Hutchinson D, Potter H, George P. [emedicine.medscape.com]
[…] antiarrhythmic drugs. 6 iii) Nonsteroidal anti-inflammatory agents reduce the efficacy of thiazide diuretics. 6 iv) Thiazides can increase the blood levels of lithium. e) Clinical Uses Thiazides can be used to treat edema associated with a variety of pathophysiologic [uky.edu]
Prevention
Sodium bicarbonate is administered IV to alkalinize the urine in patients with rhabdomyolysis because it may prevent the toxicity that can result from the presence of myoglobin in acidic urine and prevent the crystallization of uric acid. [emedicine.medscape.com]
Haynes 2 feels that the maintenance of an adequate urinary flow using dextran produces a beneficial flushing in the renal tubules and is helpful in preventing the precipitation of casts. [jamanetwork.com]
Black Box warnings from the FDA labels have been added to the discussion of each prototype when applicable, and safety alerts have been added to emphasize prevention of common medication errors. [books.google.com]
[…] increases with mannitol excretion due to direct osmotic effects sodium reabsorption is reduced because of increased urine flow rates {decreased contact time between urine and tubular epithelial cells} Clinical Uses: To increase urine volume: may be used to prevent [pharmacology2000.com]
A report in 1960 that osmotic diuresis prevented acute renal failure after aortic cross-clamping popularized the use of mannitol as a therapeutic agent (4-6). [annals.org]