Diuretics interaction

Diuretics, interaction with lithium, 36 65-66 Divalent cations hydration shell, 34 211 structure, 34 210-212... 

When the Marseilles Poisons Centre analysed information on lithium overdose between 1991 and 2000, in addition to an unspecified number of suicide attempts and accidental poisonings in children, the next most frequent reports were prescription misinterpretation (n = 43), dehydration in the elderly (n = 35), renal insufficiency (n = 15), and diuretic interactions (n = 8) (533). 

Finnegan TP, Spence JD, Cape R. Potassium-sparing diuretics interaction with dioxin in elderly men J Am GeriatrSoc (1984) 32,129-31. 

Cl=4.93, 9.53). Among the individual diuretics examined, hydrochlorothiazide carried the greatest risk (adjusted OR = 4.6 95% Cl=2.5, 8.6). This study provided empirical evidence that digoxin-diuretic interactions increase the risk of hospitalization for digoxin intoxication in patients with heart failure. 

Wang T, Su CY, Chan AL, Lian PW, Leu HB, Hsu YJ. Risk of digoxin intoxication in heart failure patients exposed to digoxin-diuretic interactions a population-based study. Br J Clin Pharmacol 2010 70 (2) 258-67. 

No significant interactions have been reported when tiie expectorants are used as directed. The exception is iodine products. Lithium and other antithyroid drug may potentiate the hypotliyroid effects of these drug if used concurrently with iodine products. When potassium-containing medications and potassium-sparing diuretics are administered with iodine products, the patient may experience hypokalemia, cardiac arrhythmias, or cardiac arrest. Thyroid function tests may also be altered by iodine... 

The hypotensive effects of most antihypertensive dru are increased when administered with diuretics and other antihypertensives. Many dnigp can interact with the antihypertensive drugs and decrease their effectiveness (eg, antidepressants, monoamine oxidase inhibitors, antihistamines, and sympathomimetic bronchodilators). When the ACE inhibitors are administered with the NSAIDs, their antihypertensive effect may be decreased. Absorption of the ACE inhibitors may be decreased when administered with the antacids. Administration of potassium-sparing diuretics or potassium supplements concurrently with the ACE inhibitors may cause hyperkalemia. When the angiotensin II receptor agonists are administered with... 

Discuss the uses, general drug actions, adverse reactions, contraindications, precautions, and interactions of the diuretics. 

The most potentially serious drug interactions include the concomitant use of NSAIDs with lithium, warfarin, oral hypoglycemics, high-dose methotrexate, antihypertensives, angiotensin-converting enzyme inhibitors, fi-blockers, and diuretics. 

Phenobarbital is a potent enzyme inducer and interacts with many drugs. The amount of phenobarbital excreted renally can be increased by giving diuretics and urinary atkalinizers. 

The interaction between NSAID and diuretics is not taken into consideration... 

Use of a hERG blocker in a patient also taking drugs inducing electrolyte imbalance (e.g. risk of hypokalemia with diuretics) this is a pharmacodynamic interaction... 

Drug interactions Diuretics" NSAIDs (e.g., ibuprofen)" Lamotrigine Clozapine" Contraceptives HIV protease inhibitors" ... 

QIO A patient is being started on amiloride/hydrochlorthiazide tablets. Which drug may interact with the diuretic ... 

For excretion processes, the same reasoning may be used as for absorption. Cases of interaction are only to be expected when active processes are involved. Increased excretion of a chemical following administration of an osmotic diuretic or alteration of the pH of the urine are well known examples of dispositional interaction. 

Drugs that may interact include ACE inhibitors, potassium-sparing diuretics, digitalis, and potassium-containing salt substitutes. 

Other drugs that may interact with cardiac glycosides include the following Albuterol, amphotericin B, beta-blockers, calcium, disopyramide, loop diuretics, nondepolarizing muscle relaxants, potassium-sparing diuretics, succinylcholine, sympathomimetics, thiazide diuretics, thioamines, and thyroid hormones. 

Diazepam (Valium, Diastat) [C-IVj [Anxiolytic, Skeletal Muscle Relaxant, Anticonvulsant, Sedative/Hypnotic/ Benzodiazepine] Uses Anxiety, EtOH withdrawal, muscle spasm, status epilepticus, panic disorders, amnesia, preprocedure sedation Action Benzodiazepine Dose Adults. Status epilepticus 5-10 mg IV/IM Anxiety 2-5 mg IM/IV Preprocedure 5-10 mg IV just prior to procedure Peds. Status epilepticus 0.5-2 mg IV/IM Sedation 0.2-0.5 mg/kg IV (onset w/in 5IV and 30 min IM duration about 1 h IV and IM) Caution [D, / -] Contra Coma, CNS depression, resp d es-sion, NAG, severe uncontrolled pain, PRG Disp Tabs 2, 5, 10 mg soln 1, 5 mg/mL inj 5 mg/mL rectal gel 2.5, 5, 10, 20 mg/mL SE Sedation, amnesia, bradycardia, i BP, rash, X resp rate Interactions T Effects W/ antihistamines, azole antifungals, BBs, CNS depressants, cimetidine, ciprofloxin, disulfiram, INH, OCP, omeprazole, phenytoin, valproic acid, verapamil, EtOH, kava kava, valman T effects OF digoxin, diuretics X effects w/ barbiturates, carbamazepine. 

Dopamine (Intropin) [Vasopressor/Adrenergic] Uses Short-tOTn use in cardiac decompensation secondary to X contractility when no hypovolemia is present T organ p fusion (at low dose) Action Renal dose 2-5 mcg/kg/min Inotropic dose 5-10 mcg/kg/min Pressor dose >10 mcg/kg/min Dose Adults Feds. 5-20 mcg/kg/min by cont inf, start at 5 and t by 5 mcg/kg/min to 20 mcg/kg/min max to effect (mix 400 mg in 250 mL DjW to make 1600 mcg/mL) (see Table 1-3) Caution [C, ] Contra Pheochromocytoma (adrenal gland tumor), VF, sulfite sensitivity Disp Inj 40, 80, 160 mg/mL, premixed 0.8, 1.6, 3.2 mg/mL SE Tach, vasoconstriction, 4- BP, HA, N/V, dyspnea Notes >10 mcg/kg/min X renal p fiision Interactions t Effects W/ a-blockers, diuretics, ergot alkaloids, MAOIs, BBs, anesthetics, phenytoin X effects W/ guanethidine EMS Correct hypovolemia before use use microdrip set or inf pump check soln- discolored... 

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