Loop diuretics are a class of medication used to quickly remove excess fluid in the body, especially in instances of peripheral and pulmonary edema. In this video, I'll teach you my visual mnemonic to help you remember the names, uses, and side effects of loop diuretics so you'll be ready for the NCLEX exam. Let's jump in! Welcome to the Pixerize Amusement Park, where the main attraction is this large loop-de-loop roller coaster. This loop-de-loop roller coaster is our symbol for loop diuretics.
Loop-de-loop for loop diuretics? Get it? Loop diuretics actually get their name because they block the transport of sodium and water at the ascending loop of Henle in the kidneys.
But... before we get into the details, let's first talk about the three main drug names that you'll need to recognize for the loop diuretics. This girl is dressed in a warm fur coat because it's a little chilly out, especially in the wind while riding the loop-de-loop roller coaster. This fur can help you remember that a very common loop diuretic is furosemide.
Fur for furosemide. Get it? In the clinical setting, you will often hear furosemide called by its trade name Lasix.
However, the NCLEX will test you using the generic name of furosemide. Be sure to remember it for test day. Next, take a look at this tour guide here. Since kids often follow tours through the different rides in the amusement park, Looks like she's really telling everyone how thrilling this loop-de-loop roller coaster is.
By the way, this tour guide is our symbol for torsemide, another loop diuretic, because tour guide and torsemide sound pretty similar, right? The tour guide wants to make sure everyone can hear her, so she's using a boombox to project her voice. See how the boom box is connected to the microphone there? This boom box is the symbol for our final loop diuretic, bumetanide.
Get it? Boom box for bumetanide? Now we've covered the most common drug names of loop diuretics, furosemide, torsemide, and bumetanide.
Actually, there is one more loop diuretic that you might come across. called ethocrinic acid, but it's not as commonly used or tested, so we won't make you memorize it here. Just remember furosemide, torsemide, and bumetanide.
Now, let's shift gears and talk about how these drugs actually work. This tour guide is advertising that this loop-de-loop roller coaster is the most intense roller coaster ever. You know how amusement parks are always competing for the biggest or scariest roller coaster?
Well, this one even says most intense on the sign. When you think of this super intense, super fast roller coaster, I want you to remember that loop diuretics are also the most powerful and fastest acting class of diuretics. The onset of the drug occurs within the first 30 minutes to one hour after administration, making it good for emergent situations where rapid fluid loss is needed. And we've already talked about how loop diuretics induce fluid loss.
They work on the kidneys, more specifically on the loop of Henle, to cause reduced iron absorption and water loss into the urine. More urine equals more diuresis. To reinforce this mechanism, let's take a closer look at this girl here. The tour guide is waving her over, trying to convince her to ride the loop-de-loop roller coaster, but the girl looks terrified. In fact, she's so scared by the super intense loop that she's wet her pants.
Which reminds me, loop diuretics are, well, diuretics, meaning that they increase the production of urine to remove excess fluid from the body. The most common instances when loop diuretics are used include peripheral edema, pulmonary edema, hypertension, and ascites. All of these cases can be thought of as situations of volume overload, which you can relieve by removing fluid from the body. On this note, let's take a moment to discuss a few clinical pearls that you'll want to remember as a nurse.
First, you'll want to avoid giving diuretics in the evening so that your patient doesn't have to make several bathroom trips during the night. You'll also want to make sure the patient has easy access to the bathroom if they're not already catheterized. And then, with any patient, but especially a patient on a diuretic, you'll want to closely monitor their urine output and report a urine output less than 30 milliliters per minute because a poor urine output, even after taking a diuretic, can be a sign of something more serious going on.
Next, Let's talk about potential adverse effects of taking the loop diuretics. The tour guide's boombox is really, really loud, and there's nothing worse than an overly loud screeching boombox speaker. It's so loud that the girl is covering her ears, which happens to be our symbol for ototoxicity. Got that? Covering ears for ototoxicity?
High doses of all-loop diuretics can cause damage to the inner ear, or ototoxicity, which manifests as ringing in the ears or hearing loss in patients. The risk of ototoxicity is increased when the drug levels are increased, such as when the drug is administered too fast. So, if your patient is experiencing ototoxicity, you may want to ask the provider to reduce the dose or rate of delivery to the patient.
Because she has used both hands to cover her ears, the girl has dropped the banana she was snacking on. Here at Pixerize, we use bananas to symbolize potassium, since bananas have a lot of potassium. Get it? So, this falling banana should help you remember a decrease or fall in potassium levels caused by loop diuretics. Loop diuretics are commonly implicated in causing hypokalemia, and this is extremely important since low potassium levels can lead to life-threatening effects.
As the nurse, you can anticipate that you will be closely monitoring your patient's potassium levels. Do not give loop diuretics if your patient already has low potassium below 3.5. Doctors will usually prescribe potassium supplements along with loop diuretics, and you can encourage your patients to eat foods high in potassium while taking these drugs. All right, that's everything you need to know about loop diuretics.
Let's do a quick review. Loop diuretics are a class of medications that cause diuresis, or fluid loss, by increasing urine output. They work by acting at the loop of Henle in the kidney in order to block sodium and other ions from being reabsorbed, which eventually leads to reduced water absorption and fluid loss in the urine. The most common loop diuretic drugs are furosemide, torsemide, and bumetanide. Loop diuretics are the most powerful diuretic drugs and are used in the clinical setting to treat fluid overload states like pulmonary edema caused by heart failure, peripheral edema, and ascites due to cirrhosis.
Potential side effects include ototoxicity and hypokalemia or low potassium levels. Now that we've learned all about loop diuretics, let's reward ourselves with a ride on the most intense loop-de-loop roller coaster. I'll see you in the next video!