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  #1  
Old 08-03-2012
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Drug Which diuretic?

A 68-year-old man requires mitral valve replacement. His medical records indicate that he has been taking losartan for treatment of moderate hypertension and that he has shown grade II retinopathic changes. The records also show that he previously had a serum creatinine level of 1.7 mg/dL and a blood urea nitrogen level of 30 mg/dL. After surgery, the patient has a urine output of 45 mL/hr. The next morning, his urine output decreases to 12 mL/hr and he is found to be euvolemic. Which of the following diuretics is most appropriate for the treatment of this patient?

a) Acetazolamide
b) Bumetanide
c) Chlorothiazide
d) Ethacrynic acid
e) Triamterene
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sruthi (08-04-2012)



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Old 08-03-2012
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D....impending renal insufficiency--> loop diuretics
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Old 08-03-2012
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Default correct answer :)

@ anomali - you are correct loop diuretics should be given. But there are 2 loop diuretics on the list

The answer is b) Bumetanide

The decrease in urine output indicates that the patient has acute renal failure. Under the circumstances, diuretics are used to prevent complete renal shutdown. The diuretics that are most commonly used to treat acute renal failure are osmotic diuretics (such as mannitol) and loop diuretics. Bumetanide is about 40 times more potent than furosemide. It is useful in patients who have severe renal impairment and require large doses of loop diuretics.

As for ethacrynic acid - Ethacrynic acid would be effective in treating this patient; however, due to its greater risk of ototoxicity when compared with bumetanide or furosemide, its use should be reserved for patients who are allergic to sulfonamide-containing diuretics.
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Old 08-04-2012
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i dint look at the other options...gotta be careful from now......
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