COPR Advanced Care Paramedic (ACP) Practice Exam

These medications are loop diuretics, indicated by the -semide suffix. They act in the thick ascending limb of the loop of Henle by inhibiting the Na+-K+-2Cl- cotransporter, which prevents reabsorption of sodium, potassium, and chloride. Water follows, producing a strong diuretic effect. Because of their potency, they’re especially useful for removing excess fluid in conditions like heart failure with edema, pulmonary edema, or certain kidney diseases. They work faster and cause more diuresis than other diuretic classes. Common examples include furosemide, torsemide, and bumetanide. Be mindful of electrolyte and fluid balance: they can cause hypokalemia, hypomagnesemia, dehydration, and increased uric acid levels, which can trigger gout. Ototoxicity is a potential risk, especially with rapid IV administration. In contrast, thiazide diuretics act on the distal tubule and are less potent; potassium-sparing diuretics act on the collecting duct and tend to preserve potassium; osmotic diuretics work by creating an osmotic gradient rather than blocking transporters and are used for different indications.