diuretics + drugs affecting urinary tract/ bladder Flashcards
rotation 2 - week 5
Finasteride is a drug used to treat _____.
BPH
Finasteride blocks the hormone ___________, which is decreasing the size of the prostate - this is relieving the BPH itself and the _________ associated with it.
-testosterone
-obstruction
What are the 3 hormonal side effects of finasteride?
-gynecomastia
-decreased libido + ejaculation volume
-low PSA levels
What are the 4 contraindications of Finasteride?
pregnancy
female
liver impairment
urinary system obstruction
Up to how long can it take Finasteride to have a therapeutic effect?
up to 12 months
oxybutynin is an antispasmodic used to treat spasms in the urinary tract and urge incontinence due to overactive or neurogenic bladder. But what other drug class does this medication belong to?
anticholinergic drug class
what are 2 complications of oxybutynin related to the urinary retention effects?
overdistension of the bladder and UTI
what are the 6 side effects of oxybutynin?
-anticholinergic effects
-somnolence
-fever
-headache
-dizziness
-heat exhaustion
what is the most important electrolyte to monitor while a patient is on furosemide or hydrochlorothiazide, due to the risk of dysrhythmias?
potassium
what are some foods rich in potassium?
-bananas
-raisins
-potatoes
-citrus fruit
Furosemide is a loop diuretic and hydrochlorothiazide is a thiazide diuretic, they block the absorption of sodium + chloride. this leads to what? (3)
-sodium + chloride excretion
-increased urine output
-potassium excretion
electrolyte imbalances
hyperglycemia
hyperuricemia
orthostatic hypotension
dehydration
are all side effects of furosemide and hydrochlorothiazide. But which side effect does furosemide have that hydrochlorothiazide does not?
ototoxicity
when is a better time of day to take diuretics, in the morning or before bed?
in the morning
if you’re giving furosemide IV, why is it important to not push or set the pump to infuse too rapidly?
because if the dose is too high or you give this medication too rapidly, it can cause ototoxicity
If your patient is pregnant and/ or has a sulfa allergy can they take hydrochlorothiazide?
NO
both of these are contraindicated
If you take an NSAID with furosemide it will ______ the diuretic effects.
decrease
when taking a loop or thiazide diuretic, while also taking digoxin, if you become hypokalemic what are at risk of developing?
digoxin toxicity
Spironolactone is a potassium _______ diuretic.
sparing
Why may patients experience endocrine related side effects like menstrual irregularities or gynecomastia while taking spironolactone?
because its a steroid and also produces effects similar to progesterone and testosterone
if hyperkalemia develops in your patient, what 3 things are you going to do?
-take an apical pulse
-EKG/ECG
-monitor for dysrhythmias
A patient taking spironolactone needs to be educated on avoiding what?
-potassium supplements
-potassium rich foods
HTN, edema, and hyperkalemia are indications to use what medication?
spironolactone, a potassium sparing diuretic
If you have a sulfa allergy, which diuretics shouldn’t you take?
Thiazide and Loop diuretics both contain sulfa
Acetazolamide is a mild diuretic that increases the amount of sodium and bicarbonate that is excreted through the urine. What drug class does this medication belong to?
carbonic anhydrase inhibitor
Since Acetazolamide is excreting all of that bicarb. what is one of the biggest side effects that could occur?
metabolic acidosis
Which drug is used to treat open angle glaucoma because it decreases aqueous humor formation and IOP?
Acetazolamide
Mannitol is an osmotic diuretic that ____ ___ into the renal tubules to be excreted.
draws water
What 3 conditions are indicated for osmotic diuretic use?
-glaucoma
-increased IOP
-to induce renal excretion of toxins, like from Rhabdo.
Mannitol is not generally used, and is actually contraindicated in fluid overload conditions like HF + pulmonary edema because why?
it could cause an exacerbation of these conditions
Mannitol is ONLY given IV and it is important that the drug crystals are _______ in _______ water.
-dissolved
-warm
Fosfomycin is an anti-infective used to treat _____.
UTI
Does Fosfomycin treat gram negative or gram positive bacteria to lead to cell death?
fosNOmycin
gram negative bacteria
What are 3 non-pharmacological things a patient can do while having a UTI to help get rid of this infection?
-proper hygiene
-stay hydrated
-proper diet
How does phenazopyridine relieve the pain, urgency, burning, frequency or discomfort associated with infection, trauma, surgery or procedures as a urinary tract analgesic?
this drug coats the urinary tract mucosa
Which side effect needs to be reported and the medication discontinued and which side effect is expected?
- jaundice – 2.red/ orange urine that stains
jaundice needs to be reported and medication needs to be discontinued
red/orange urine is an expected side effect
pentosan polysulfate sodium is a bladder protectant. But this drug also has _______ + ________ effects that makes monitoring for bleeding super important as this patients nurse.
anticoagulant + fibrinolytic
which medication coats the bladder mucosal wall to protect it from solutes in the urine in conditions like interstitial cystitis?
protects from PP
pentosan polysulfate sodium
pentosan polysulfate sodium should be taken on an ______ ________, either 1 hour before meals or 2 hours after, to help with GI disturbances and with absorption.
empty stomach
Doxazosin is an alpha adrenergic blocker so it is ________ arterioles and veins in the bladder and urinary tract, via sympathetic relaxation.
dilating
It is important to apply safety precautions to patients taking doxazosin due to what 3 side effects?
-postural dizziness
-vertigo
-hypotension
While a patient is on doxazosin it it important to monitor their cardiopulmonary status due to what 2 side effects?
tachycardia + palpitations
why do you have to educate the patient whos taking oxybutynin about the risk of heat exposure?
due to the anticholinergic effects - they won’t be producing sweat to regulate body temperature
