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Pharmacology FINAL EXAM > GU Medication > Flashcards

GU Medication Flashcards

1
Q

Reasons to give IV fluid to Pt’s

A
  1. NPO
  2. Hypovolemia
  3. Dehydration
  4. Certain Medications – certain dye’s for angiograms
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2
Q

Where is most fluid located?

A

In the cells

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3
Q

Oncotic Pressure

A

Pressure that a protein will exert to pull fluids towards them

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4
Q

Hydrostatic pressure

A

Pressure that pulls fluid out and puts it into the interstitial space

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5
Q

Normal Osmolality in blood

A

275 - 295 mOsm/kg

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6
Q

Hypertonic IV fluid

-Does what?

A
  1. Water moves from interstitial space to plasma
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7
Q

Hypotonic IV fluid

-does what?

A
  1. Water moves from plasma to interstitial space
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8
Q

Isotonic IV fluid

-Does what?

A
  1. No fluid shift

2. Don’t give to someone with with HTN

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9
Q

0.9 normal Saline and Lactated Ringer

A

Isotonic Solution

-Stays in the vessel

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10
Q

D5.9

A
  1. Hypertonic Solution
  2. Fluid is going to leave cell and interstitial space into the plasma
  3. Cells will shrink from loss of fluid
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11
Q

D5W

A
  1. Hypotonic solution

2. Fluid will move out of plasma and into interstitial and cellular space.

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12
Q

Crystalloids

A
  1. Contain Electrolytes (Lactated ringer, Saline)
  2. Used to replace fluids and promote urine output
  3. Compartment entered depends on tonicity of IV fluid
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13
Q

Colloids

A
  1. Molecules to large to easily cross capillary membrane
    - Stays in IV space
    - Rapidly expand plasma volume
  2. Draw water from intracellular fluid and interstitial spaces into plasma
    - –ULTIMATE Hypertonic solution
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14
Q

Diuretics

-Used for

A
  1. High potassium
  2. Kidney failure (Don’t work when kidneys have failed)
  3. Fluid overload
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15
Q

Pharmacotherapy considerations for Renal Failure

-Adjustments

A
  1. Reduce medications because they are excreted in the kidneys
  2. Call pharmacy to properly adjust the dose
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16
Q

Pharmacotherapy considerations for Renal Failure

-Labs and tests to see Renal Failure

A
  1. GFR
  2. Creatinine clearance
  3. BUN
  4. Urine output 30ml/hr test
  5. Person w/ kidney failure will have high potassium levels
  6. Calcium will be low and phosphorus will be high
  7. Sodium can be low
  8. Early signs of renal failure is HTN
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17
Q

Sings of liver failure

A
  1. Person w/ kidney failure will have high potassium levels
  2. Calcium will be low and phosphorus will be high
  3. Sodium can be low
  4. Early signs of renal failure is HTN
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18
Q

Loop diuretics

-Examples

A
  1. Lasix

2. Bumex

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19
Q

Thiazide type diuretics

-Examples

A
  1. Hydrochlorothiazide

2. Metolazone (Zaroxolyn)

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20
Q

Potassium sparing diuretics

-Examples

A
  1. Triamterene (Dyrenium)

2. Spirolactone (Aldactone)

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21
Q

Combination of diuretics

-Examples

A
  1. Maxide

2. Diazide

22
Q

Diuretic Uses

A
  1. Hypertension
  2. Hyperkalemia
  3. CHF
  4. Fluid Overload
  5. Primary Aldosteronism
23
Q

Diuretic Contraindications

A
  1. Electrolyte depletion (especially potassium)
  2. Pregnancy
  3. Anuria or progressive oliguria
    - Anuria is <400 ml/24hr
  4. Hypokalemia (Loop and thiazide) (check lab electrolytes)
  5. Hyperkalemia (w/ K+ sparing)
  6. Renal dysfunction
24
Q

Prednisone (glucocorticoid)

-Interaction

A

Prednisone decreases potassium

Also can decrease calcium and magnesium

25
Q

Hypokalemia and Digoxin

A

Hypokalemia can cause digoxin toxicity

26
Q

Hyperkalemia and ACE inhibitor & ARB

A

don’t give together.

27
Q

Diuretic

-Drug interactions

A
  1. ACE Inhibitors
  2. NSAID’s
    - Can decrease the effectiveness of diuretics and ACE inhibitors
  3. Digoxin Toxicity (with hypokalemia)
  4. Corticosteroids (K will decrease)
28
Q

Digoxin Toxicity

-Signs

A
  1. Light halo’s
  2. Visual disturbances
  3. Severe N/V
29
Q

Diuretics

-Adverse Effects

A
  1. Hypotension
  2. Electrolyte Imbalance
  3. Hearing Changes (LASIX) **TEXT
  4. Photosensitivity (hydrochlorothyozide) –turns urine blue **TEST
  5. Dehydration – If BUN is high but everything is normal cut back on diuretics.
30
Q

Hydrochlorothyozides

A
  1. turns urine blue

2. Photosensitivity

31
Q

Lasix

-Implications

A

Can cause uric acid levels and gout

32
Q

Hydrochlorothyozide

-Implications

A

Limit Sun Exposure

33
Q

Lasix IV push

-How fast does it work?

A
  1. 5 minutes to take effect
34
Q

Diuretics

-How to know they are working

A
  1. Lowered BP
  2. Potassium levels are good
  3. CHF is good
  4. They are urinating
35
Q

Antispasmodics

A
  1. Parasympatholitic action to relax bladder muscle and increase holding capacity
36
Q

Antispasmodics

-Examples

A
  1. Urispas
37
Q

Antispasmodics

-Contraindications

A
  1. Narrow-angle glaucoma
  2. myasthenia gravis
  3. CAD
  4. GI bleeding or issues w/ motility
38
Q

Antispasmodics

-Pyridium (phenazopyridine)

A
  1. Pyridium turns the urine blood orange and it stains.

2. Anesthetic effect on the urinary mucosa

39
Q

Antispasmodics

-Used for

A
  1. Dysuria
  2. Urgency
  3. Nocturia
  4. Pain
  5. Frequency
  6. Relief after transurethral surgery // Neurogenic bladder
40
Q

Antispasmodics

-Adverse effects

A
  1. Headache, dizziness, restlessness
  2. N/V, dry mouth
  3. Heart palpitations and tachycardia
  4. Urinary retention
41
Q

Antispasmodics

-Implications

A
  1. Watch for GI distress cause anti-cholinergic slow digestive process
  2. Watch symptoms of liver and kidney damage
  3. Urine can stain while on Pyridium
  4. Watch I/O
42
Q

ACE Inhibitors

-Overview

A
  1. Causes dry cough
  2. Increases potassium
  3. Contraindicated with renal stenosis
  4. Don’t use with pregnancy
43
Q

Phosphate-Binding Agent

A
  1. Corrects the calcium/phosphorus imbalance from renal failure
  2. Binds w/ phosphorus in the GI tract
44
Q

Phosphate-Binding Agent

-When to give

A
  1. Give right before meal time
45
Q

Phosphate-Binding Agent

-Contraindication

A
  1. Hypercalcemia

2. Hypophosphatemia

46
Q

Potassium

-can it be given IV push?

A

potassium cannot be given IV push.

It is never safe to push potassium

47
Q

Cation-Exchange Resin

A
  1. It will give a sodium molecule and take away a potassium molecule
  2. Works in the stomach as well as the intestine (oral and enema)
48
Q

Cation-Exchange Resin

-Contraindications

A
  1. Potassium is exchanged for Sodium so fluid follows sodium.
  2. HTN
  3. CHF
  4. Marked Edema
49
Q

Cation-Exchange Resin

-Interactions

A
  1. Cation-donating antacids/laxatives
50
Q

Cation-Exchange Resin

-Adverse Effects

A
  1. Hypokalemia
  2. Hypocalcemia
  3. Hypomagnesemia
    1, 2, and 3 work together / if one goes down, look at the others
  4. Sodium retention

Pharmacology FINAL EXAM (9 decks)

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