Renal Disorders & Elecrolytes Modifiers Flashcards
What are the two prototype medications for renal disorders in the electrolyte modifier class?
- potassium binder: sodium polystyrene sulfonate (kayexalate)
- phosphate scavenger : sevelamer
What is sodium polystyrene sulfonate (kayexalate) used for?
Used for treatment of hyperkalemia
Will excrete k+ ions in exchange for sodium (n’a+)
Acts in large intestine
What are some contraindications to sodium polystyrene sulfonate (kayexalate)?
- constipation
- pt with abnormal bowel function
- hypokalemia
What are some possible AE with sodium polystyrene sulfonate (kayexalate)?
Nausea& vomiting
Electrolyte imbalances :
- hypernatremia
- hypokalemia
- hypocalcemia
- hypomagnesia
(When calcium decreases, mg decreases as well)
What are some drug interactions with sodium polystyrene sulfonate (kayexalate)?
Decrease effectiveness with:
- antacids
- laxatives
What are some important nursing interventions and points to know about sodium polystyrene sulfonate (kayexalate)?
- administer > 3 hrs before or after other meds
- monitor serum potassium qday
- monitor intake and outputs
- shake bottle we’ll before given
- close monitoring of all electrolytes levels
- do not mix with k+ containing liquids or foods
How should sodium polystyrene sulfonate (kayexalate) be taken?
- take >3hrs before or after other meds
- don’t take with laxatives and/or antacids
- don’t take with other meds
- don’t take with k* containing foods or drinks
What are some k+ containing foods or drinks that should be avoided with kayexalate?
- bananas
- oranges
- cantaloupe
- apricots
- grapefruit
- milk
- yogourt
- broccoli
- tomatoes
- coconut
- almonds
- avocados
- spinach
- kiwi
- bok choy
What are some possible drug therapy for hyperkalemia?
- calcium gluconique
- IV glucose, & insulin (humulin R) —> for fast acting
- B2 adrénergiques agonist (salbutamol)
- kayexalate
What is the indication for the medication Sevelamer (Renagel)? And how does it work?
Used for tx of hyperphosphatemia for pts with CKD on dialysis
Works by binding to phosphate in the GI tract
Used when diet restriction is not sufficient
What are some AE of sevelamer (renagel)?
- bowel obstruction
- esophageal obstruction
- diarrhea
- dyspepsia
- vomiting
How should sevelamer (renagel) be taken?
- take other meds 1hr before or 3hrs after
- administer with meals to decrease GI upset
What are some contraindications to sevelamer (renagel) the phosphate scavenger?
- KDA
- bowel obstruction
- hypophosphatemia
What are some drug interactions with sevelamer (renagel)?
- decrease absorption of other drugs : ciproflaxin, fat soluble vitamins, folic acids
