Renal, Genitourinary & Reproductive Drug List

Question 1

Toradol

Black Box Alert

Answer 1

Generic Name: Ketorolac

Classification: NSAID

Common use: mild to moderate pain

Common Side/Adverse Effects: headache, nausea, abd pain, peptic ulcer

Black Box Warning: Increases risk of serious thrombotic events such as myocardial infarction, CVA. Increased risk of severe GI reactions.

Nursing Interventions: Monitor kidney function and urine output. Monitor bowel pattern and stool consistency, check for occult blood loss. Monitor for bleeding.

Teaching Points: Avoid aspirin and alcohol. Take with food or milk to prevent GI upset. Report bloody stools or pain in abd.

Question 2

Potassium citrate

Answer 2

Trade Name: Klor-Con EF

Classification: Electrolyte; potassium replenisher

Common Use: Prevents/corrects K+ deficiency

Common Side/Adverse Effects: GI discomfort (nausea, vomiting, diarrhea), hyperkalemia, dysrhythmias

Nursing Interventions: Monitor K+ levels. IV potassium must ALWAYS be diluted before administrating. Be alert to s/s of hyperkalemia.

Teaching points: Report any paresthesia, weakness, tarry/bloody stools.

Question 3

Bacille Calmette-Guerin (BCG)

Answer 3

Trade Name: TheraCys BCG, TICE BCG

Classification: live TB vaccine

Common Side/Adverse Effects: swollen lymph nodes, sores at injection site, fever

Teaching Points: Immediately call provider if you have wheezing, rash, or difficulty breathing/swallowing

Question 4

Calcium gluconate IV

Answer 4

Trade Name:

Classification: antacid, antihypocalcemic, antihyperkalemi, antihyper magnesemic, antihyperphosphatemic

Common use: for hypocalcemia, calcium channel blocker overdose, antacid

Common Side/Adverse Effects: pain, rash, mild constipation, peripheral edema, n&v, hypercalcemia

Nursing Interventions: Monitor serum BMP, calcium, magnesium, phosphate, BP, heart rhythms, renal function. Monitor s/s of hypercalcemia.

Teaching points: Avoid excessive intake of alcohol, caffeine, or tobacco.

Question 5

Sodium bicarbonate

Answer 5

Trade Name:

Classification: antacid electrolyte, urinary/systemic alkalinizer

Common use: to manage metabolic acidosis and gastric hyperacidity

Common Side/Adverse Effects: flatulence, belching, bloating

Nursing Interventions: Monitor urinary pH, and CO2. Monitor serum electrolytes and bicarbonate levels. Be alert for s/s of metabolic alkalosis or fluid overload.

Question 6

Sodium polystyrene sulfonate

Answer 6

Trade Name: Kayexalate

Classification: Antihyperkalemic

Common use: hyperkalemia

Common Side/Adverse Effects: anorexia, n&v, constipation, hypokalemia

Nursing Interventions: Frequently monitor serum potassium levels. Monitor EKG. Monitor serum Mg, Ca levels.

Question 7

Lisinopril

Black Box Alert

Answer 7

Trade Names: Zestril, Prinivil, Qbrelis

Classification: ACE-inhibitor; antiHTN

Common Use: HTN, HF, MI

Common Side/Adverse Effects: Headache, dizziness, HoTN, dry cough, angioedema

Black Box Warning: May cause fetal injury/mortality.

Nursing Interventions: Assess for edema. Auscultate lungs for rales. Assist w/ ambulation.

Teaching points: Change positions slowly. Report persistent cough, vomiting, swelling in face/lips/tongue (angioedema), diff. breathing. Limit alcohol intake.

Question 8

Losartan

Black Box Alert

Answer 8

Trade Names: Cozaar

Classification: Angiotensin II receptor antagonists; antiHTN

Common Use: HTN

Common Side/Adverse Effects: Upper respiratory tract infection, dizziness, HoTN

Black Box Warning: May cause fetal unjury/mortality. Discont. asap once pregnancy is detected.

Nursing Interventions: Maintain hydration, Assess for signs of upper rep infection or cough. Monitor BP, pulse.

Teaching points: Avoid tasks that require alertness. Female pts of childbearing age take measures to avoid pregnancy. Report any signs of infection or CP.

Question 9

Sevelamer carbonate

Answer 9

Trade Name: Renagel, Renvela

Classification: antiphosphatemia

Common use: Reduces serum phosphorus (for pts w/ CKD on hd)

Common Side/Adverse Effects: infection, pain, HoTN, n&v

Nursing Interventions: Monitor serum phosphorus, chloride, calcium, and bicarbonate

Teaching Points: Take with meals. Do not chew/crush/dissolve/divide tablets- swallow them whole. Report persistent HoTN, n&v, diarrhea, and headache

Question 10

Calcitriol

vitamin D

Answer 10

Trade Name: Rocaltrol, Vectical

Classification: vitamin D supplement

Common use: Manage hypocalcemia in pts w/ chronic renal dialysis, secondary hypothyroidism in CKD

Common Side/Adverse Effects: side effects are uncommon, but may lead to hypercalcemia

Nursing Interventions: Monitor serum urinary calcium levels, phosphate, magnesium, BUN, creatinine. Ensure adequate fluid intake. Monitor for s/s of vitamin D intoxication.

Teaching points: Adequate calcium intake should be maintained. Foods high in phosphorus are to be restricted. Avoid excessive doses. Report any s/s of hypercalcemia (headache, weakness, drowsiness, n&v, muscle/bone pain.

Question 11

Epoetin alfa

Black Box Alert

Answer 11

Trade Name: Epogen

Classification: erythropoietin

Common use: anemia from dialysis

Common Side/Adverse Effects: HTN, headache, arthralgia, nausea

Black Box Warning: Increased risk of serious cardiovascular events, thromboembolic events, mortality, time-to-tumor progression in pts w/ h&n cancer, breast cancer, and NSCLC.

Nursing Interventions: Monitor CBC, especially Hct, and Hgb. Monitor and be alert for HTN. Monitor BUN, uric acid, creatinine, phosphorus, and potassium.

Teaching Points: Expect frequent lab assessments. Call provider if you have severe headache. Avoid potentially dangerous activities during first 90 days of therapy.

Question 12

Iron sucrose IV

Answer 12

Trade Name: Venofer

Classification: hematinic iron preparation

Common use: (iron) anemia from CKD

Common Side/Adverse Effects: HoTN, leg cramps, diarrhea

Nursing Interventions: Monitor Hgb, Hct, and serum ferritin, and transferrin. Reliable serum iron values can be obtained 48hrs after administration.

Question 13

Folic Acid

Answer 13

Trade Name: FA-8

Classification: Coenzyme; nutritional supplement

Common use: megaloblastic and macrocytic anemias

Common Side/Adverse Effects: nausea, bloating, rash, allergic reactions

Nursing Interventions: Assess for relief from anemia symptoms (fatigue, pallor, SOB)

Teaching points: Eat folic-rich foods such as dark leafy greens, fruits, and beans.

Question 14

Atorvastatin

Answer 14

Trade Names: Lipitor

Classification: Hydroxymethylglutaryl CoA reductase inhibitor; lipid-lowering agents

Common Use: High cholesterol, reduce risk of angina, stroke, MI

Common Side/Adverse Effects: Headache, myalgia, cataracts, rash, photosensitivity

Nursing Interventions: Monitor for headache. Assess for rash. Monitor cholesterol and triglyceride.

Teaching points: Follow special diet, Do not crush/chew/dissolve/cut tablets. Report dark urine, muscle fatigue, bone pain.

Question 15

Gemfibrozil

Answer 15

Trade Name: Lopid

Classification: antihyperlipidemic

Common Use: to lower high cholesterol and triglyceride levels

Common Side/Adverse Effects: dyspepsia, pain in abd, GI upset, fatigue

Nursing Interventions: Monitor LDL, VLDL, serum triglycerides, cholesterol, LFT. Monitor daily bowl pattern and stool consistency. Assess for pain in RUQ for adverse gallbladder effects.

Teaching Points: Take before meals. Expect frequent lab tests. Report blurred vision, nausea, dizziness, vomiting.

Question 16

Tamoxifen

Black Box Alert

Answer 16

Trade Name: Soltamox

Classification: nonsteroidal antiestrogen; antineoplastic

Common use: breast cancer

Common Side/Adverse Effects: hot flashes, n&v, retinopathy

Black Box Warning: Serious, possibly fatal, stroke, PE, uterine malignancy

Nursing Interventions: Be alert for bone pain. Monitor for edema. Assess for hypercalcemia.

Teaching points: Report vaginal bleeding/discharge/itching, leg cramps, SOB, weakness. May initially experience bone pain. Report persistent n&v

Question 17

Raloxifene

Black Box Alert

Answer 17

Trade Name: Evista

Classification: selective estrogen receptor modulator; osteoporosis preventive

Common use:prevention of osteoporosis and risk of invasive breast cancer

Common Side/Adverse Effects: hot flashes, flu-like symptoms, arthralgia, pneumonia

Black Box Warning: Increases risk of DVT. Women w/ coronary hr disease are at increased risk for death due to stroke

Nursing Interventions: Monitor total cholesterol, calcium, inorganic phosphate, protein, albumin, platelet count, and bone mineral density.

Teaching points: Avoid prolonged periods of not moving while traveling. Take calcium and vitamin D. Engage in weight-bearing exercise.

Question 18

Trastuzumab

Black Box Alert

Answer 18

Trade Name: Herceptin

Classification: antineoplastic

Common use: HER2 breast cancer, cancer of stomach, and esophagus

Common Side/Adverse Effects: Pain, asthenia, fever, chills, n&v

Black Box Warning: Fatalities have been associated with anaphylactic reaction, infusion reaction, acute resp distress syndrome. Severe HF may result in thrombus formation, stoke, or cardiac death. Exposure during pregnancy may cause pulmonary hypoplasia, skeletal malformation, and neonatal death.

Nursing Interventions: Monitor for deteriorating cardiac function. Assess for asthenia. Monitor for fever, chills, back and abd pain, nausea.

Teaching points: Avoid those who recently got the oral polio vaccine. Avoid crowds of people. Don’t get immunizations w/o physician’s approval.

Question 19

Zoledronic acid

Answer 19

Trade Name: Reclast, Zometa

Classification: calcium regulator, bone resorption inhibitor

Common Use: hypercalcemia, osteoporosis

Common Side/Adverse Effects: fever, n&v, constipation, renal toxicity (if IV is administered <15min)

Nursing Interventions: Monitor serum renal function, I&O, CBC, serum BUN and creatinine. Monitor calcium, phosphate, and magnesium levels. Assess vertebral bone mass

Question 20

Bicalutamide

Answer 20

Trade Name: Casodex

Classification: antineoplastic

Common Use: advanced metastatic prostatic carcinoma

Common Side/Adverse Effects: hot flashes, pain in breast or muscles, asthenia

Nursing Interventions: Monitor for diarrhea, nausea, vomiting. Discontinue treatment if

Teaching Points: Take med same time each day. Report persistent n/v, vomiting, diarrhea, or yellowing of skin or eyes. Expect frequent side effects (hot flashes, breast or muscle pain, constipation, diarrhea)