Renal, Genitourinary & Reproductive Drug List Flashcards
Toradol
Black Box Alert
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.
Potassium citrate
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.
Bacille Calmette-Guerin (BCG)
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
Calcium gluconate IV
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.
Sodium bicarbonate
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.
Sodium polystyrene sulfonate
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.
Lisinopril
Black Box Alert
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.
Losartan
Black Box Alert
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.
Sevelamer carbonate
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
Calcitriol
vitamin D
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.
Epoetin alfa
Black Box Alert
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.
Iron sucrose IV
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.
Folic Acid
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.
Atorvastatin
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.
Gemfibrozil
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.
Tamoxifen
Black Box Alert
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
Raloxifene
Black Box Alert
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.
Trastuzumab
Black Box Alert
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.
Zoledronic acid
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
Bicalutamide
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)
