Renal meds Flashcards
Hydrochlorothiazide (Hydrodiuril)
Thiazide diuretic -> Acts on the early distal tubule -> increasing excretion of sodium, water, chloride, and potassium
USES:
Edema, hypertension, diuresis, HF; idiopathic lower extremity edema therapy
Contact prescriber immediately if muscle cramps, weakness, nausea, dizziness, or numbness occurs; rash
spironolactone (Aldactone)
Potassium-sparing -> acts on late distal tubule -> in excretion of sodium chloride, water, retention of potassium, phosphate
USES:
Edema of HF, hypertension, diuretic-induced hypokalemia, primary hyperaldosteronism (diagnosis, short-term treatment, long-term treatment), edema of nephrotic syndrome, cirrhosis of the liver with ascites
Watch:
Hypokalemia: assess for polyuria, polydipsia (excessive thirst), dysrhythmias including a U wave, depressed T wave on ECG
• Hyperkalemia: assess for weakness, fatigue, dyspnea, dysrhythmias, confusion, peak T wave.
Furosemide (Lasix)
Loop diuretic -> Acts on thick ascending limb of Henle’s loop -> inhibiting reabsorption of sodium and chloride & causing excretion of sodium, calcium, magnesium, chloride, water, and some potassium
Watch:
Ototoxicity: Assess patient for tinnitus, hearing loss, ear pain
Hypokalemia: assess for polyuria, polydipsia (excessive thirst), dysrhythmias including a U wave, depressed T wave on ECG
Orthostatic hypotension can occur rapidly
Captopril
Angiotensin-converting enzyme (ACE) inhibitor -> Selectively suppresses renin-angiotensin-aldosterone system; inhibits ACE; prevents conversion of angiotensin I to angiotensin II
Therapeutic outcome:
Decreased B/P in hypertension; decreased preload, afterload in HF
NO pregnancy
Watch: decreased platelets, orthostatic hypotension, syncope, allergic reactions (angioedema - difficulty breathing/swallowing)
EPINEPHrine
ACTION:
β1- and β2-agonist causing increased levels of cyclic AMP producing bronchodilatation, cardiac and CNS stimulation; large doses cause vasoconstriction via α-receptors; small doses can cause vasodilation via β2-vascular receptors
USES:
Acute asthmatic attacks, hemostasis, bronchospasm, anaphylaxis, allergic reactions, cardiac arrest, adjunct in anesthesia, shock
Diphenhydramine (Benadryl)
ACTION:
Acts on blood vessels, GI, respiratory system by competing with histamine for H1-receptor site; decreases allergic response by blocking histamine
Therapeutic outcome:
Absence of allergy symptoms and rhinitis, decreased dystonic symptoms, absence of motion sickness, absence of cough, ability to sleep
Teach patient product should be discontinued 4 days prior to skin allergy tests (cause false-positive result)
methylPREDNISolone
Corticosteroid
ACTION:
Decreases inflammation by suppression of migration of polymorphonuclear leukocytes, fibroblasts; reverses increased capillary permeability and lysosomal stabilization
Therapeutic outcome: Decreased inflammation
USES:
Severe inflammation, shock, adrenal insufficiency, collagen disorders, management of acute spinal cord injury, multiple sclerosis
Albuterol
Bronchodilator, Adrenergic β2-agonist
ACTION:
Causes bronchodilation by action on β2 (pulmonary) receptors by increasing levels of cyclic AMP, which relaxes smooth muscle; produces bronchodilatation; CNS, cardiac stimulation, increased diuresis, and increased gastric acid secretion; longer acting than isoproterenol
Therapeutic outcome: Increased ability to breathe because of bronchodilation
USES:
Prevention of exercise-induced asthma, acute bronchospasm, bronchitis, emphysema, bronchiectasis, reversible airway obstruction
Aluminum, Magnesium with simethicone (Mylanta)
Antacid - neutralizes acid, quick relief, short duration
NO renal failure pt
Take 2hrs before another oral med
Take 1-3 hrs after meal & before bedtime
Shake well before use - liquid form is better
Decreased absorption: digoxin, tetracycline, aspirin, iron, Propranolol (Inderal) - beta blocker to Decrease B/P, heart rate
mycophenolate (Cellcept)
Immunosuppressant
ACTION:
Inhibits inflammatory responses that are mediated by the immune system - suppress Tcells, Bcells => pt not supposed to have fever & increased BP (fluid retention)
USES:
Organ transplants to prevent rejection (renal); prophylaxis of rejection in allogenic cardiac, hepatic, renal transplants
Polyethylene glycol (GoLytely)
Act thru osmotic effect -> retaining water in colon and produces a watery stool.
to clean the colon before a colonoscopy or barium enema X-ray examination.
Neomycin
Antibiotic
Works by stopping the growth of bacteria in the intestines.
Neomycin may also be used along with a special diet to treat a certain serious brain problem (hepatic encephalopathy)
Calci-Chew
prevent or treat low blood calcium levels
treat conditions caused by low calcium levels such as bone loss (osteoporosis), weak bones (osteomalacia/rickets), decreased activity of the parathyroid gland (hypoparathyroidism), and certain muscle disease (latent tetany)
Lanthanum carbonate (Fosrenol)
Aluminum-free, calcium-free phosphate binder -> bind to dietary phosphorus in GI tract -> lower phosphorus level thru stools
Calcium salts (Tums)
Antacids, calcium supplement
ACTION:
Neutralizes gastric acidity
Assess for milk-alkali syndrome (due to hypercal): nausea, vomiting, disorientation, headache
Diphenoxylate w/ Atropine (Lomotil)
Antidiarrheal
Diphenoxylate is similar to opioid pain relievers, but it acts mainly to slow the gut. Atropine belongs to a class of drugs known as anticholinergics, which help to dry up body fluids and also slow gut movement
NO treating diarrhea w/ C.diff, kid <6 yo
Propantheline bromide (Pro-Banthine) discontinued in US
Anticholinergics (antispasmatics)
Function: inhibits gastric acid secretion in large doses
NO pt w/ glaucoma, prostate hypertrophy, paralytic ileus, hiatal hernia, GERD
Loperamide (Imodium)
Antidiarrheal
ACTION:
Direct action on intestinal muscles to decrease GI peristalsis; reduces volume, increases bulk; electrolytes are not lost
USES:
Diarrhea (cause undetermined), chronic diarrhea, to decrease amount of ileostomy discharge, traveler’s diarrhea
Do not break, crush, or chew caps
NO infectious diarrhea
Peri-Colace (sennoside & docusate combo)
Treat constipation
Sennosides are known as stimulant laxatives -> keeping water in the intestines -> cause movement of the intestines.
Docusate is known as a stool softener. -> increase the amount of water in the stool -> softer and easier to pass
Dopamine
low doses causes renal and mesenteric vasodilatation -> increase BP & cardiac output (.22mcg)
high dose kills kidney (50mg)
Antidote: Phentolamine (Regitine)
inFLIXimab (Remicade)
ACTION:
Monoclonal antibody that neutralizes the activity of tumor necrosis factor α (TNFα) that has been found in Crohn’s disease; decreased infiltration of inflammatory cells
Therapeutic outcome: Decreased cramping and blood in stools -> control bowel movement
USES:
Crohn’s disease, fistulizing, moderate to severe; rheumatoid arthritis given with methotrexate, plaque psoriasis, ankylosing spondylitis, ulcerative colitis, psoriatic arthritis, psoriasis
tamsulosin (Flomax)
α-adrenergic blocker
ACTION: decrease smooth muscle tone of prostate gland & bladder neck, increase urine flow, not affecting libido
USES:
Symptoms of BPH, renal stones
Watch: hypotension, dizziness, postural hypotension
Finasteride (Proscar)
5α-Reductase inhibitor
Inhibits conversion of testosterone to dihydrotestosterone (DHT) -> decreased amounts of DHT => reduce size of prostate, increase urine flow, help w/ hair growth on crown & eyelashes
Decrease libido, erection + increase breast size (Gynecomastia)
Oxybutynin (Ditropan)
urinary antispasmatic
ACTION:
Relaxes smooth muscles in urinary tract by inhibiting acetylcholine at postganglionic sites
Therapeutic outcome: Decreased symptoms of urgency, nocturia, incontinence
USES:
Antispasmodic for neurogenic bladder, overactive bladder in females (OTC), renal stones
Phenazopyridine (Pyridium)
relieve symptoms caused by irritation of the urinary tract such as pain, burning, and the feeling of needing to urinate urgently or frequently.
