Renal meds

Question 1

Labs to assess kidney function:

Answer 1

Serum creatinine
BUN
Glomerular filtration rate (GFR) - measures volume of filtrate passing through Bowman’s capsule per minute.
BMET

Question 2

What drug is a loop diuretic?

Answer 2

furosemide (Lasix)

Question 3

What is the MOA of furosemide?

Answer 3

Acts on the ascending loop of Henle.

Blocks reabsorption of sodium chloride and passive reabsorption of water.

Most effective diuretics available.

Question 4

What are the prime uses of furosemide?

Answer 4

Pulmonary edema w/HF, edematous states of hepatic, cardiac, or renal in origin. HTN not controlled with other diuretics.

Question 5

AE for furosemide:

Answer 5

AE: Hyponatremia, hypochloremia, dehydration, hypotension, hypokalemia, hyperglycemia.

Check potassium level prior to administration.

PO/IV

Question 6

What is a thiazide drug?

Answer 6

hydrochlorothiazide(hctz) (HydroDIURIL)

Question 7

What is the MOA of hctz?

Answer 7

1. Blocks reabsorption of Na& Cl in early segment distal convoluted tubule.
2. Retention of Na&Cl in nephron causes H2O retention increasing flow of urine.

Question 8

Prime use and AE for hctz:

Answer 8

Prime uses: essential HTN, edema.

AE: hypo-natremia/chloremia/kalemia and dehydration.

Ineffective GFR <15-20mL/min cannot be used to promote fluid loss in severe renal impairment.

Question 9

What is a potassium sparing diuretic?

Answer 9

spironolactone (Aldactone)

Question 10

What is the MOA of spironolactone?

Answer 10

1. Blocks aldosterone in distal nephron.
2. Leads to retention of potassium and increased excretion of sodium.

Takes 48 hours to develop effects.

Question 11

What is the prime use for spironolactone?

Answer 11

HTN, edema, HF, primary hyperaldosteronism.

Question 12

Nursing considerations for spironolactone:

Answer 12

Give with food to increase absorption.

Can cause fetal harm so two sets of gloves to be worn when administering if pregnant.

Question 13

What drug is a potassium sparing diuretic?

Answer 13

triamterene (Dyrenium)

Question 14

What is the MOA of triamterene?

Answer 14

1. Disrupts sodium-potassium exchange in distal nephron and direct inhibitor of the ion exchange mechanism.
2. Decreases Na reuptake and reduction in K secretion.

Acts more quickly than spironolactone, diuresis is minimal though.

Question 15

Nursing considerations of triamterene:

Answer 15

Prime use: HTN and edema.

AE: hyperkalemia, leg cramps, N&V, dizziness, blood disorders.

PO usually BID