Renal Pharm (Exam 2) Flashcards
BCG vaccine: Class
Intravesical Therapy
BCG Vaccine: MOA
-Stimulates inflammatory response in the bladder –goal is for the immune system to recognize cancerous cells and attack
BCG Vaccine: Indication
Bladder Cancer
BCG Vaccine: Adverse Reactions
Bladder irritation
Systemic infections because the drug is a live vaccine
BCG Vaccine: Patient Instruction
Patient Instructions:
- Empty bladder
- Instill Vaccine into bladder (dwell 2 hours)
- Change positions q 15
BCG Vaccine: NSG Consideration
-Given weekly for 6-12 weeks
-Disinfect urine for 6 hours post treatment; watch for infection
-Live vaccine: Do not give to HIV or AID or immunocompromised
Sodium Bicarbonate: MOA
-Alkaline agent and decrease pH
Sodium Bicarbonate: Indications
-Metabolic acidosis causing CKD
-Slow CKD
Prevent bone loss
Improve nutritional status
Sodium Bicarbonate: Adverse Reactions
-Bloating
Sodium Bicarbonate: NSG consideration
-Initiate when HCO3 is less than 15 mEq/mL: Goal is 18-20
calcium carbonate: MOA
Bind to phosphate
calcium carbonate: Indications
-Keep normal phosphate levels and decrease mortality
calcium carbonate: Adverse Reaction
Hypercalcemia
calcium carbonate: NSG considerations
Take with meals
calcitriol: MOA
-Activated from vitamin D; stimulate intestinal absorption of calcium/phosphate and bone mineralization
calcitriol: Indications
-Used to treat renal osteodystrophy
calcitriol: Adverse Reaction
-Hypercalcemia
-Hypophosphatemia
calcitriol: NSG consideration
-25 dihydroxy vitamin D (active)
finasteride: Class
5-alpha- reductase inhibitor
finasteride: MOA
-Blocks conversion of testosterone to DHT (alpha 1 receptors)
-Decrease epithelial tissue in prostate
finasteride: Indications
-Mechanical obstruction of urethra
finasteride: Adverse Reaction
-Impotence
Decreased libido (5-10%)
Gynecomastia
finasteride: NSG consideration
-6-12 months for the med to work and take for the rest of your life
-Increase hair growth and used to treat baldness
-Cannot donate blood
finasteride works best in men whose
prostate is very enlarged
If PSA levels do not drop while on finasteride then
you should be evaluated for prostate cancer
What drug should women not handle
finasteride and dutasteride
Dutasteride
Same as finasteride
tamsulosin: Class
Alpha1 – Adrenergic Antagonist
tamsulosin: MOA
-Relaxes smooth muscle cells
-Selective for alpha receptors in the prostate
tamsulosin: Indications
-Dynamic obstruction of urethra
tamsulosin: Adverse Reactions
-Abnormal ejaculation
-Well tolerated
tamsulosin: NSG consideration
-Works quickly but has to be taken for life to maintain benefits
sildenafil: Class
PDE-5 inhibitors
sildenafil: MOA
-Inhibits PDE5
-Increases and preserves cGMP levels
-Only enhance the normal response to sexual stimulation
sildenafil: Indications
-Relief of ED
-Pulmonary arterial hypertension
-BPH
sildenafil: Adverse Reactions
-HA 16%
-Flushing 10%
-Dyspepsia 7%
-Priapism: Erection that is painful or last more than 4 hours medical emergency
-No more than once per day
sildenafil: NSG consideration and contriandication
-Take up to 4 hours before sexual activity (onset 30-60 minutes)
-Contraindicated: Preexisting CV disease or if on nitrate and hypotension
