Renal pharmacology

Question 1

Oxybutynin (Ditropan XL) classification

Answer 1

Anti-cholinergic

Question 2

Oxybutynin (Ditropan XL) MOA

Answer 2

Blocks muscarinic receptors on bladder detrusor to inhibit bladder contractions

Question 3

Indication for Oxybutynin (Ditropan XL)

Answer 3

Overactive bladder, bladder spasm associated with kidney stones

Question 4

Oxybutynin (Ditropan XL) side effects

Answer 4

Dry mouth, blurred vision, constipation, tachycardia, urinary hesitancy/ retention, hallucination, confusion, sedation (older adult)

Question 5

Oxybutynin (Ditropan XL) nursing considerations

Answer 5

Available in transdermal patch, gel, and tablet
Monitor for signs of urinary retention, UTI, constipation
Caution with hazardous activities, alcohol
Assess for confusion in older patients

Question 6

Mirabegron (Myrbetriq) classification

Answer 6

Selective Beta3-adrenergic agonist

Question 7

Mirabegron (Myrbetriq) MOA

Answer 7

Causes relaxation of detrusor muscles in bladder, allows increased filling, effect is modest but used when unable to tolerate anti-cholinergic (eg. heart failure patients)

Question 8

Indication for Mirabegron (Myrbetriq)

Answer 8

Overactive bladder

Question 9

Adverse effects of Mirabegron (Myrbetriq)

Answer 9

Slight increase in HR and BP, can increase digoxin levels so dose needs to be lowered

Question 10

Nursing considerations for Mirabegron (Myrbetriq)

Answer 10

Monitor for urinary retention, monitor vital signs

Question 11

Treatment approach for glomerulonephritis

Answer 11

Antibiotics (penicillin for strep infection)
Diuretics
Na/ water restriction
Rest

Question 12

Antibiotics for UTI

Answer 12

Trimethoprim/ Sulfamethoxazole (Septra)
Nitrofurantoin
Ciprofloxacin

Question 13

Trimethoprim/ Sulfamethoxazole (Septra) class

Answer 13

Anti-infective

Question 14

Trimethoprim/ Sulfamethoxazole (Septra) MOA

Answer 14

Bacteriostatic - inhibits growth of bacteria

Question 15

Indication for Trimethoprim/ Sulfamethoxazole (Septra)

Answer 15

Treatment of uncomplicated UTIs, prophylaxis for recurrent UTIs

Question 16

Adverse effects of Trimethoprim/ Sulfamethoxazole (Septra)

Answer 16

Nausea, vomiting, abdominal pain

Question 17

Trimethoprim/ Sulfamethoxazole (Septra) nursing considerations

Answer 17

Ask about sulfa allergies
Teach patients to drink a glass of water with each dose (can form crystals that precipitate in kidney tubule)
Remind patients to finish all doses to avoid drug resistance
Monitor for rash, aching joints and muscles (Stevens Johnson Syndrome)

Question 18

Treatment approach for renal calculi

Answer 18

Pain management
Spasmolytic drugs
Antibiotics
Drugs to help with stone expulsion

Question 19

Ketorolac class

Answer 19

NSAID

Question 20

Ketorolac MOA

Answer 20

Inhibits prostaglandin synthesis

Question 21

Indication for Ketorolac

Answer 21

Moderate to severe pain (including pain associated with passing renal calculi)

Question 22

Adverse effects of Ketorolac

Answer 22

Drowsiness, bleeding, rarely Stevens Johnson Syndrome

Question 23

Ketorolac nursing considerations

Answer 23

Pain assessment, monitor for signs of bleeding (bruising) and allergic reaction (rash/ blisters, pain in muscle or joints)