Renal pharmacology Flashcards
Oxybutynin (Ditropan XL) classification
Anti-cholinergic
Oxybutynin (Ditropan XL) MOA
Blocks muscarinic receptors on bladder detrusor to inhibit bladder contractions
Indication for Oxybutynin (Ditropan XL)
Overactive bladder, bladder spasm associated with kidney stones
Oxybutynin (Ditropan XL) side effects
Dry mouth, blurred vision, constipation, tachycardia, urinary hesitancy/ retention, hallucination, confusion, sedation (older adult)
Oxybutynin (Ditropan XL) nursing considerations
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
Mirabegron (Myrbetriq) classification
Selective Beta3-adrenergic agonist
Mirabegron (Myrbetriq) MOA
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)
Indication for Mirabegron (Myrbetriq)
Overactive bladder
Adverse effects of Mirabegron (Myrbetriq)
Slight increase in HR and BP, can increase digoxin levels so dose needs to be lowered
Nursing considerations for Mirabegron (Myrbetriq)
Monitor for urinary retention, monitor vital signs
Treatment approach for glomerulonephritis
Antibiotics (penicillin for strep infection)
Diuretics
Na/ water restriction
Rest
Antibiotics for UTI
Trimethoprim/ Sulfamethoxazole (Septra)
Nitrofurantoin
Ciprofloxacin
Trimethoprim/ Sulfamethoxazole (Septra) class
Anti-infective
Trimethoprim/ Sulfamethoxazole (Septra) MOA
Bacteriostatic - inhibits growth of bacteria
Indication for Trimethoprim/ Sulfamethoxazole (Septra)
Treatment of uncomplicated UTIs, prophylaxis for recurrent UTIs
Adverse effects of Trimethoprim/ Sulfamethoxazole (Septra)
Nausea, vomiting, abdominal pain
Trimethoprim/ Sulfamethoxazole (Septra) nursing considerations
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)
Treatment approach for renal calculi
Pain management
Spasmolytic drugs
Antibiotics
Drugs to help with stone expulsion
Ketorolac class
NSAID
Ketorolac MOA
Inhibits prostaglandin synthesis
Indication for Ketorolac
Moderate to severe pain (including pain associated with passing renal calculi)
Adverse effects of Ketorolac
Drowsiness, bleeding, rarely Stevens Johnson Syndrome
Ketorolac nursing considerations
Pain assessment, monitor for signs of bleeding (bruising) and allergic reaction (rash/ blisters, pain in muscle or joints)
