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NURS 2514 > Urinary elimination pharmacology > Flashcards

Urinary elimination pharmacology Flashcards

1
Q

Captopril classification

A

Angiotensin Converting Enzyme (ACE) Inhibitor

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2
Q

Captopril MOA

A

Inhibits ACE to reduce levels of angiotensin II

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3
Q

Indication for Captopril

A

Used in the treatment of hypertension, heart failure, MI, and diabetic neuropathy. Also used to prevent cardiac events

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4
Q

Therapeutic effect of Captopril

A

Blood vessel dilation, reduced blood volume, decreased cardiac/ vascular remodeling

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5
Q

How does Angiotensin II increase filtration pressure?

A

Increasing pressure in the afferent arteriole

Constricting the efferent arteriole, thereby generating back-pressure in the glomerulus

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6
Q

Captopril contraindications

A

Pregnancy, breastfeeding, bilateral renal artery stenosis, angioedema (1%)

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7
Q

Adverse effects of Captopril

A

First dose hypotension, cough (10%), hyperkalemia

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8
Q

Nursing considerations of Captopril

A

Blood pressure should be monitored (esp w/ first dose and dose changes)
Fluid volume/ hydration status
Blood work to monitor: Na, K, Urea, Crea

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9
Q

Candesartan classification

A

Angiotensin II Receptor Blockers (ARBs)

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10
Q

Candesartan MOA

A

Blocks Angiotensin II from reaching receptor site

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11
Q

Candesartan indication

A

Hypertension, HF, MI, Diabetic Nephropathy

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12
Q

Therapeutic effects of Candesartan

A

Blood vessel dilation, reduced blood volume

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13
Q

Candesartan contraindications

A

Pregnancy, breastfeeding, bilateral renal artery stenosis, angioedema

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14
Q

Adverse effects of Candesartan

A

Hypotension, hyperkalemia (rare)

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15
Q

Nursing considerations of Candesartan

A

Blood pressure should be monitored (esp w/ first dose and dose changes)
Fluid volume/ hydration status
Blood work to monitor: Na, K, Urea, Crea

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16
Q

Atorvastatin (Lipitor) classification

A

HMG-CoA Reductase Inhibitors
Drugs that lower lipoprotein production
Lower LDL (25%-60%) and total cholesterol
Increases HDL (5-22%)
Significant reduction in 2 weeks but effect goes away if drug is stopped

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17
Q

Atorvastatin (Lipitor) MOA

A

Inhibit synthesis of cholesterol by blocking HMG CoA enzyme, increases LDL receptors in hepatocytes allowing for increased removal of LDL

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18
Q

Indication for Atorvastatin (Lipitor)

A

Dyslipidemia is common in CKD

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19
Q

Adverse effects of Atorvastatin (Lipitor)

A

Generally well tolerated
Headache, rash, memory loss, GI disturbance (usually transient)
Myopathy/ rhabdomyolysis
Hepatotoxicity

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20
Q

Nursing considerations for Atorvastatin (Lipitor)

A

Dose should be given in evening because of cholesterol synthesis
GI assessment (dyspepsia, cramps, flatulence, constipation, abd pain)
Monitor liver observe for muscle pain (legs often)

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21
Q

What tests can be ran to determine myopathy/ rhabdomyolysis?

A

LFTs: Liver function tests
CK: Creatine kinase (an enzyme released from injured muscle)

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22
Q

Furosemide classification

A

Loop diuretic

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23
Q

Furosemide MOA

A

Acts on ascending limb of loop of Henle to block reabsorption of sodium and chloride

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24
Q

Furosemide indication

A

Pulmonary edema, edema related to hepatic, cardiac, or renal origin unresponsive to other diuretics, hypertension unresponsive to other diuretics

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25
Q

Therapeutic effects of furosemide

A

Profound diuresis (even when GFR is low)

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26
Q

Furosemide contraindications

A

Anuria, hepatic coma, sensitivity

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27
Q

Adverse effects of Furosemide

A

Hyponatremia, hypochloremia, dehydration, hypotension, hypokalemia, ototoxicity

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28
Q

Nursing considerations of Furosemide

A

Ins & outs
Daily weights
BP (postural)
Dehydration (skin turgor, dry mouth, thirst, dizziness)
Hearing changes, tinnitus
Rashes, elevated temp

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29
Q

Hydrochlorothiazide classification

A

Thiazide diuretic

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30
Q

Hydrochlorothiazide MOA

A

Blocks Na and Cl in early segment of the distal convoluted tubule (only 10% of Na and Cl normally absorbed here)

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31
Q

Hydrochlorothiazide indication

A

Hypertension, edema (HF, liver or kidney disease)

32
Q

Therapeutic effects of Hydrochlorothiazide

A

Diuresis (ineffective when GFR less than 15-20 mL/min)

33
Q

Contraindications of Hydrochlorothiazide

A

Anuria, hepatic coma, sensitivity

34
Q

Adverse effects of Hydrochlorothiazide

A

Hyponatremia, hypochloremia, dehydration, hypotension, hypokalemia

35
Q

Nursing considerations of Hydrochlorothiazide

A

Ins & outs
Daily weights
BP (postural)
Dehydration (skin turgor, dry mouth, thirst, dizziness)
Rashes, elevated temp

36
Q

Spironolactone classification

A

Potassium-sparing diuretic

37
Q

Spironolactone MOA

A

Blocks the action of aldosterone in the distal nephron

38
Q

Indication for Spironolactone

A

Hypertension, edema, heart failure

39
Q

Therapeutic effects of Spironolactone

A

Retention of potassium and excretion of sodium, mild diuresis

40
Q

Spironolactone contraindications

A

Hypersensitivity, anuria, Addison’s disease, severe renal disease (GFR <30 mL/min), hyperkalemia, pregnancy, breastfeeding

41
Q

Adverse effects of Spironolactone

A

Hyperkalemia, endocrine effects (gynecomastia, menstrual irregularities, impotence, hirsutism, deepening of the voice)

42
Q

Nursing considerations of Spironolactone

A

Signs of hyperkalemia and hypokalemia
Ins & outs/ daily weights/ BP
Rashes, elevated temp

43
Q

Erythropoietin classification

A

Hematopoietic agents

44
Q

Erythropoietin MOA

A

A glycoprotein hormone that stimulates production of RBCs in bone marrow, made from rDNA

45
Q

Indication for Erythropoietin

A

1) Anemia secondary to; CKD, chemotherapy, HIV treatment
2) Pre-op anemia (elective surgeries)

46
Q

Therapeutic effects of Erythropoietin

A

Elevation of erythrocyte counts

47
Q

Contraindications for Erythropoietin

A

Sensitivity, uncontrolled hypertension

48
Q

Adverse effects of erythropoietin

A

Hypertension, cardiovascular events

49
Q

Erythropoietin description

A

Starts working in 2-3 weeks, peak effect in 2-3 months
Lower Hgb goal. 100-120 g/L
Route: SC
Dosing: 3x/week

50
Q

Calcium carbonate classification

A

Calcium-based phosphate binder

51
Q

Calcium carbonate MOA

A

Binds to phosphate in GI tract and is excreted in stool

52
Q

Indication for Calcium carbonate

A

Hyperphosphatemia

53
Q

Calcium carbonate therapeutic effects

A

Lowers serum phosphate

54
Q

Contraindications for Calcium carbonate

A

Hypercalcemia, severe cardiac disease

55
Q

Adverse effects of Calcium carbonate

A

Constipation, GI irritation, severe cardiac disease

56
Q

Nursing considerations of Calcium carbonate

A

Monitor blood work (Ca, Phos), GI assessment, monitor for signs of dig toxicity, give 1 hour after meals

57
Q

Kayexalate classification

A

Potassium binding agents

58
Q

Kayexalate MOA

A

Removes potassium by exchanging sodium for potassium in large intestine

59
Q

Indication for Kayexalate

A

Hyperkalemia

60
Q

Therapeutic effect of Kayexalate

A

Lowers serum potassium

61
Q

Contraindications of Kayexalate

A

GI obstruction

62
Q

Adverse effects of Kayexalate

A

Constipation, nausea, vomiting, diarrhea, digoxin toxicity

63
Q

Nursing considerations of Kayexalate

A

Assess for hyperkalemia, GI assessment (must have bowel sounds)

64
Q

Ferrous sulfate classification

A

Iron preparation

65
Q

Ferrous sulfate MOA

A

Replaces iron stores needed for red blood cell development

66
Q

Indication for Ferrous sulfate

A

Iron deficiency anemia, nutritional supplementation

67
Q

Therapeutic effect of Ferrous sulfate

A

Improvement of anemia

68
Q

Adverse effects of Ferrous sulfate

A

Nausea, constipation, epigastric pain, black tarry stools

69
Q

Nursing considerations for Ferrous sulfate

A

Monitor Hgb, GI assessment

70
Q

Calcitriol classification

A

Vitamin D hormone

71
Q

Calcitriol MOA

A

Increases intestinal absorption of calcium

72
Q

Indication for Calcitriol

A

Hypocalcemia with CKD, renal osteodystrophy

73
Q

Therapeutic effect of Calcitriol

A

Treatment of Vitamin D deficiency

74
Q

Contraindications of Calcitriol

A

Hyperphosphatemia, hypercalcemia

75
Q

Adverse effects of Calcitriol

A

GI upset

76
Q

Calcitriol nursing considerations

A

Monitor blood work (Ca, Phos), abdominal assessment

NURS 2514 (14 decks)

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