Urinary&Reproductive Sys(Pharm) Flashcards
Nitrofurantoin
G Name: Nitrofurantin
T Name: Furdantin, Macrodantin
Trimethoprim & Sulfamethoxazole
G Name: Trimethoprim & Sulfamethoxazol
T Name: Bactrim, Septra
Phenazopyridine HCL
G Name: Phenazopyridine HCL
T Name: Pyridium
Chlorothiazide
G Name: Chlorothiazide
T Name: Diuril
Hydrochlorothiazide
G Name: Hydrochlorothiazide
T Name: Hydro Diuril, Esidrix
Acetazolamide
G Name: Acetazolamide
T Name: Diamox
Furosemide
G Name: Furosemide
T Name: Lasix
Mannitol
G Name: Mannitol
T Name: Osmitrol
Spironolactone
G Name: Spironolactone
T Name: Aldactone
Triamterene
G Name: Triamterene
T Name: Dyrenium
Bethanechol Chloride
G Name: Bethanechol Chloride
T Name: Urecholine
Oxybutynin Chloride
G Name: Oxybutynin Chloride
T Name: Ditropan
Bumetanide
G Name: Bumetanide
T Name: Bumex
Conjugated Estrogen
G Name: Conjugated Estrogen
T Name: Premarin
Medroxy Progesterone Suspension
G Name: Medroxy Progesterone Suspension
T Name: Depo Provera
Menotropins
G Name: Menotropins
T Name: Pergonal
Methyltestosterone
G Name: Methyltestosterone
T Name: Android
Fluoxymesterone
G Name: Fluoxymesterone
T Name: Halotestin
Nandrolone Phenpropionate
G Name: Nandrolone Phenpropionate
T Name: Durabolin
Oxytocin
G Name: Oxytocin
T Name: Syntocinon, Pitocin
Ergonovine Maleate
G Name: Ergonovine Maleate
T Name: Ergotrate
Methylergonovine
G Name: Methylergonovine
T Name: Methergine
Bromocriptine Mestlate
G Name: Bromocriptine Mestlate
T Name: Parlodel
Megestrol Acetate
G Name: Megestrol Acetate
T Name: Megace
Ritrodine HCL
G Name: Ritrodine HCL
T Name: Yutopar
Diuretics
action: remove sodium and water from the body
indication: edema, ascites, hypertension
types:
1) Thiazides
2) Loops
3) Potassium Sparing
4) Osmotics
5) Carbonic Anhydrase Inhibitors
Thazides(Diuretic)
- Inhibit the reabsorption of sodium and chloride from the DISTAL TUBULES
- end up losing Na and H20
- safest diuretics
- related to sulfonamides: allergy to sulfur
Thazides(Diuretic)(Side Effect)
-Electrolyte imbalance, Decrease Na(Hyponatriema), potassium depleting(Hypokalemia), decrease Choride(Hypochlorimia) diabetic patient effect glucose constipation dehydration
Thiazide(Diuretic)
- interaction: CNS depressants, Lithium, Digoxin
- onset:2hrs
- peak: 2-6hrs
- duration: 6-12hr
Thazides(Diuretic)(Drugs)
- Chlorothiazide(Diuril)-1/2-2g per day
- Hydrochlorothiazide(Hydrodiruil)-12.5-50mg per day depending on use
- works about 2hrs after medication given
- going to have to use the bathroom
- prevent nocturia take early in the morning
- risk for orthostatic hypotension b/c lowers bp
Thazides(Diuretic)(Nursing Implication)
- ask about allergy to sulfur
- increase K in the diet or as supplements(b/c potassium depleting drug)-increase in leafy veggie
- insulin dose adjustment needed(b/c hyperglycemia may need more insulin
- monitor electrolytes
- i/o
- blood glucose level
- uric acid monitor(careful with gout pt)
- BUN, Creatine
- Skin tugor, dry membrane
- pt education
- dangle, rise slowly of bed
- avoid hot showes
- baseline bp
Loops(Diuretic)
action: inhibit the reabsorption of sodium and chloride in the ASCENDING LOOP OF THE HENLE
indication: hypertension,CHF, Pulmonary Edema, Ascities, Renal Failure
- Most potent and strongest
- safetest for elderly population
- derived from sulfonamides
Loops(Diuretic)(Side Effect)
- Electrolyte imbalance
- hyponatremia
- hypochloremia
- dehydration
- potassium depleting
- increase in sugar level
- ototoxicity=baseline hearing assessment
Loops(Diuretic)(Nursing Implication)
- interaction w/ lithium,ASA,Aminoglycosides=greater risk for salicysim/ototoxicity
- ask if allerguc to sulfa
- give with food or milk b/c gi toxic
- ototoxicity increaseed with aminoglycosides
Loop(Diuretuc)(Drug)
- Furosemide(Lasix)=20-80mg, max in 24hr period 1g, po/iv, intravenous route
- Bumetanide(Bumex)=most potent
Potassium Sparing
action: inhibits the action of aldosterone in the distal tubules(Aldosterone Antagonit). Inhibts Na channel
- weak diuretic
- often combined with thiazides
indication: renal failure,CHF,Liver Cirrhosis, Hypokalemia
Potassium Sparing(side effect)
- Hyperkalemia(avoid increase in K food)
- gastrotoxic: flatus,headache,anorexia,n/v,flatus
Potassium Sparing(Drug) Aldosterone Antagonist
- aldosterone antagonist(effecting hormones)
- in male patients cause impotence/gynocomastia
- in femal menstrual cycle
- Sprionolactone(aldactone)-Aldosterone Antagonist
- Triamterene(Dyrenium)-Aldosterone Antagonist
Osmotics
action: concentrate in the kidney tubules and selectively prevent the reabsorption of water,sodium,and chloride
indication: ac renal faliure, intraoccular pressure, intracranial pressure
- powerful form diuretic
- concentrate in kidney tublue
- prevent water,sodium reabsorption
- cause rapid excretion of fluid
- emergency situation
- for acute renal failure
- for acute glucoma(take pressure off eye)
Osmotics(Drugs)
Mannitol(Osmitrol)
- iv:500-200mg a day; 500ml in bag
- neuro assesment
- crystals can form in med
- will neeed a filter tubing
- monitor site for infiltration iv
- headaches, electrolytes imbalance,dehyrdration
- rapid removal of fluid
- baseline vital signs needed
- cns assessment needed
- powerful form of diuretic
- concentrate in kidney tubules
- prevent water,na,reabsorption
- cause rapid excertion of fluid
- emergent situation(acute renal failure, acute glucoma to take pressure of the eye
Osmotics(Nuring implication)
- monitor electrolyte
- neuro assessment
- monitor vision
Carbon Anhydrae Inhibitor
action: prevent the action of enzyme anhydrase in the proximal tubules to promote the excretion of Na,sodium bicarbonate,K,h20
indication treat chronic glaucoma, baseline info for eye pain,pressure on eye
side effect: electrolyte imbalance,gastrotocity and bone marrow deression, monitor mental status=confusion,drowsiness
drug: Acetazolamide(Diamox)(0.2-1g)
Overall nursing imlpication for Diuretic
- brp=bathroom previlges
- i/o
- weight
- edema=indication of drug effectiveness
- state od hydration
- adminster early am=prevent noctoria
- monitor hydration,electrolyte,vital signs
- monitor for hypokalemia,hyponatremia,sourece of potassium,orthostatic hypotension,photosensitivity_avoid ultraviolet rays
- interaction-digoxin and litium
Urinary antiseptic
indication=UTI
s/s: urgency,frequency,burning
Trimethoprim(proloprim)
action: block bacterial synthesis of folic acid
- often combined with sulfamethoxazole as bactrim/septra
- ade: rash pruritis, n/v, epigastric distress
Nalidixic Acid(Neggram)
action: interfere with bacterial DNA replication
- adverse effects: N&V, anorexia, diarrhea, abdominal pain, skin rash, headache, blurred vision, dizziness, drowsiness, weakness, photosensitivity and convulsion
- contraindication-children
- gram
- gather baseline info on integmentary system, cns system
- avoid ultra violet rays
Nitrofurantoin
action: bacteriostatic. bacteriocidal
adverse effect-hypersensitivity, N&V,anorexia, skin rash, headache, peripheral neuropathy(tingling nerve), respiratory depression, muddy brown discoloration of the urine
-contraindication: renal failuire, resp. depression and pregnancy
-only effective in gu/urinary tract
-50-100mg a day
-w/ food or milk
Methenamine Products(Mandelamine)
- action: bacteriocidal, when urine is acdic gets converted to ammonia and formaldehyde
- to make urine acidic give acidifiers such as prune,plum or cranberry juice
- adverse effect- N/V,anorexia,stomatits, cramps, burning on urination and bladder irration
- chronic reoccurent ti
- 500mg-1g enteric coated
- acid convert ammonia to formaldehyde
- avoid milk(alkaline)(drug best in acdic environment
Fosfomycin(monurol)
- single dose treatment
- uncomplicated UTI
- requires constituition
- PO
- only drug single dose treatment
- female uncomplicated uti
- 3g pack granules reconstitued in 3-4oz
- should relieve in 2-3 days
- if burning continue not effective
Urinary Tract Analgesic
- treat dull pain
- local effect-relieve pain in GU tract
- action: relief burning and itching
- pyridium is a dye that exerts its eefect on the lining of the urinary tract
- discolors urine-reddish orange
- adverse effect: headache, rash, gastrotoxicity
- phenazopyridine(Pyridium)-dye analgesic effect on lining in GU tract 300mg po TID
Nursing Implication
- urine c/s before and periodic
- stop after 3 days of sterile urine or one weel after all symptoms subside
- all drug are gastrotxic so give with meals
- all cause photosensititivy
- give 2-3 liters fluid per day
- 3 negative clean catch specimen daily for daily
- report 1 or more pound daily
- report 5 more pound weekly
Antispasmodic/Anticholinergic
- act directly on bladder muscle to relax bladder muscle and reduce spasm
- indiaction- bladder instability, neurogenic bladder and UTI
- adverse effect-atropine like
- review D part of map
- given to pt w/ overactive bladder
- decrease frequency
- decrease to motility
- drying
- could cause hesitency and urinary retention
- constipation
- contraindicated in glacoma pt
Antispasmodic/Anticholinergic(Drug)
- Oxybutynin Chloride(Ditropan)
- 5mg 3x day
Drugs used for Enuresis
- Tricyclic Antidepressant
-imipramine HCL(tofranil)-used to treat urine production, anticholenerfic property
2, Antidiuretic Hormone
-Demopressin Acetate(DDAVP)-hormone, renal tube instill in nose, water toxication
-diabetes insipidus(treat)
-enuresis(treat)
Bladder Stimulant
- action: cholinergic causes the bladder to contract, resulting in voiding,
- indication: urinary retention, post op and post partum
- side effects: cholinergic like
- Bethanechol Chloride(Urecholine)-
Benign Prostate Hypertrophy(BPH)
- alpha 1blockers(Tansulosin(Flomax)
- 0.4mg per day/hypotension(AVE)
- lessen severity of the ADE when given with food
- do not crush it
- urine flow increase 1-2 weeks
Drugs used for Erectile Dysfunction
open up blood flow improve blood flow to penis
prostagladins:
1) alprostadil: used to keep vessels open have neurpogenic/spinal problems
- intaureathral medication
- injected in penis last 30-60min
- injectable./suppository in the urethra
Phosphodiesterase Inhibtors:
- inbiting an enzyme allowing nitrous oxide to work
- increase blood flow to the sex organ
- only effective if sexually aroused
1) sildenafil(viagra) - 25-100mg po
- taken immediately up to 4hrs before activities
- start to work 16-30min up to about 4hrs
2) Tadalafil(cialis) - 2.5-5mg po once in 24hr period
- work in 30min and duration 36hr
-SDE: flushing, nasal congestion, headache, visual disturbances, priapism, hypertension, arrhythmias, cva-stoke/tia-mini stroke, sudden death
Intravenous solution
- maintain fluid and electrolyte balance
- provide nutrients
- adminster medications
- replce or supplement needed lood components
- normal serum osmolarity=280-300
- isotonic: tonicity same as blood plasma
- hypotontic:tonicity lower than blood plasma
- hypertonic: tonicity greater than blood plasma
crystalloid solutions
-contain molecules that pass over semipermable membrane sterile water electrolyte
Isotonic crystalloid solutions
- expand the fluid volume
- have some, osmlarity plasma, so the fluids remian primarily in the intravascular compartment
- replace fluid loss
- exand vessels
1) Normal Saline - provide na and cl in water w/ some osmolarity as serum
- provides no calories or fire wwater(water w/o solute)
- pt w/ low na and cl level
- -used for initateing and ending blood transfusion
2) 5% dextrose in water - 170kc per L of fluid
- only isotonic in the bag
- once in body glucose quickly metabolized and leaves just free water(hypotonic)
- for pt w/ nutritional needs
- isotonic in bag in vessels become hypotonic
3) Ringers Solution - contains electrolytes no dextrose or free water
- for pt with purns or vomitting frequently
4) Lactated Ringers - contains electrolyte similar concentration to plasma
- provides no dextrose, magnesium, or freewater
- for p with burns/vomitting frequentlty
Intravenous solution
- maintain fluid and electrolyte balance
- provide nutrients
- adminster medications
- replce or supplement needed lood components
- normal serum osmolarity=280-300
- isotonic: tonicity same as blood plasma
- hypotontic:tonicity lower than blood plasma
- hypertonic: tonicity greater than blood plasma
crystalloid solutions
-contain molecules that pass over semipermable membrane sterile water electrolyte
Isotonic crystalloid solutions
- expand the fluid volume
- have some, osmlarity plasma, so the fluids remian primarily in the intravascular compartment
- replace fluid loss
- exand vessels
1) Normal Saline - provide na and cl in water w/ some osmolarity as serum
- provides no calories or fire wwater(water w/o solute)
- pt w/ low na and cl level
- -used for initateing and ending blood transfusion
2) 5% dextrose in water - 170kc per L of fluid
- only isotonic in the bag
- once in body glucose quickly metabolized and leaves just free water(hypotonic)
- for pt w/ nutritional needs
- isotonic in bag in vessels become hypotonic
3) Ringers Solution contains electrolytes but no dextrose-for pt with burns
4) Lactated Ringers - contain electrolytes provide no magnesium/magnesium/bicarbonate
- for pt with burnings
Hypotonic crystalloid solutions
- reverse dehydration and achieve cellular hydration
- lower toncity then blood
- water pulled out blood vesseld into the cells resulting in decrease vascular volume and increase cell water
- lower bp,not for ac brain injury cant lead to cerebral edema
- increasingn intra/extra cellular fluid
1) 5% dextrose in water - isotonic in iv bag
- hypotonic effect in body as dextrose is quickylu metabolized
2) 0.45% ns and 0.225 normal saline
3) saline mixed with dextrose and water
Hypertonic crystalloid solutions
- 3%normal saline and 5%normal saline
- 10% dextrose in water
- double amount=340kc per liter
- for pt w/ edmea
- high tonicty than blood
- water from cells into vessels
- expand blood volume
colloid solution
- solution that contains protein and starch molecules. molecules do not dissolve but can be distributed in the extra cellular and vascular space
- siae do not aloow cross to large
Hypertonic crystalloid solutions
- 3%normal saline and 5%normal saline
- 10% dextrose in water
- double amount=340kc per liter
- for pt w/ edmea
- high tonicty than blood
- water from cells into vessels
- expand blood volume
colloid solution
- solution that contains protein and starch molecules. molecules do not dissolve but can be distributed in the extra cellular and vascular space
- siae do not aloow cross to large
