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2514 Patho/phys/assess > Week 11 AKI & UTD pharm > Flashcards

Week 11 AKI & UTD pharm Flashcards

1
Q

what is the drug class of Trimethoprim/sulfamethoxazole (Septra)

A

*Anti-infective
Anti-biotic
Anti-fungal

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2
Q

What is the MOA of Trimethoprim/sulfamethoxazole (Septra)

A
  • Inhibits growth of bacteria
  • Bacteriostatic (not the killing one)
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3
Q

What is Trimethoprim/sulfamethoxazole (Septra) used to treat?

A

UTIs
*Uncomplicated
* Recurrent

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4
Q

What are the adverse effects of Trimethoprim/sulfamethoxazole (Septra) and why?

A

most common:
N&V, rash

less common:
1. hypersensitivity - b/c all meds
2. Anemia b/c
3. renal damage b/c crystalized aggrigates which can damage nephrons?
4. Birth defects - because it interacts with folate - the growth nutrient
5. hyperkalemia - due to excessive urinating?

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5
Q

What allergy do we need to pay particular attention to with Trimethoprim/sulfamethoxazole (Septra) (it’s in the name)

A

Sulfa allergies - must ask!

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6
Q

What should nurses discuss with their patients about Trimethoprim/sulfamethoxazole (Septra)?

A
  1. ask about sulfa allergy
  2. drink a glass of water with each dose
  3. Don’t stop - finish it! (anti-biotic)
  4. GI assessment- b/c n&v is most common
  5. Monitor for adverse reaction like rash, fever, malaise
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7
Q

What is the drug class of Oxybutynin (Ditropan XL)?

A

Anti-cholinergic

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8
Q

What is the MOA of Oxybutynin (Ditropan XL)?

A
  • stops bladder contractions
  • how? blocks muscarinic receptors on bladder detrusor (muscle) = blocks ACH
  • Blocks PNS (rest and digest) - b/c no ACH
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9
Q

Why do we give Oxybutynin (Ditropan XL)?

A
  1. overactive bladder
  2. bladder spasm w/Kidney stones
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10
Q

What are the adverse effects of Oxybutynin (Ditropan XL) and why?

A
  1. *Dry mouth - most common - b/c muscarinic
  2. *blurred vision
  3. constipation - block PNS
  4. tachycardia- block PNS/SNS increase
  5. hard to pee/retention
  6. hallucination, confusion, sedation (older adult)- anticholinergic
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11
Q

Which Medication for UTIs impacts older adults more negatively?
1. Oxybutynin (Ditropan XL)
2. Mirabegron (Myrbetriq)
3. Ketorolac
4.Trimethoprim/Sulfamethoxazole (Septra)

A

Oxybutynin (Ditropan XL)

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12
Q

What application is Oxybutynin (Ditropan XL) available in?

A

Transdermal patch
Gel
Tablet (pill)

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13
Q

What do nurses want to monitor with Oxybutynin (Ditropan XL)

A
  1. Urinary retention - b/c we’re slowing down the bladder
  2. UTI - because of slow bladder =bacteria growth
  3. constipation - b/c PNS blocked
  4. confusion in older adults
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14
Q

What should people NOT do when taking Oxybutynin (Ditropan XL)?

A
  1. No alcohol
  2. careful hazardous activities
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15
Q

What drug class is Mirabegron (Myrbetriq)?

A

Selective beta 3- adrengergic agonist (enhances)
- also enhances beta 1 and 2 (agonist- could have slight impact)

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16
Q

Which drug is better to give to control detrusor muscle and why?

A

Mirabegron (Myrbetriq)
- enhances the Beta 3 receptor

17
Q

What is Mirabegron (Myrbetriq) MOA?

A

-Beta 3 adrenergic agonist causes relaxation of the detrusor muscle in bladder
- increases filling time
- If can’t tolerate anticholinergic we use this
- effect is not strong - its modest

18
Q

If someone is having bladder spasms and can’t handle anti-cholinergic what med do we give them?

A

Mirabegron (Myrbetriq)

19
Q

What is the main diff between Oxybutynin MOA and Mirabegron (Myrbetriq) MOA?

A

Oxybutynin blocks PNS & muscerinic recepter in bladder so ACH can’t tell it to contract

Mirabegron enhances beta 3 bladder muscle receptor

20
Q

Who is Mirabegron (Myrbetriq) contraindicated in and why?

A

People with HTN - because it can increase Beta 1 - so HR and thus CO is increased. Bad for HTN

21
Q

What strong heart medication levels (bio availability) can be raised if someone is taking Mirabegron (Myrbetriq)?

A

Dig

22
Q

What do nurses want to monitor with Mirabegron (Myrbetriq) and why?

A
  1. Vitals - BP & HR especially b/c it can impact Beta 1 and beta 2
  2. urinary retention - make sure they are peeing because we are slowing the bladder
23
Q

What drug class is Ketorolac?

A

NSAID

24
Q

What is Ketorolac MOA?

A

inhibits prostaglandin synthesis
1st gen so cox 1 and cox 2 ?

25
Q

What are the reasons for pain that we can give Ketorolac regarding Kidneys?

A
  1. AKI
  2. UTD
  3. Renal calculi
26
Q

What are the 3 adverse effects of Ketorolac?

A
  1. Drowsiness
  2. bleeding
  3. Stevens Johnsons Syndrome (rare)

2514 Patho/phys/assess (27 decks)

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