Week 11 AKI & UTD pharm Flashcards
what is the drug class of Trimethoprim/sulfamethoxazole (Septra)
*Anti-infective
Anti-biotic
Anti-fungal
What is the MOA of Trimethoprim/sulfamethoxazole (Septra)
- Inhibits growth of bacteria
- Bacteriostatic (not the killing one)
What is Trimethoprim/sulfamethoxazole (Septra) used to treat?
UTIs
*Uncomplicated
* Recurrent
What are the adverse effects of Trimethoprim/sulfamethoxazole (Septra) and why?
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?
What allergy do we need to pay particular attention to with Trimethoprim/sulfamethoxazole (Septra) (it’s in the name)
Sulfa allergies - must ask!
What should nurses discuss with their patients about Trimethoprim/sulfamethoxazole (Septra)?
- ask about sulfa allergy
- drink a glass of water with each dose
- Don’t stop - finish it! (anti-biotic)
- GI assessment- b/c n&v is most common
- Monitor for adverse reaction like rash, fever, malaise
What is the drug class of Oxybutynin (Ditropan XL)?
Anti-cholinergic
What is the MOA of Oxybutynin (Ditropan XL)?
- stops bladder contractions
- how? blocks muscarinic receptors on bladder detrusor (muscle) = blocks ACH
- Blocks PNS (rest and digest) - b/c no ACH
Why do we give Oxybutynin (Ditropan XL)?
- overactive bladder
- bladder spasm w/Kidney stones
What are the adverse effects of Oxybutynin (Ditropan XL) and why?
- *Dry mouth - most common - b/c muscarinic
- *blurred vision
- constipation - block PNS
- tachycardia- block PNS/SNS increase
- hard to pee/retention
- hallucination, confusion, sedation (older adult)- anticholinergic
Which Medication for UTIs impacts older adults more negatively?
1. Oxybutynin (Ditropan XL)
2. Mirabegron (Myrbetriq)
3. Ketorolac
4.Trimethoprim/Sulfamethoxazole (Septra)
Oxybutynin (Ditropan XL)
What application is Oxybutynin (Ditropan XL) available in?
Transdermal patch
Gel
Tablet (pill)
What do nurses want to monitor with Oxybutynin (Ditropan XL)
- Urinary retention - b/c we’re slowing down the bladder
- UTI - because of slow bladder =bacteria growth
- constipation - b/c PNS blocked
- confusion in older adults
What should people NOT do when taking Oxybutynin (Ditropan XL)?
- No alcohol
- careful hazardous activities
What drug class is Mirabegron (Myrbetriq)?
Selective beta 3- adrengergic agonist (enhances)
- also enhances beta 1 and 2 (agonist- could have slight impact)
Which drug is better to give to control detrusor muscle and why?
Mirabegron (Myrbetriq)
- enhances the Beta 3 receptor
What is Mirabegron (Myrbetriq) MOA?
-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
If someone is having bladder spasms and can’t handle anti-cholinergic what med do we give them?
Mirabegron (Myrbetriq)
What is the main diff between Oxybutynin MOA and Mirabegron (Myrbetriq) MOA?
Oxybutynin blocks PNS & muscerinic recepter in bladder so ACH can’t tell it to contract
Mirabegron enhances beta 3 bladder muscle receptor
Who is Mirabegron (Myrbetriq) contraindicated in and why?
People with HTN - because it can increase Beta 1 - so HR and thus CO is increased. Bad for HTN
What strong heart medication levels (bio availability) can be raised if someone is taking Mirabegron (Myrbetriq)?
Dig
What do nurses want to monitor with Mirabegron (Myrbetriq) and why?
- Vitals - BP & HR especially b/c it can impact Beta 1 and beta 2
- urinary retention - make sure they are peeing because we are slowing the bladder
What drug class is Ketorolac?
NSAID
What is Ketorolac MOA?
inhibits prostaglandin synthesis
1st gen so cox 1 and cox 2 ?
