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PCC renal pharm

Hydrochlorothiazide (HydroDIURIL) Indications increase urine output, treat HTN, edema for HF (p. 642)
Hydrochlorothiazide (HydroDIURIL) Pharmacokinetics Readily absorbed in the GI tract. t½: 6
Hydrochlorothiazide (HydroDIURIL) Administration administer in the morning to avoid nocturia. Take with food to avoid GI upset.
Hydrochlorothiazide (HydroDIURIL) Side effects electrolyte imbalances, hyperglycemia, dizziness, N/V, photosensitivity,
Hydrochlorothiazide (HydroDIURIL) Adverse reactions severe dehydration, hypotension, Life threatening: aplastic anemia,thrombocytopenia , agranulocytosis
Hydrochlorothiazide (HydroDIURIL) Contraindications renal failure, electrolyte depletion
Hydrochlorothiazide (HydroDIURIL) Interactions Digoxin, Decrease effectiveness of antidiabetics, potentiate the action of other antihypertensives
Hydrochlorothiazide (HydroDIURIL) is a – thiazide
Main purposes of diuretics ↓ B/P & ↓ edema in HF and renal or liver disorders.
Diuretics produce ↑ urine output by inhibiting sodium and water reabsorption from the kidney tubules.
Diuretics may cause loss of electrolytes
Two main types of diuretics Potassium sparing and potassium wasting
Four major types of Potassium wasting diuretics Thiazide(thiazide like), Loop(high-ceiling), Diuretics, Carbonic-anhydrase inhibitor
Thiazides are primarily used for clients with normal renal function.
Thiazides can cause multiple electrolyte imbalances.
Loop diuretic: Action Inhibit sodium and water reabsorption.
Loop diuretic Excretes calcium so can be used with end stage renal disease or a creatinine clearance less than 30/min.
Loop diuretic can cause multiple lab value changes
Osmotic (diuretic): Action increase the osmolality (or the concentration ) and sodium reabsorption.
Osmotic(diuretic) Excretes sodium, Chloride, potassium, & water.
Osmotic(diuretic) used in emergency situations with ICP and IOP.
Carbonic anhydrase inhibitor: Action Increases sodium, potassium, and bicarbonate excretion. Carbonic anhydrase inhibitor primarily used to
Potassium sparing diuretic: Action promote sodium and water excretion and potassium.
Potassium sparing diuretics can cause Hyperkalemia.
Potassium sparing are weaker diuretics than thiazides and loops.
When potassium sparing diuretics are given with ACE inhibitors they can cause increased serum potassium levels to life threatening levels. (p. 647)
Furosemide (Lasix) – indications: fluid retention/fluid overload (p. 645)
Furosemide (Lasix) Pharmacokinetics – rapidly absorbed in the GI tract. t½: 30-50min. Excretion in urine, some in feces.
When do you give Furosemide (Lasix) in morning or afternoon but not after 5 pm
Furosemide (Lasix) Administration – Take in the morning or afternoon no later than 5pm to avoid nocturia. Take with food to avoid nausea.
Furosemide (Lasix) Side effects electrolye imbalance, Nausea, diarrhea, blurred vision, ECG changes, photosensitivity, vertigo
Furosemide (Lasix) Adverse reactions severe dehydration, marked hypotension, Life threatening: Renal Failure, thrombocytopenia
Furosemide (Lasix) Contraindications severe electrolyte imbalance, hepatic coma
Furosemide (Lasix) Interactions Digoxin can cause toxicity
Osmotic Diuretics indications prevent kidney failure, ↓ intracranial Pressure (ICP), and ↓ Intraocular pressure (IOP). (p. 645)
Osmotic Diuretics Administration Diuresis occurs within 1-3 hours after IV administration. Administer over 3 to 5 minutes.
Osmotic Diuretics Side effects fluid & electrolyte imbalance, pulmonary edema, N/V, tachycardia, acidosis
Osmotic Diuretics Adverse reactions renal failure, HF
Osmotic Diuretics Contraindications Extreme caution must be used with clients who have HF and heart disease .
Osmotic Diuretics Interactions Hypokalemia ↑ risk of digoxin toxicity.
Triamterene (Dyrenium) indications ↑ urine output, treat fluid retention/overload (p. 648)
Triamterene (Dyrenium) Pharmacokinetics – rapidly absorbed in the GI tract, t½: 1.5 to 2.5h, Excreted in urine.
Triamterene (Dyrenium) Administration – Administer in am to avoid nocturia. Administer with food or milk to minimize GI distress. Can open capsules and mix with food if patient has difficulty swallowing.
Triamterene (Dyrenium) Side effects electrolyte imbalance, N/V, diarrhea, dizziness, photosensitivity, dry mouth
Triamterene (Dyrenium) Adverse reactions Life threatening: severe hyperkalemia, thrombocytopenia, megaloblastic anemia
Triamterene (Dyrenium) Contraindications kidney or hepatic disease, severe hyperkalemia
Triamterene (Dyrenium) Interactions potassium supplements, antihypertensives & lithium
Spironolactone (Aldactone) indications treat edema and HTN (p. 649, Davis’s Drug Guide p. 456)
Spironolactone (Aldactone) Pharmacokinetics – rapidly absorbed in the GI tract, t½: 1.5-2h, Excreted in urine.
Spironolactone (Aldactone) Administration – Administer in AM to avoid nocturia. Administer with food or milk to minimize GI distress.
Spironolactone (Aldactone) Side effects electrolyte imbalances, dizziness, N/V
Spironolactone (Aldactone) Adverse reactions Life threatening:severe hyperkalemia
Spironolactone (Aldactone) Contraindications Hyperkalemia, renal insufficiency, anuria
Spironolactone (Aldactone) Interactions alcohol, antihypertensives, nitrates, digoxin
Urinary Antiseptics and Antibiotics Prevent the growth of bacteria in the kidneys and the bladder only. (p. 471)
When Urinary Antiseptics and Antibiotics are given in lower doses they have a bacteriostatic effect.
When Urinary Antiseptics and Antibiotics are given in larger doses they have a bactericidal effect.
Acute Cystitis(lower UTI common use for urinary antiseptics/antibiotics) commonly occurs in females because of short urethra.
Nitrofurantoin (Macrodantin) is a –urinary antiseptic & antibiotic
Nitrofurantoin (Macrodantin) used to treat acute or chronic UTIs (p. 472)
Nitrofurantoin (Macrodantin) Pharmacokinetics Well absorbed in GI tract. t½: 20 min. Excreted in the urine.
Nitrofurantoin (Macrodantin) Administration – Take with food to decrease GI distress. Do not crush or open capsules. Shake liquid suspension well. Rinse mouth after taking.
Nitrofurantoin (Macrodantin) Side effects Dizziness, HA, drowsiness, Rust
Nitrofurantoin (Macrodantin) Adverse reactions Superinfection, peripheral neuropathy, Life Threatening: hepatotoxicity, Stevens
Nitrofurantoin (Macrodantin) Contraindications Hypersensitivity, renal impairment, oliguria , anuria
Nitrofurantoin (Macrodantin) Interactions probenecid decreases effects of Macrodantin), Antacids(it decreases absorption of Macrodantin
Urinary Analgesics Action relieves pain, burning sensation, frequency, urgency associated with urination.
Urinary Analgesics Only treats the symptoms, not the underlying cause of the symptoms.
Urinary Analgesics May be taken concurrently with an antibiotic.
Urinary Analgesics should not be used long term for undiagnosed urinary tract pain.
Phenazopyridine hydrochloride (Pyridium): Indications chronic cystitis to alleviate pain & burning with urination. (p. 476, Davis’s Drug Guide p. 1014)
Phenazopyridine hydrochloride (Pyridium) Pharmacokinetics Rapidly absorbed in GI tract. Excreted in urine.
Phenazopyridine hydrochloride (Pyridium): Administration – Take after meals. Do not crush, break or chew tablet.
Phenazopyridine hydrochloride (Pyridium): Side effects GI upset, red orange urine
Phenazopyridine hydrochloride (Pyridium): Adverse reactions Blood dyscrasia, nephrotoxicity , hepatotoxicity
Phenazopyridine hydrochloride (Pyridium): Contraindications severe hepatitis, renal failure
Urinary Stimulants Action Increases bladder tone of detrusor muscle. The detrusor muscle produces the contraction of the bladder and with the increased tone will produce a contraction strong enough to stimulate micturition
Bethanechol Chloride (Urecholine) is a – urinary stimulant
Bethanechol Chloride (Urecholine): Indications treat urinary retention (p. 273, 474, 476)
Bethanechol Chloride (Urecholine): Pharmacokinetics action: promote bladder contractions, ↑ GI peristalsis, ↑ GI secretion, ↑ pupil constriction, ↑ bronchoconstriction, t½: UK
Bethanechol Chloride (Urecholine): Administration PO: 10 to50 mg b.i.d. or q.i.d., max: 120mg/d; take this med on an empty stomach, Can be given SubQ but not IM or IV.
Bethanechol Chloride (Urecholine) can be given _____ but not ___ or ___ can be given SubQ but not IM or IV
Bethanechol Chloride (Urecholine) should be given on an – empty stomach
Bethanechol Chloride (Urecholine): Side Effects GI distress, dizziness, fainting
Bethanechol Chloride (Urecholine): Adverse Reactions orthostatic hypotension, bradycardia, muscle weakness; (Life Threatening): acute asthmatic attack, heart block, circulatory collapse, cardiac arrest.
Bethanechol Chloride (Urecholine): Contraindications intestinal or urinary tract obstruction, severe bradycardia,active asthma , hypotension , Peptic ulcer
Bethanechol Chloride (Urecholine):Interactions antidysrhythmics
Urinary Antispasmodics/Antimuscarinics Action Direct action on smooth muscles to relieve spasms of the bladder.
Oxybutynin (Ditropan): Indications: treat spasms and overactive bladder (p. 476)
Oxybutynin (Ditropan): is a urinary antispasmodic/antimuscarinics
Oxybutynin (Ditropan): Administration Immediate release tablets must be given on empty stomach while extended release can be given with or without food.
Oxybutynin (Ditropan): Side effects Drowsiness, tachycardia , dizziness, fainting, blurred vision, dry mouth, constipation
Oxybutynin (Ditropan): Adverse reactions hyperthermia
Oxybutynin (Ditropan): Contraindications Avoid in narrow-angle glaucoma,cardiac, renal , hepatic, prostate problems
Oxybutynin (Ditropan): Interactions antidepressants, haloperidol, alcohol, antihistamines, opioids.
Tolterodine tartrate (Detrol): Indications decrease urinary frequency, urgency, & incontinence (p. 280, 475
Tolterodine tartrate (Detrol): Pharmacokinetics Absorbed in GI tract. t½: 2
Tolterodine tartrate (Detrol): Administration – do NOT crush or break extended release tabs.
Tolterodine tartrate (Detrol): Side effects N/V, dizziness, vertigo, dry mouth , constipation, wt gain
Tolterodine tartrate (Detrol): Adverse reactions bronchitis, visual abnormalities, chest pain, HTN
Tolterodine tartrate (Detrol): Contraindications in client’s with narrow angle glaucoma or cardiac, renal, hepatic, prostate problems
Tolterodine tartrate (Detrol): Interactions tricyclic antidepressants, azole antifungals, cyclosporine
antispasmodics has the same effects as antimuscarinics(agents that block parasympathetic nerve impulses), parasympatholytics, and anticholinergics
Created by: 747795147
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