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