renal drugs

ch 50-52

loop diuretic: furosemide

blocks reabsorption of Na, Cl, h2o

i: pulmonary & peripheral edema, HTN, ascites

s/e: dehydration, electrolyte imbalances, hypotension, ototoxicity, hyeprglycemia

nc: daily weights, monitor i&o

pt: consume potassium rich foods

thiazide diuretic: hydrochlorothiazide

moa: blocks reabsorption of na, cl, h2o

i: HTN, edema

s/e: dehydration, hypokalemia, hyponatremia, hyperglycemia

nc: take @ AM, daily weight, monitor i&o

pt: consume potassium-rich foods

potassium sparing diuretics: spinorolactone

moa: excretes na & h2o, retains k

i: HF, HTN

s/e: hyperkalemia, tumors

nc: monitor k levels

pt: avoid salt substitutes w/ k

osmotic diuretics: mannitol

moa: decreased ICP & IOP, increased serum osmolality

i: ICP, IOP, edema

s/e: HF, pulmonary edema, renal failure, dehydration

nc: monitor electrolytes

carbonic anhydrase inhibitors: acetazolamide

moa: inhibits carbonic anhydrase in the eye & kidneys

i: glaucoma, HF, altitude sickness

s/e: flu-like sx,electrolyte imbalances, hyperchloremic acidosis

pt: take w/ food

urinary tract antiseptics: nitrofurantoin

moa: inhibits bacterial enzymes involved in DNA/RNA synthesis & cell wall protein

i: UTI

s/e: brown discoloration of urine

pt: take w/ food

urinary tract analgesic: phenazopyridine

moa: acts as a local anaesthetic on the urinary tract, doesn’t treat UTI

i: pain, frequency, urgency associated with UTI

s/e: orange/red discoloration of urine

pt: can stain contacts, clothes, bedding

alpha 1 adrenergic blockers: tamsulosin, doxazosin

moa: relaxes the smooth prostate muscles

i: BPH, HTN

s/e: hypotension, ejaculation issues

nc: monitor BP

pt: take @ same time daily

direct-acting cholinergic agonists: bethanechol

moa: stimulate cholinergic receptors, causes contraction & emptying of bladder

i: non-obstructive urinary retention

s/e: cholinergic symptoms (SLUDGE)

pt: take 1h before or 2h after meals

anticholinergics: oxybutynin

moa: decreases urinary urgency & frequency

i: overactive bladder

s/e: anticholinergic s/e