Urinary System and GI System

diuretics

influence function of urinary tract to increase urine excretion

indications are: reduce circulating fluid volume for edema or hypertension

types of diuretics

thiazides, loop diuretics, potassium sparing diuretics, osmotic agents

thiazides

MOST FREQ USED TYPE OF DIURETIC

stimulates kidneys to excrete excess fluid and electrolytes

USE: hypertension, prevent formation of stones

thiazides side effects

SIDE EFFECTS: hypokalemia, postural hypotension, vertigo

drug to know thiazides

hydrochlorothiazide

loop diuretics

act on loop of henle in kidney to inhibit na and cl reabsorption back into blood

USE: edema

loop diuretics side effects

SIDE EFFECTS: fluid/electrolyte imbalance causing chest pain, hypokalemia, hypotension

drugs to know loop diuretics

furosemide

bumetanide

torsemide

aka -emide

potassium sparing diuretics

prescribed with other diuretics

USE: under conditions where K depletion can be dangerous-can counteract increased glucose and uric acid lvls associated with thiazide use

drugs to know potassium sparing diuretics

spironolactone

triamterene

osmotic agents

USE: reduce intraocular/intracranial pressure-emergency situations that involve CNS trauma to reduce risk of dmg from swelling

EXTREME CAUTION: hx of kidney or heart failure

osmotic agents side effects

SIDE EFFECTS: fluid/electrolyte imbalance, headache, vertigo, tachycardia, anaphylaxis

drug to know osmotic agents

mannitol

gout

metabolic disorder with accumulation of uric acid crystals in joints, tissues, kidneys that causes inflammation and pain

most commonly in BIG TOE, ankle, knee, elbow

acute and chronic

common at night when not well hydrated

limit fruit juice, seafood, red meat, foods high in sugar and salt

acute gout tx

nsaids: naproxen, ibuprofen-for pain from gout

corticosteroids: prednisone-acute goat pain in pts who cant take nsaids

colchicine: not an analgesic-relive inflammation in acute gout arthritis and prevent recurrent attacks

-SIDE EFFECTS: gi upset, n/v/d

chronic gout tx

uricosuric agents: probenecid

-USE: block reabsorption in kidneys and promote urinary excretion of uric acid-only for chronic

-SIDE EFFECTS: kidney stones

antispasmodics

overactive bladder with frequency and urgency

USE: increase capacity and decrease urgency of bladder

antispasmodics side effects

SIDE EFFECTS: urinary retention/constipation, blurred vision, mental confusion, tachycardia, palpitations

drugs to know antispasmodics

tolterodine

oxybutynin

cholinergics

USE: stimulate parasympathetic nerves to cause urinary contraction in cases of non-obstructive urinary retention-called the "pharmacological catheterization"

cholinergic side effects

SIDE EFFECTS: GI issues (nvd), sweating, slow heartbeat, urinary urgency

drugs to know cholinergics

bethanechol

urinary analgesics

USE: short term relief of burning, pain, discomfort, urgecy associated with. cystitis or UTIs

urinary analgesic side effects

SIDE EFFECTS: orange red urine or discoloration of contact lenses

drugs to know urinary analgesics

phenazopyridine

meds for bph

antiandrogens

alpha blockers

phosphodiesterase

antiandrogens

USE: suppress prostate growth-not curative

CAUTIONS: pts should rule out cancer diagnosis first-should not be handled by pregnant women

antiandrogen side effects

SIDE EFFECT: impotence, decreased libido, gynecomastia

drugs to know antiandrogens

finasteride

dutasteride

alpha blockers

USE: block alpha receptors found in smooth muscle in bladder neck and prostate-causing both to relax and improve urine flow

alpha blockers side effects

SIDE EFFECTS: dizziness, orthostatic hypotension, decreased libido, impotence

drugs to know alpha blockers

doxazosin

tamsulosin

phosphodiesterase inhibitors

USE: smooth muscle relaxation and increased blood flow-commonly used for erectile dysfunction

phosphodiesterase inhibitors side effects

SIDE EFFECTS: hypertension, fainting

drugs to know phosphodiesterase inhibitor

tadalafil

antacids

USE: work against excessive acid production to reduce harmful effects

CAUTION: should not be taken w/in 2 hours of anti-infectives, digoxin, and certain hormones (increase/decrease effects of other meds)

antacid side effects

SIDE EFFECTS: constipation, electrolyte imbalance

drug to know antacids

calcium carbonate-tums

H2 blockers

USE: reduce gastric acid secretion by blocking histamine receptors in stomach

H2 blocker side effects

SIDE EFFECTS: diarrhea, mental confusion. Long term is vit/mineral def

Drug to Know H2 Blockers

famotidine-pepcid

PPIs

USE: gastric anti-secretory agent. Short term symptomatic relief of GERD, ulcers, heartburn

FIRST LINE FOR GERD AND ULCERS

PPI side effects

SIDE EFFECTS: GI issues, increased risk of pneumonia and cdiff

drug to know PPIs

omeprazole-prilosec

lansoprazole-prevacid

salicylates

USE: anti-inflammatory activity on GI tract-specifically designed to reach ileum and colon and to bypass stomach

CHEMICAL MAKEUP IS SIMILAR TO ASPIRIN

salicylates side effects

SIDE EFFECTS: GI upset

drug to know salicylates

sulfasalazine-azulfidine

monoclonal antibodies

USE: decrease body's inflammatory response-admined via injection or IV

CAUTION: higher risl of infection and should not recieve live vaccines

drug to know monoclonal antibodies

adalimumab-humira

Bismuth subsalicylate

USE: anti-infective and anti-secretory properties-has a direct mucosal protective effect

bismuth subsalicylate side effects

SIDE EFFECTS: discoloration of tongue and stool (black)

drug to know bismuth subsalicylate

bismuth subsalicylate-pepto bismol

Opiate Agonists

USE: slow intestinal motility, allowing for more resorption of fluid back into body-solidifying feces

opiate agonist side effects

SIDE EFFECTS: anticholinergic (drying secretions, blurred vision, etc.) with Lomotil

drugs to know opiate agonists

diphenoxylate/atropine-lomotil

loperamide-imodium

stool softeners

USE: allow water and oil to enter stool causing to soften and pass easier

drugs to know stool softeners

docusate-dulcolax

saline laxatives

USE: draw water to bowel from surrounding tissue making stoll easier to pass and increasing number of bowel mvmnts

CAUTION: onset of action is .5-3 hrs

cardiac, renal, hepatic complications

saline laxative side effects

SIDE EFFECTS: (with prolonged use) electrolyte imbalance

drugs to know saline laxatives

magnesium hydroxide-milk of magnesia

antidopaminergics

USE: symptomatic relief by interfering with stimulation of chemoreceptor trigger zone in brain-therefore blocking messages to GI tract

antidopaminergic side effects

SIDE EFFECTS: drowsiness, dizziness

drugs to know antidopaminergics

promethazine-phenergan

metoclopramide-reglan

serotonin-receptor antagonists

USE: block serotonin receptors in CTZ and in intestine to control emesis

serotonin-receptor antagonist side effects

SIDE EFFECTS: drowsiness, vertigo, confusion (esp in older adults)

drugs to know serotonin-receptor antagonists

ondansetron - zofran