lecture recording on 26 February 2025 at 11.00.01 AM

Autotoxicity and Patient Monitoring

  • Autotoxicity: A condition where a substance produced by an organism is toxic to itself.

  • Uric Acid Increase: Monitor patients with diabetes for increased uric acid levels and blood sugar fluctuations.

  • Hypotension in Diabetic Patients: Be wary of low blood pressure in diabetic patients.

  • Medications: Certain medications such as laxatives and aspirin may exacerbate issues, particularly for patients unable to tolerate them.

Patient Diet Considerations

  • Importance of Potassium-Rich Foods: Essential for patients taking diuretics. Common foods include:

    • Spinach

    • Orange Juice

  • Monitor patients on diuretics for potential potassium imbalances.

  • Educate on reporting symptoms such as dizziness or syncope and vitamin B changes.

Weight Monitoring Protocol

  • Daily Weighing: Essential for managing patients on diuretics to identify fluid retention or loss.

  • Report any fluctuations:

    • 3-pound change in one day.

    • 7-pound change in one week.

  • This protocol aids in preventing electrolyte imbalances.

Conditions Treated with Diuretics

  • Treat Hypertension, edema from heart failure, and cirrhosis.

  • Adverse Effects: Be aware of hyperkalemia, and other unique symptoms include:

    • Ventricular irregularities.

    • Abnormal hair growth, deepening of voice in assigned females at birth.

Educating Patients on Medication Effects

  • Patients on Potassium-Sparing Diuretics: Avoid potassium-rich foods (e.g., bananas).

  • Report any hormonal changes or adverse effects promptly.

  • Common issues include diarrhea or excessive weight loss due to fluid loss.

Long-term Medication Considerations

  • Patients with congestive heart failure often require lifelong diuretics.

  • Follow protocols to avoid rapid weight loss that can lead to electrolytic imbalances.

Understanding Hydrochlorothiazide (HCTZ)

  • HCTZ is often combined with other antihypertensive medications.

  • Caution with dosing, as it could lead to hypotensive episodes.

  • Monitor patients for kidney function as HCTZ affects electrolytes.

Administering Diuretics

  • Timing: Diuretics should be administered in the morning to reduce nighttime bathroom trips and falls.

5-alpha Reductase Inhibitors

  • Used for enlarged prostate; reduces prostate cancer risk.

  • Side effects include decreased libido and ejaculate volume. Monitor PSA levels for effectiveness.

Flomax (Tamsulosin) Overview

  • Alpha-adrenergic receptor antagonist.

  • Used for patients experiencing urinary retention due to enlarged prostate symptoms.

  • Possible side effects: headache, dizziness, ejaculation failure (retrograde).

Oxybutynin and Overactive Bladder Medications

  • Treats urinary urge incontinence and neurogenic bladder.

  • Considerations: Anticholinergic effects cause dry mouth, constipation, and urine retention.

    • Monitor hydration levels and educate patients on side effects.

Cholesterol Medications

  • Statins like Rosuvastatin target LDL levels.

  • Monitor for liver enzyme elevations, teach patients about lifestyle modifications alongside medication.

Managing Cardiovascular Medications

  • Adenosine: Used in emergencies for supraventricular tachycardia (SVT).

    • Administer via IV push for rapid action.

Patient Education on Medications

  • Monitor blood pressure with new antihypertensive medications; teaching patients self-monitoring is crucial.

  • Report hypotension symptoms and any adverse reactions immediately to healthcare providers.

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