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.