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Flashcards in Urinary&Reproductive Sys(Pharm) Deck (68):
1

Nitrofurantoin

G Name: Nitrofurantin
T Name: Furdantin, Macrodantin

2

Trimethoprim & Sulfamethoxazole

G Name: Trimethoprim & Sulfamethoxazol
T Name: Bactrim, Septra

3

Phenazopyridine HCL

G Name: Phenazopyridine HCL
T Name: Pyridium

4

Chlorothiazide

G Name: Chlorothiazide
T Name: Diuril

5

Hydrochlorothiazide

G Name: Hydrochlorothiazide
T Name: Hydro Diuril, Esidrix

6

Acetazolamide

G Name: Acetazolamide
T Name: Diamox

7

Furosemide

G Name: Furosemide
T Name: Lasix

8

Mannitol

G Name: Mannitol
T Name: Osmitrol

9

Spironolactone

G Name: Spironolactone
T Name: Aldactone

10

Triamterene

G Name: Triamterene
T Name: Dyrenium

11

Bethanechol Chloride

G Name: Bethanechol Chloride
T Name: Urecholine

12

Oxybutynin Chloride

G Name: Oxybutynin Chloride
T Name: Ditropan

13

Bumetanide

G Name: Bumetanide
T Name: Bumex

14

Conjugated Estrogen

G Name: Conjugated Estrogen
T Name: Premarin

15

Medroxy Progesterone Suspension

G Name: Medroxy Progesterone Suspension
T Name: Depo Provera

16

Menotropins

G Name: Menotropins
T Name: Pergonal

17

Methyltestosterone

G Name: Methyltestosterone
T Name: Android

18

Fluoxymesterone

G Name: Fluoxymesterone
T Name: Halotestin

19

Nandrolone Phenpropionate

G Name: Nandrolone Phenpropionate
T Name: Durabolin

20

Oxytocin

G Name: Oxytocin
T Name: Syntocinon, Pitocin

21

Ergonovine Maleate

G Name: Ergonovine Maleate
T Name: Ergotrate

22

Methylergonovine

G Name: Methylergonovine
T Name: Methergine

23

Bromocriptine Mestlate

G Name: Bromocriptine Mestlate
T Name: Parlodel

24

Megestrol Acetate

G Name: Megestrol Acetate
T Name: Megace

25

Ritrodine HCL

G Name: Ritrodine HCL
T Name: Yutopar

26

Diuretics

action: remove sodium and water from the body
indication: edema, ascites, hypertension

types:
1)Thiazides
2)Loops
3)Potassium Sparing
4)Osmotics
5)Carbonic Anhydrase Inhibitors

27

Thazides(Diuretic)

-Inhibit the reabsorption of sodium and chloride from the DISTAL TUBULES
-end up losing Na and H20
-safest diuretics
-related to sulfonamides: allergy to sulfur

28

Thazides(Diuretic)(Side Effect)

-Electrolyte imbalance,
Decrease Na(Hyponatriema),
potassium depleting(Hypokalemia),
decrease Choride(Hypochlorimia)
diabetic patient effect glucose
constipation
dehydration

29

Thiazide(Diuretic)

-interaction: CNS depressants, Lithium, Digoxin
-onset:2hrs
-peak: 2-6hrs
-duration: 6-12hr

30

Thazides(Diuretic)(Drugs)

-Chlorothiazide(Diuril)-1/2-2g per day
-Hydrochlorothiazide(Hydrodiruil)-12.5-50mg per day depending on use
-works about 2hrs after medication given
-going to have to use the bathroom
-prevent nocturia take early in the morning
-risk for orthostatic hypotension b/c lowers bp

31

Thazides(Diuretic)(Nursing Implication)

-ask about allergy to sulfur
-increase K in the diet or as supplements(b/c potassium depleting drug)-increase in leafy veggie
-insulin dose adjustment needed(b/c hyperglycemia may need more insulin
-monitor electrolytes
-i/o
-blood glucose level
-uric acid monitor(careful with gout pt)
-BUN, Creatine
-Skin tugor, dry membrane
-pt education
-dangle, rise slowly of bed
-avoid hot showes
-baseline bp

32

Loops(Diuretic)

action: inhibit the reabsorption of sodium and chloride in the ASCENDING LOOP OF THE HENLE

indication: hypertension,CHF, Pulmonary Edema, Ascities, Renal Failure

-Most potent and strongest
-safetest for elderly population
-derived from sulfonamides

33

Loops(Diuretic)(Side Effect)

-Electrolyte imbalance
-hyponatremia
-hypochloremia
-dehydration
-potassium depleting
-increase in sugar level
-ototoxicity=baseline hearing assessment

34

Loops(Diuretic)(Nursing Implication)

-interaction w/ lithium,ASA,Aminoglycosides=greater risk for salicysim/ototoxicity
-ask if allerguc to sulfa
-give with food or milk b/c gi toxic
-ototoxicity increaseed with aminoglycosides

35

Loop(Diuretuc)(Drug)

-Furosemide(Lasix)=20-80mg, max in 24hr period 1g, po/iv, intravenous route
-Bumetanide(Bumex)=most potent

36

Potassium Sparing

action: inhibits the action of aldosterone in the distal tubules(Aldosterone Antagonit). Inhibts Na channel
-weak diuretic
-often combined with thiazides

indication: renal failure,CHF,Liver Cirrhosis, Hypokalemia

37

Potassium Sparing(side effect)

-Hyperkalemia(avoid increase in K food)
-gastrotoxic: flatus,headache,anorexia,n/v,flatus

38

Potassium Sparing(Drug)
Aldosterone Antagonist

-aldosterone antagonist(effecting hormones)
- in male patients cause impotence/gynocomastia
-in femal menstrual cycle

-Sprionolactone(aldactone)-Aldosterone Antagonist
-Triamterene(Dyrenium)-Aldosterone Antagonist

39

Osmotics

action: concentrate in the kidney tubules and selectively prevent the reabsorption of water,sodium,and chloride

indication: ac renal faliure, intraoccular pressure, intracranial pressure
-powerful form diuretic
-concentrate in kidney tublue
-prevent water,sodium reabsorption
-cause rapid excretion of fluid
-emergency situation
-for acute renal failure
-for acute glucoma(take pressure off eye)

40

Osmotics(Drugs)

Mannitol(Osmitrol)
-iv:500-200mg a day; 500ml in bag
-neuro assesment
-crystals can form in med
-will neeed a filter tubing
-monitor site for infiltration iv
-headaches, electrolytes imbalance,dehyrdration
-rapid removal of fluid
-baseline vital signs needed
-cns assessment needed
-powerful form of diuretic
-concentrate in kidney tubules
-prevent water,na,reabsorption
-cause rapid excertion of fluid
-emergent situation(acute renal failure, acute glucoma to take pressure of the eye

41

Osmotics(Nuring implication)

-monitor electrolyte
-neuro assessment
-monitor vision

42

Carbon Anhydrae Inhibitor

action: prevent the action of enzyme anhydrase in the proximal tubules to promote the excretion of Na,sodium bicarbonate,K,h20

indication treat chronic glaucoma, baseline info for eye pain,pressure on eye

side effect: electrolyte imbalance,gastrotocity and bone marrow deression, monitor mental status=confusion,drowsiness

drug: Acetazolamide(Diamox)(0.2-1g)

43

Overall nursing imlpication for Diuretic

-brp=bathroom previlges
-i/o
-weight
-edema=indication of drug effectiveness
-state od hydration
-adminster early am=prevent noctoria
-monitor hydration,electrolyte,vital signs
-monitor for hypokalemia,hyponatremia,sourece of potassium,orthostatic hypotension,photosensitivity_avoid ultraviolet rays
-interaction-digoxin and litium

44

Urinary antiseptic

indication=UTI
s/s: urgency,frequency,burning

45

Trimethoprim(proloprim)

action: block bacterial synthesis of folic acid
-often combined with sulfamethoxazole as bactrim/septra
-ade: rash pruritis, n/v, epigastric distress

46

Nalidixic Acid(Neggram)

action: interfere with bacterial DNA replication
-adverse effects: N&V, anorexia, diarrhea, abdominal pain, skin rash, headache, blurred vision, dizziness, drowsiness, weakness, photosensitivity and convulsion
-contraindication-children
-gram
-gather baseline info on integmentary system, cns system
-avoid ultra violet rays

47

Nitrofurantoin

action: bacteriostatic. bacteriocidal
adverse effect-hypersensitivity, N&V,anorexia, skin rash, headache, peripheral neuropathy(tingling nerve), respiratory depression, muddy brown discoloration of the urine
-contraindication: renal failuire, resp. depression and pregnancy
-only effective in gu/urinary tract
-50-100mg a day
-w/ food or milk

48

Methenamine Products(Mandelamine)

-action: bacteriocidal, when urine is acdic gets converted to ammonia and formaldehyde
-to make urine acidic give acidifiers such as prune,plum or cranberry juice
-adverse effect- N/V,anorexia,stomatits, cramps, burning on urination and bladder irration
-chronic reoccurent ti
-500mg-1g enteric coated
-acid convert ammonia to formaldehyde
-avoid milk(alkaline)(drug best in acdic environment

49

Fosfomycin(monurol)

-single dose treatment
-uncomplicated UTI
-requires constituition
-PO
-only drug single dose treatment
-female uncomplicated uti
-3g pack granules reconstitued in 3-4oz
-should relieve in 2-3 days
-if burning continue not effective

50

Urinary Tract Analgesic

-treat dull pain
-local effect-relieve pain in GU tract
-action: relief burning and itching
-pyridium is a dye that exerts its eefect on the lining of the urinary tract
-discolors urine-reddish orange
-adverse effect: headache, rash, gastrotoxicity
-phenazopyridine(Pyridium)-dye analgesic effect on lining in GU tract 300mg po TID

51

Nursing Implication

-urine c/s before and periodic
-stop after 3 days of sterile urine or one weel after all symptoms subside
-all drug are gastrotxic so give with meals
-all cause photosensititivy
-give 2-3 liters fluid per day
-3 negative clean catch specimen daily for daily
-report 1 or more pound daily
-report 5 more pound weekly

52

Antispasmodic/Anticholinergic

-act directly on bladder muscle to relax bladder muscle and reduce spasm
-indiaction- bladder instability, neurogenic bladder and UTI
-adverse effect-atropine like
-review D part of map
-given to pt w/ overactive bladder
-decrease frequency
-decrease to motility
-drying
-could cause hesitency and urinary retention
-constipation
-contraindicated in glacoma pt

53

Antispasmodic/Anticholinergic(Drug)

-Oxybutynin Chloride(Ditropan)
-5mg 3x day

54

Drugs used for Enuresis

1. Tricyclic Antidepressant
-imipramine HCL(tofranil)-used to treat urine production, anticholenerfic property
2, Antidiuretic Hormone
-Demopressin Acetate(DDAVP)-hormone, renal tube instill in nose, water toxication
-diabetes insipidus(treat)
-enuresis(treat)

55

Bladder Stimulant

-action: cholinergic causes the bladder to contract, resulting in voiding,
-indication: urinary retention, post op and post partum
-side effects: cholinergic like
-Bethanechol Chloride(Urecholine)-

56

Benign Prostate Hypertrophy(BPH)

-alpha 1blockers(Tansulosin(Flomax)
-0.4mg per day/hypotension(AVE)
-lessen severity of the ADE when given with food
-do not crush it
-urine flow increase 1-2 weeks

57

Drugs used for Erectile Dysfunction

open up blood flow improve blood flow to penis

prostagladins:
1)alprostadil: used to keep vessels open have neurpogenic/spinal problems
-intaureathral medication
-injected in penis last 30-60min
-injectable./suppository in the urethra

Phosphodiesterase Inhibtors:
-inbiting an enzyme allowing nitrous oxide to work
-increase blood flow to the sex organ
-only effective if sexually aroused
1) sildenafil(viagra)
-25-100mg po
-taken immediately up to 4hrs before activities
-start to work 16-30min up to about 4hrs
2) Tadalafil(cialis)
-2.5-5mg po once in 24hr period
-work in 30min and duration 36hr

-SDE: flushing, nasal congestion, headache, visual disturbances, priapism, hypertension, arrhythmias, cva-stoke/tia-mini stroke, sudden death

58

Intravenous solution

-maintain fluid and electrolyte balance
-provide nutrients
-adminster medications
-replce or supplement needed lood components

-normal serum osmolarity=280-300
-isotonic: tonicity same as blood plasma
-hypotontic:tonicity lower than blood plasma
-hypertonic: tonicity greater than blood plasma

59

crystalloid solutions

-contain molecules that pass over semipermable membrane sterile water electrolyte

60

Isotonic crystalloid solutions

-expand the fluid volume
-have some, osmlarity plasma, so the fluids remian primarily in the intravascular compartment
-replace fluid loss
-exand vessels
1) Normal Saline
-provide na and cl in water w/ some osmolarity as serum
-provides no calories or fire wwater(water w/o solute)
-pt w/ low na and cl level
--used for initateing and ending blood transfusion
2) 5% dextrose in water
-170kc per L of fluid
-only isotonic in the bag
-once in body glucose quickly metabolized and leaves just free water(hypotonic)
-for pt w/ nutritional needs
-isotonic in bag in vessels become hypotonic
3)Ringers Solution
-contains electrolytes no dextrose or free water
-for pt with purns or vomitting frequently
4)Lactated Ringers
-contains electrolyte similar concentration to plasma
-provides no dextrose, magnesium, or freewater
-for p with burns/vomitting frequentlty

61

Intravenous solution

-maintain fluid and electrolyte balance
-provide nutrients
-adminster medications
-replce or supplement needed lood components

-normal serum osmolarity=280-300
-isotonic: tonicity same as blood plasma
-hypotontic:tonicity lower than blood plasma
-hypertonic: tonicity greater than blood plasma

62

crystalloid solutions

-contain molecules that pass over semipermable membrane sterile water electrolyte

63

Isotonic crystalloid solutions

-expand the fluid volume
-have some, osmlarity plasma, so the fluids remian primarily in the intravascular compartment
-replace fluid loss
-exand vessels
1) Normal Saline
-provide na and cl in water w/ some osmolarity as serum
-provides no calories or fire wwater(water w/o solute)
-pt w/ low na and cl level
--used for initateing and ending blood transfusion
2) 5% dextrose in water
-170kc per L of fluid
-only isotonic in the bag
-once in body glucose quickly metabolized and leaves just free water(hypotonic)
-for pt w/ nutritional needs
-isotonic in bag in vessels become hypotonic
3)Ringers Solution contains electrolytes but no dextrose-for pt with burns
4)Lactated Ringers
-contain electrolytes provide no magnesium/magnesium/bicarbonate
-for pt with burnings

64

Hypotonic crystalloid solutions

-reverse dehydration and achieve cellular hydration
-lower toncity then blood
-water pulled out blood vesseld into the cells resulting in decrease vascular volume and increase cell water
-lower bp,not for ac brain injury cant lead to cerebral edema
-increasingn intra/extra cellular fluid
1) 5% dextrose in water
-isotonic in iv bag
-hypotonic effect in body as dextrose is quickylu metabolized
2)0.45% ns and 0.225 normal saline
3)saline mixed with dextrose and water

65

Hypertonic crystalloid solutions

-3%normal saline and 5%normal saline
-10% dextrose in water
-double amount=340kc per liter
-for pt w/ edmea
-high tonicty than blood
-water from cells into vessels
-expand blood volume

66

colloid solution

-solution that contains protein and starch molecules. molecules do not dissolve but can be distributed in the extra cellular and vascular space
-siae do not aloow cross to large

67

Hypertonic crystalloid solutions

-3%normal saline and 5%normal saline
-10% dextrose in water
-double amount=340kc per liter
-for pt w/ edmea
-high tonicty than blood
-water from cells into vessels
-expand blood volume

68

colloid solution

-solution that contains protein and starch molecules. molecules do not dissolve but can be distributed in the extra cellular and vascular space
-siae do not aloow cross to large