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NURS 2514 > Urinary elimination pharmacology > Flashcards

Urinary elimination pharmacology Flashcards

(76 cards)

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1
Q

Captopril classification

A

Angiotensin Converting Enzyme (ACE) Inhibitor

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2
Q

Captopril MOA

A

Inhibits ACE to reduce levels of angiotensin II

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3
Q

Indication for Captopril

A

Used in the treatment of hypertension, heart failure, MI, and diabetic neuropathy. Also used to prevent cardiac events

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4
Q

Therapeutic effect of Captopril

A

Blood vessel dilation, reduced blood volume, decreased cardiac/ vascular remodeling

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5
Q

How does Angiotensin II increase filtration pressure?

A

Increasing pressure in the afferent arteriole

Constricting the efferent arteriole, thereby generating back-pressure in the glomerulus

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6
Q

Captopril contraindications

A

Pregnancy, breastfeeding, bilateral renal artery stenosis, angioedema (1%)

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7
Q

Adverse effects of Captopril

A

First dose hypotension, cough (10%), hyperkalemia

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8
Q

Nursing considerations of Captopril

A

Blood pressure should be monitored (esp w/ first dose and dose changes)
Fluid volume/ hydration status
Blood work to monitor: Na, K, Urea, Crea

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9
Q

Candesartan classification

A

Angiotensin II Receptor Blockers (ARBs)

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10
Q

Candesartan MOA

A

Blocks Angiotensin II from reaching receptor site

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11
Q

Candesartan indication

A

Hypertension, HF, MI, Diabetic Nephropathy

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12
Q

Therapeutic effects of Candesartan

A

Blood vessel dilation, reduced blood volume

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13
Q

Candesartan contraindications

A

Pregnancy, breastfeeding, bilateral renal artery stenosis, angioedema

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14
Q

Adverse effects of Candesartan

A

Hypotension, hyperkalemia (rare)

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15
Q

Nursing considerations of Candesartan

A

Blood pressure should be monitored (esp w/ first dose and dose changes)
Fluid volume/ hydration status
Blood work to monitor: Na, K, Urea, Crea

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16
Q

Atorvastatin (Lipitor) classification

A

HMG-CoA Reductase Inhibitors
Drugs that lower lipoprotein production
Lower LDL (25%-60%) and total cholesterol
Increases HDL (5-22%)
Significant reduction in 2 weeks but effect goes away if drug is stopped

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17
Q

Atorvastatin (Lipitor) MOA

A

Inhibit synthesis of cholesterol by blocking HMG CoA enzyme, increases LDL receptors in hepatocytes allowing for increased removal of LDL

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18
Q

Indication for Atorvastatin (Lipitor)

A

Dyslipidemia is common in CKD

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19
Q

Adverse effects of Atorvastatin (Lipitor)

A

Generally well tolerated
Headache, rash, memory loss, GI disturbance (usually transient)
Myopathy/ rhabdomyolysis
Hepatotoxicity

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20
Q

Nursing considerations for Atorvastatin (Lipitor)

A

Dose should be given in evening because of cholesterol synthesis
GI assessment (dyspepsia, cramps, flatulence, constipation, abd pain)
Monitor liver observe for muscle pain (legs often)

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21
Q

What tests can be ran to determine myopathy/ rhabdomyolysis?

A

LFTs: Liver function tests
CK: Creatine kinase (an enzyme released from injured muscle)

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22
Q

Furosemide classification

A

Loop diuretic

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23
Q

Furosemide MOA

A

Acts on ascending limb of loop of Henle to block reabsorption of sodium and chloride

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24
Q

Furosemide indication

A

Pulmonary edema, edema related to hepatic, cardiac, or renal origin unresponsive to other diuretics, hypertension unresponsive to other diuretics

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25
Therapeutic effects of furosemide
Profound diuresis (even when GFR is low)
26
Furosemide contraindications
Anuria, hepatic coma, sensitivity
27
Adverse effects of Furosemide
Hyponatremia, hypochloremia, dehydration, hypotension, hypokalemia, ototoxicity
28
Nursing considerations of Furosemide
Ins & outs Daily weights BP (postural) Dehydration (skin turgor, dry mouth, thirst, dizziness) Hearing changes, tinnitus Rashes, elevated temp
29
Hydrochlorothiazide classification
Thiazide diuretic
30
Hydrochlorothiazide MOA
Blocks Na and Cl in early segment of the distal convoluted tubule (only 10% of Na and Cl normally absorbed here)
31
Hydrochlorothiazide indication
Hypertension, edema (HF, liver or kidney disease)
32
Therapeutic effects of Hydrochlorothiazide
Diuresis (ineffective when GFR less than 15-20 mL/min)
33
Contraindications of Hydrochlorothiazide
Anuria, hepatic coma, sensitivity
34
Adverse effects of Hydrochlorothiazide
Hyponatremia, hypochloremia, dehydration, hypotension, hypokalemia
35
Nursing considerations of Hydrochlorothiazide
Ins & outs Daily weights BP (postural) Dehydration (skin turgor, dry mouth, thirst, dizziness) Rashes, elevated temp
36
Spironolactone classification
Potassium-sparing diuretic
37
Spironolactone MOA
Blocks the action of aldosterone in the distal nephron
38
Indication for Spironolactone
Hypertension, edema, heart failure
39
Therapeutic effects of Spironolactone
Retention of potassium and excretion of sodium, mild diuresis
40
Spironolactone contraindications
Hypersensitivity, anuria, Addison's disease, severe renal disease (GFR <30 mL/min), hyperkalemia, pregnancy, breastfeeding
41
Adverse effects of Spironolactone
Hyperkalemia, endocrine effects (gynecomastia, menstrual irregularities, impotence, hirsutism, deepening of the voice)
42
Nursing considerations of Spironolactone
Signs of hyperkalemia and hypokalemia Ins & outs/ daily weights/ BP Rashes, elevated temp
43
Erythropoietin classification
Hematopoietic agents
44
Erythropoietin MOA
A glycoprotein hormone that stimulates production of RBCs in bone marrow, made from rDNA
45
Indication for Erythropoietin
1) Anemia secondary to; CKD, chemotherapy, HIV treatment 2) Pre-op anemia (elective surgeries)
46
Therapeutic effects of Erythropoietin
Elevation of erythrocyte counts
47
Contraindications for Erythropoietin
Sensitivity, uncontrolled hypertension
48
Adverse effects of erythropoietin
Hypertension, cardiovascular events
49
Erythropoietin description
Starts working in 2-3 weeks, peak effect in 2-3 months Lower Hgb goal. 100-120 g/L Route: SC Dosing: 3x/week
50
Calcium carbonate classification
Calcium-based phosphate binder
51
Calcium carbonate MOA
Binds to phosphate in GI tract and is excreted in stool
52
Indication for Calcium carbonate
Hyperphosphatemia
53
Calcium carbonate therapeutic effects
Lowers serum phosphate
54
Contraindications for Calcium carbonate
Hypercalcemia, severe cardiac disease
55
Adverse effects of Calcium carbonate
Constipation, GI irritation, severe cardiac disease
56
Nursing considerations of Calcium carbonate
Monitor blood work (Ca, Phos), GI assessment, monitor for signs of dig toxicity, give 1 hour after meals
57
Kayexalate classification
Potassium binding agents
58
Kayexalate MOA
Removes potassium by exchanging sodium for potassium in large intestine
59
Indication for Kayexalate
Hyperkalemia
60
Therapeutic effect of Kayexalate
Lowers serum potassium
61
Contraindications of Kayexalate
GI obstruction
62
Adverse effects of Kayexalate
Constipation, nausea, vomiting, diarrhea, digoxin toxicity
63
Nursing considerations of Kayexalate
Assess for hyperkalemia, GI assessment (must have bowel sounds)
64
Ferrous sulfate classification
Iron preparation
65
Ferrous sulfate MOA
Replaces iron stores needed for red blood cell development
66
Indication for Ferrous sulfate
Iron deficiency anemia, nutritional supplementation
67
Therapeutic effect of Ferrous sulfate
Improvement of anemia
68
Adverse effects of Ferrous sulfate
Nausea, constipation, epigastric pain, black tarry stools
69
Nursing considerations for Ferrous sulfate
Monitor Hgb, GI assessment
70
Calcitriol classification
Vitamin D hormone
71
Calcitriol MOA
Increases intestinal absorption of calcium
72
Indication for Calcitriol
Hypocalcemia with CKD, renal osteodystrophy
73
Therapeutic effect of Calcitriol
Treatment of Vitamin D deficiency
74
Contraindications of Calcitriol
Hyperphosphatemia, hypercalcemia
75
Adverse effects of Calcitriol
GI upset
76
Calcitriol nursing considerations
Monitor blood work (Ca, Phos), abdominal assessment

NURS 2514 (14 decks)

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