Silvestri-Renal Medications

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Author:
Sarahndipity81
ID:
213997
Filename:
Silvestri-Renal Medications
Updated:
2013-04-17 00:34:23
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Renal Medications
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Description:
Renal Medications
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  1. What is a urinary tract antiseptic used for?
    To treat acute cystitis or UTI
  2. What do urinary tract antiseptics do?
    Inhibit the growth of bacteria in the urine
  3. Urinary tract antiseptics
    4
    • Cinoxacin
    • Methenamine
    • Nalidixic acid
    • Nitrofurantoin
  4. Cinoxacin doses should be reduced in clients with....?
    Renal impairment...failure to do so could result in accumulation of the medication to toxic levels
  5. Methenamine is used to treat .... ?... but is not recommended for... ?....
    ...chronic UTIs, but is not recommended for acute infections
  6. When should Methenamine be administered?
    after meals and at bedtime to reduce gastric distress
  7. Methenamine should not be used in clients with....?
    Renal impairment or liver dysfunction
  8. What pH urine does methenamine require?
    5.5 or lower (acidic)
  9. What does increasing fluid intake do when taking methenamine?
    Reduces its antibacterial effects by diluting the medication and raising urine pH
  10. What should not be taken with methenamine?
    • Sulfonamides (risk of crystalluria and urinary tract injury)
    • Alkalinizing agents
  11. What are some side effects of nalidixic acid?
    5
    • GI upset
    • Rash
    • Photosensitivity
    • Visual disturbances
    • Insomnia
  12. What side effect can nalidixic acid have in pediatric patients?
    Intracranial hypertension and shouldn't be given to infants under 3 months
  13. What drugs can be affected by nalidixic acid?
    Anticoagulant effects can be intensified
  14. In what patients is nalidixic acid contraindicated in?
    Hx of convulsive disorders
  15. What are some of the pulmonary reactions when taking nitrofurantoin and how long does it take them to resolve?
    6
    • Dyspnea
    • Chest pain
    • Chills
    • Fever
    • Cough
    • Alveolar infiltrates
    • 2-4 days following cessation of treatment
  16. What may nitrofurantoin do to urine?
    Cause it to be a brown color (harmless)
  17. Who is nitrofurantoin contraindicated for?
    Clients with renal impairment
  18. Do not take nitrofurantoin with....?
    antacids
  19. What do fluoroquinolones do?
    Suppress bacterial growth by inhibiting an enzyme necessary fro DNA synthesis
  20. Fluoroquinolones
    4
    • Ciprofloxacin
    • Enoxacin
    • Levofloxacin
    • Norofloxacin
  21. What are some of the side effects of fluoroquinolones?
    5
    • Dizziness
    • Drowsiness
    • GI distress
    • Diarrhea
    • Nausea and vomiting
  22. What are some of the adverse effects of fluoroquinolones?
    5
    • Psychosis
    • Hallucinations
    • Confusion
    • Tremors
    • Interstitial Nephritis
  23. Who should fluoroquinolones be used with caution in?
    Clients with hepatic, renal, or CNS disorders
  24. What urine output should persons taking fluoroquinolones maintain and why?
    1200-1500 mL daily to minimize the development of crystalluria
  25. What are the indicators of fluoroquinolones CNS toxicity?
    5
    • Dizziness
    • Lightheadedness
    • Visual disturbances
    • Increased light sensitivity
    • Depression
  26. Fluoroquinolones are toxic to ....
    ...the renal and hepatic systems
  27. What do sulfonimides do?
    Suppress bacterial growth by inhibiting the synthesis of folic acid
  28. What are sulfonamides primarily used to treat?
    Acute UTIs
  29. What are the hypersensitivity reactions of sulfonamides?
    4
    • Rash
    • Fever
    • Photosensitivity
    • Stevens-Johnson syndrome
  30. What is Stevens-Johnson syndrome?
    The most severe sulfonamide hypersensitivity response producing symptoms that include widespread lesions of the skin and mucous membranes, fever, malaise, and toxemia
  31. Sulfonamides
    4
    • Sulfadiazine
    • Slufisoxazole
    • Trimethoprim
    • TMP/SMZ
  32. Adults should maintain a daily urine output of ...
    1200 mL to minimize risk of renal damage
  33. How is an IV dose of TMP/SMZ administered?
    Over 60-90 minutes and NOT mixed with any other meds
  34. What is phenazopyridine?
    A urinary tract analgesic
  35. What are the side effects of phenazopyridine?
    3
    • Nausea
    • Headache
    • Vertigo
  36. Who are urinary tract analgesics contraindicated in?
    Renal or hepatic disease
  37. What are anticholinergics-antispasmodics used for?
    Overactive bladder
  38. Anticholinergics-Antispasmodics
    5
    • Darifenacin
    • Oxybutynin chloride
    • Solifenacin
    • Tolterodine
    • Trospium
  39. Side effects of anticholinergics-antispasmodics?
    6
    • Anorexia
    • Nausea/Vomiting
    • Dry Mouth
    • Blurred Vision
    • Drowsiness
    • Urinary Retention
  40. Signs of anticholinergic-antispasmodic toxicity?
    6
    • Hypotension/Hypertension
    • Confusion
    • Tachycardia
    • Flushed/Red Face
    • Respiratory Depression
    • Nervousness
  41. What is bethanechol chloride?
    A cholinergic used to increase bladder tone and function and to treat nonobstructive urinary retention and neurogenic bladder
  42. When should bethanechol chloride be administered?
    1 hour before or 2 hours after a meal to lessen nausea and vomiting
  43. What are the signs of cholinergic overdose?
    5
    • Excessive salivation
    • Sweating
    • Involuntary urination/defecation
    • Bradycardia
    • Severe hypotension
  44. What is the antidote to bethanechol chloride (cholinergic)?
    Atropine sulfate
  45. What types of medications are used for preventing organ rejection?
    4
    • Immunosuppressants
    • Corticosteroids
    • Cytotoxic medications
    • Antibodies
  46. What is cyclosporine used for?
    Preventing rejection of allogeneic kidney, liver and heart transplants
  47. Immunosuppressants
    3
    • Cyclosporine
    • Sirolimus
    • Tacrolimus
  48. What route of administration is preferred for cyclosporine?
    Oral
  49. What system is cyclosporine toxic to?
    Nephrotoxic
  50. What are the most common adverse effects of cyclosporine?
    5
    • Nephrotoxicity
    • Infection
    • Hypertension
    • Tremor
    • Hirsutism
  51. In whom is cyclosporine contraindicated in?
    • Pregnancy/Breast feeding
    • Recent inoculation with live virus
    • Recent contact with active infection such as chickenpox
  52. What should a client unable to swallow their cyclosporine pill do?
    Mix liquid with milk or OJ in a glass container and drink immediately
  53. What risks do sirolimus increase?
    4
    • Infection
    • Renal injury
    • Lymphocele
    • Raises triglycerides
  54. What are some of the side effects of tacrolimus?
    9
    • Nephrotoxicity
    • Infection
    • HTTN
    • Tremor
    • Hirsutism
    • Neurotoxicity
    • GI effects
    • Hyperkalemia
    • Hyperglycemia
  55. Glucocorticoid
    Prednisone
  56. What can occur with prednisone use?
    2
    • Hyperglycemia
    • Hypokalemia
  57. Cytotoxic medications
    2
    • Azathioprine
    • Mycophenolate mofetil
  58. What are some of the side effects of azathioprine?
    • Neutropenia
    • Thrombocytopenia
    • (Due to bone marrow suppression)
  59. What are some of the adverse effects of mycophenolate mofetil?
    4
    • Diarrhea
    • Severe neutropenia
    • Vomiting
    • Sepsis
  60. Antibodies
    4
    • Antithyocyte globluin, equine
    • Basiliximab
    • Daclizumab
    • Muromonab-CD3
  61. What should a client do before the first infusion of antithymocyte globulin, equine?
    Undergo intradermal skin testing to determine hypersensitivity
  62. What are some of the adverse reactions to muromonab-CD3?
    5
    • Fever
    • Chills
    • Dyspnea
    • Chest pain
    • Nausea/Vomiting
  63. Types of hematoporetic growth factors
    3
    • Erythropoietic
    • Leukopoietic
    • Thrombopoietic
  64. Erythropoeitic growth factors stimulate production of...?
    RBCs
  65. Leukopoietic growth factors stimulate production of...?
    WBCs
  66. Thrombopoietic growth factors stimulate production of...?
    Platelets
  67. What is the major side effect of erythropoeitic growth factors?
    HTTN
  68. What are some of the adverse effects of erythropoeitic growth factors?
    3
    • Heart failure
    • Thrombotic events
    • Cardiac arrest
  69. Side effects of leukopoietic growth factors?
    3
    • Bone pain
    • Leukocytosis
    • Elevated plasma uric acid
  70. What are some of the adverse effects of thrombopoietic growth factors?
    5
    • Fluid retention
    • Cardiac dysrhythmias
    • Conjunctival infection
    • Visual blurring
    • Papilledema

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