Renal Drugs

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Author:
Mundi
ID:
250651
Filename:
Renal Drugs
Updated:
2013-12-04 02:10:28
Tags:
renal drugs
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Description:
Pharm Renal Drugs
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  1. Mannitol
    • Osmotic Diuretics
    • Works @ glomerus

    MOA: pulls H2O into renal tubule w/o Na loss; changes blood osmolarity

    IND: increase cranial pressure, acute renal failure due to shock, drug OD, trauma

    Contra: *CHF, renal disease, anuria, pulmonary congestion, intracranial bleeding, dehydration

    AE: hypovolemic shock (sudden fluid loss), hypotension, light headed, confusion

    • Nursing: use for emergencies & w/ care
    • Monitor for fluid intake & out
    • Electrolyte levels (K, Mg, Ca, Na)
    • BP
  2. Acetazolamide
    • Carbonic Anhydrase Inhibitor
    • @proximal tubule

    MOA: blocks effects of carbonic anhydrase; slow movement of H ions; Na & bicarbonate lost in urine

    Ind: glaucoma; adjuncts 

    AE: electrolyte & pH disturbances; renal calculi; bone marrow suppression; weight loss; metabolic acidosis

    D2D: salicylates, lithium salts
  3. Furosemide (Lasix)
    • Loop Diueretics
    • @ ascending looping
    • - more common, less powerful, more safe at home

    MOA:block Cl pump; reabsorption of Na & Cl

    Ind:acute CHF, edema assoc CHF, acute pulmonary, hypertension

    Contra:eletro depletion, anuria, severe liver failure

    Caution: SLE, gout, DM

    AE: imbalance electro & fluid, hypokalemia, hypocalcemia, alkalosis

    D2D: aminoglycosides, anticoagulants, indomethacin, ibuprofen, salicy, NSAIDs

    SrCr increases if dehydrated
  4. Spironolactone
    • Potassium-Sparing
    • @distal tubule

    MOA: blocks aldosterone (oppose effects of steriods); loss of Na, retain K

    Ind: adjunct w/ thiazide or loop

    Contra: hyper kal, renal, anuria; taking amiloride or ortriameterne

    AE: hirsutism, gynecomastia, deepening of the voice, irregular menses

    D2D: salicylates

    *monitor for hyperkalemia
  5. Hydrochlorothiazide
    • Thiazide
    • @distal tubule & collecting ducts

    MOA: blocks Cl pump; Cl & Na excreted; alters blood glucose levels

    Ind: edema assoc w/ CHF, liver, or renal disease

    Contra: bipolar (lithium), allergy to sulfonamides

    AE: GI irritability, muscle cramps & spasms (r/t Ca & K imbalance), dry mouth

    D2D: cholesyramine (for high lipid, related to heart & diabetes), digoxin, antidiabetics

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