Renal Drugs
Terms
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- Fursoemide (Loop Diuretic)
- used to treat edema from renal diseases and antihypertensive, first choice diuretic for treating hypertension w/preexisting renal disease, works in the loop of Henle to excrete sodium, chloride, potassium and water, contraindication=anuria in CRF, Most common adverse effect=potassium loss, Most serious adverse effect hypokalemai, permanent deafness, Minimizing adverse effects=administer IV push slowly
- Mannitol(Osmotic Duretic)
- filtered in glomerulus and not reabsorbed by tubules, pull fluid into vascular space, treats acute renal failure, major contraindications=anuria dure to severe renal disease, pulmonary edema, and intraocular bleeding, most common adverse effects=dizziness and GI problems, Most serious adverse effects=fluid and electrolyte imbalances, Maximizing theraputic effects=WARM the DRUG VIAL before using if CRYSTALS are seen, ADMINISTER using an in-line filter
- Renal vasodilator
- Low-Dose Dopamine (inotropin)= used for improving kidney blood supply, given by injection through a vein,dose= 2- 10 mcg/kg/min,inhances renal function in early stages of renal dysfunction, increases BP, Nausea, vomiting or headache may occur. If these persist or worsen, notify your doctor. Report promptly: any irregular or rapid heartbeat, chest pain, dizziness, trouble breathing
- ACE inhibitors (Captopril)
- inhibits angiotensin I to angiotensin II, less angiotension II means less vasoconstriction, decreases serum aldosterone, used for proteinuric renal disease especially diabetics, adverse effects=COUGH, skin rash, metallic taste, Drug interactions=NSAIDs
- Antianemia drugs (Epogen & Procrit)
- Stimulate bone marrow to produce RBCs (shot or IV), increases reticulocyte count in 7-10 days, increases Hemoglobin & Hematocrit in 2-6 weeks, adverse reactions=inrombotic events, polycythemia vera, contraindication=hypersensitivity to drug
- Iron supplements (Iron dextran, Slow Fe, Feosol)
- necessary for RBC production, protienuric disease (DM), Adverse reaction to iron=GI constipation, N&V, Black tarry stools, IV form=hypotention, phlebitis, rapid heartbeat, Serious SE= anaphylaxis, seizures, when taking with antacids decreases work of Iron or Citrus
- Heavy Metal Antagonist deferoxamine (Desferal)
- chelates w/ iron, treatment of acute iron intoxication and of chronic iron overload due to transfusion-dependent anemias, also used for aluminum
- Antihemorrhagic drugs Desmopression
- stops bleeding
- Phosphate Binders (Aluminum hydroxide/Amphojel, calcium acetate/PhosLo, calcium carbonate/Tums, Maalox, Caltrate)
- Monitor calcium and phospherous levels (inverse relationship), phosphate binders are given to increase Calcium absorption, requires activation of vitamin D, PREVENTS Absoption of Digoxin and Antibotics, Give 1-3 hours after meals, and 1-2 hours before or after other meds, calcium salts cause mild GI complants