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Urinary drug classifications
Terms in this set (17)
Cholinergic blocking drugs that inhibit balder contractions and delay the urge to void, control the discomfort associated with irritation of the lower urinary tract.
Drugs: Oxybutynin and toterodine (Detrol)
Uses: over active bladder
Side effects: Dry mouth constipation, photosensitivity,headache urinary retention
Monitor for heat prostration
Oxybutynin and Detrol antispasmodic
Take with or with out food, oxybutynin contains outer coating that may remain intact appear in stool, contraindicated in patients with glaucoma
Have rapid excretion, high urine concentration, bacteriostatic/bactericidal.
Uses: Acute UTI's
Drugs: Naldixic acid, nitrofurantoin, Bactrim/septra, phenazopyridine
Increase fluid intake to 2000 mL urine should be dilute and clear
Naldixic Acid anti-infective
Inhibits replication of DNA, active against gram negative urinary tract microorganism.
Side effects: Photosensitivity, GI disturbances, visual disturbances may cause drowsiness caution with driving. Do not use in patients with seizure disorders.
Metabolized in liver tendon rupture may present in jaundice.
Broad spectrum acts by interfering with bacterial multiplication in urine may be bactericidal at high concentrations. Therapeutic levels are achieved only in the urine.
Uses: lower urinary tract infections
Side effects: GI disturbances, acute/chronic pulmonary reactions.
take with food or milk to improve reabsorption and prevent GI upset, urine may appear brown, contact PCP if fever, chills, cough, SOB, chest pain.
Trimethoprim/ Sulfamethoxazole anti-infective
Inhibits synthesis of folic acid, broad spectrum 80% of pathogens susceptible first choice for UTI.
Side effects: Glossitis, Steven-Johnson's, blood dyscrasias (thrombocytopenia, anemia), renal damage, allergic reaction.
drugs that increase urine excretion by the kidneys
Uses: HF, endocrine disorders, kidney/liver disease, edema,
Carbonic Anhydrase Inhibitors
Carbonic anhydrase inhibition result in excretion of sodium, potassium, bicarb, and water. Decreases production of aqueous humor in eyes.
Drugs: Diamox (acetazolamide), Methazolamide
Uses: Glaucoma, IOP, altitude sickness
Side effects: Steven-Johnson's , acidosis, thrombocytopenia, aplastic anemia, photosensitivity.
Increase chloride and sodium excretion in distal/proximal tubules and loop of henle
Bumetanide (Bumex), Furosemide (Lasix), Torsemide (Demadex)
Uses: CHF, cirrhosis of liver, renal disease, HTN, pulmonary edema
Side effects: contraindicated in patient with intracranial bleeding, orthostatic hypotension, electrolyte/hematologic imbalances, glycosuria, photosensitivity
Monitor potassium level when taking digoxin may cause hypokalemia and need potassium supplement to prevent arrhythmias. Take in the AM with food to prevent GI upset
Increase density of filtrate in glomerulus, increase sodium and chloride excretion.
Uses: cerebral edema, decrease IOP and cranial pressure, glaucoma (pre/post op) treat oliguric phase of renal failure
Drugs: Mannitol, glycerin, urea
Side effects: blurred vision, syncope, headache, urinary retention, fluid/electrolyte imbalance
Contraindicated in active cranial bleed
Potassium Sparing Diuretics
Depress reabsorption of sodium in kidney tubules, antagonizes aldosterone, decreases potassium excretion and increases water and sodium in urine.
Uses: HTN, edema due to HF, hypokalemia, hyperaldosteronism, cirrhosis
Side effects: Gynecomastia in men, headache, drowsiness, gastritis
When taking potassium sparing monitor for
hyperkalemia (<5mEq/l), avoid foods high in potassium, do not use salt substitutes that are potassium based, if sensitive to sulfanoamide may have allergic reactions
paresthesia, muscular weakness, fatigue, flaccid paralysis of extremities, bradycardia, shock, EKG abnormalities
Thiazide and Related Diuretics
Inhibit reabsorption of sodium and chloride resulting in the excretion of sodium chloride and water.
Drugs: Metolazone ( Zaroxolyn ), hydrochlorothiazide, Diuril
Uses: HTN edema, hepatic cirrhosis, corticosteroid and estrogen therapy, renal insufficiency.
Side effects: orthostatic hypotension, vertigo, photosensitivity, hyperglycemia
can cause hyperglycemia use cautiously in patient with diabetes, monitor labs for azotemia (accumulation of nitrogenous waste) can cause gout attack, if taking while on digitalis glycoside require frequent monitoring of pulse/rhythm due to increase risk of cardiac arrhythmias.
fluid and electrolyte imbalance
dry mouth, thirst, weakness, lethargy, drowsiness, muscle pains, confusion, hypotension, oliguria, tachycardia
value less than 3.5, need potassium supplement or food high in potassium like dark leafy greens, dried apricots, avocado, bananas, prunes, nuts
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