Pharmacology of NSAIDs and Hydrochlorothiazide

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Questions and Answers

What is the primary mechanism of action of non-steroidal anti-inflammatory drugs (NSAIDs)?

Stimulating the synthesis of anti-inflammatory cytokines

Inhibition of beta-adrenergic receptors

Enhancing the metabolism of liver enzymes

Blocking the production of prostaglandins by inhibiting cyclooxygenase (COX) (correct)

Which of the following is an important nursing consideration when administering Celecoxib (Celebrex)?

Monitor for signs of respiratory distress due to bronchoconstriction

Check for elevated blood sugar levels in diabetic patients

Assess for potential liver function impairment due to extensive metabolism (correct)

Observe for swollen extremities as a sign of fluid retention

Which condition is NOT typically indicated for treatment with NSAIDs?

Ankylosing spondylitis (AS)

Rheumatoid arthritis (RA)

Systemic lupus erythematosus (SLE)

Anaphylaxis (correct)

What are the potential adverse effects of using Celecoxib (Celebrex)?

Gastrointestinal bleeding and cardiovascular risks Signup and view all the answers

Which of the following NSAIDs specifically inhibits COX-2 to reduce pain and inflammation?

Celecoxib Signup and view all the answers

What is the primary mechanism of action of hydrochlorothiazide?

Enhance excretion of Na+, Cl-, and water Signup and view all the answers

Which nursing consideration is most important when administering spironolactone?

Monitor for hypotension Signup and view all the answers

Which of the following is a contraindication for the use of hydrochlorothiazide?

Patients with anuria Signup and view all the answers

What adverse reaction is associated with potassium-sparing diuretics like spironolactone?

Hyperkalemia Signup and view all the answers

For which condition is hydrochlorothiazide primarily indicated?

Hypertension Signup and view all the answers

What is the peak time for hydrochlorothiazide following oral administration?

4 hours Signup and view all the answers

Which of the following nursing interventions is crucial for patients taking oxybutynin?

Assess for urinary retention Signup and view all the answers

What mechanism does osmotic diuretics like mannitol use to exert their effect?

Hold water in the lumen by osmotic effect Signup and view all the answers

What is a common adverse effect of oxybutynin?

Dry mouth Signup and view all the answers

Which of the following statements about thiazide diuretics is true?

They may cause dehydration and low blood pressure Signup and view all the answers

What is the half-life range for hydrochlorothiazide?

6-15 hours Signup and view all the answers

In which scenario would it be important for a patient taking spironolactone to avoid high potassium foods?

To prevent hyperkalemia Signup and view all the answers

What is a primary action of phenazopyridine in the urinary tract?

Provide local anesthetic effects Signup and view all the answers

What is the bioavailability of spironolactone?

60-90% Signup and view all the answers

What is the primary mechanism of action of loop diuretics like Furosemide?

Blocking sodium and chloride reabsorption in the ascending loop of Henle Signup and view all the answers

Which of the following conditions is NOT indicated for the use of diuretics?

Hyperglycemia Signup and view all the answers

What potential adverse effect is commonly associated with loop diuretics?

Hypokalemia Signup and view all the answers

Which nursing consideration is important when administering Thiazide diuretics?

Observing for signs of photosensitivity Signup and view all the answers

What distinguishes potassium-sparing diuretics from loop and thiazide diuretics?

They are less effective in reducing fluid volume Signup and view all the answers

What is a primary nursing intervention to monitor when administering loop diuretics?

Monitor blood pressure for postural hypotension Signup and view all the answers

What common effect does the administration of Diuretics have on urine production?

Increases urine output Signup and view all the answers

Which type of diuretic is primarily used for its efficacy in treating hypertension?

Thiazide diuretics Signup and view all the answers

What is a serious adverse effect that can result from excessive use of loop diuretics?

Dehydration Signup and view all the answers

Which of the following electrolytes is primarily monitored during the administration of Thiazide diuretics?

Potassium Signup and view all the answers

Furosemide's effect on the nephron involves which of the following?

Inhibits sodium and chloride reabsorption in the ascending limb of the Loop of Henle Signup and view all the answers

When should thiazide diuretics be administered to minimize disruption of sleep?

In the early morning Signup and view all the answers

In the context of renal failure, what impact does renal impairment have on pharmacotherapy?

Increases the risk of drug toxicity Signup and view all the answers

What is the purpose of administering medications for erythropoietin in patients with renal failure?

To stimulate red blood cell production Signup and view all the answers

Study Notes

Drugs Affecting the Urinary and Immune System

This lecture covers drugs affecting the urinary and immune systems.
Learning objectives include describing kidney function, reabsorption/secretion processes, and the impact of renal failure on pharmacotherapy.
It also covers indications for diuretics and the use of other urinary tract medications.

Urinary System

The urinary system comprises the kidneys, ureters, urinary bladder, and urethra.
Kidneys filter blood and excrete waste products, maintaining electrolyte and fluid balance.
Reabsorption is the process of returning essential substances from the filtrate back into the blood.
Secretion moves substances from the blood into the filtrate..
Renal failure decreases kidney function, leading to drug accumulation and potential toxicity.

The Nephron

The nephron is the functional unit of the kidney.
It involves filtration, reabsorption, and secretion.
Specific processes occur at the glomerulus, Bowman's capsule, proximal tubule, loop of Henle, distal tubule, and collecting duct.
Filtration filters blood; reabsorption moves good substances into the blood; secretion moves wastes into the filtrate; excretion removes the waste from the body.

Reabsorption

Reabsorption is crucial for regulating fluid and electrolyte balance.
Water, glucose, amino acids, and essential ions are reabsorbed.
The process occurs through the walls of the nephron.

Secretion

Certain ions and molecules are secreted from the blood into the filtrate.
Substances like potassium, phosphate, hydrogen, and ammonium ions are secreted.
Some drugs are secreted through the proximal tubule.

Renal Failure

Renal failure impacts pharmacotherapy significantly.
Electrolyte and fluid balance are disrupted.
Waste products accumulate, leading to toxicity.
Can be acute or chronic.

Diuresis

Diuresis is the increased production of urine.
Drugs block sodium reabsorption, increasing sodium excretion.
Chloride and water follow sodium, increasing urine volume.

Diseases Treated by Diuretics

Diuretics are used to treat hypertension, heart failure, kidney failure, pulmonary edema, and liver failure/cirrhosis.

Diuretics (Types)

Loop diuretics (act on the loop of Henle)
Thiazide and thiazide-like diuretics (act on the distal tubule)
Potassium-sparing diuretics (used cautiously, as they retain potassium)
Other diuretics (osmotic agents, carbonic anhydrase inhibitors).

Loop Diuretics (e.g., Furosemide)

Furosemide is a potent diuretic that acts on the loop of Henle.
It inhibits sodium and chloride reabsorption.
Often administered intravenously for rapid effect.
Side effects can include fluid and electrolyte imbalances, hypokalemia, ototoxicity, and metabolic alkalosis.

Thiazides and Thiazide-Like Diuretics (e.g., Indapamide, Hydrochlorothiazide)

Indapamide and Hydrochlorothiazide are weaker diuretics.
They act on the distal tubule.
Used primarily to treat mild to moderate hypertension.
Side effects include fluid and electrolyte imbalances, hypokalemia, dehydration, and low blood pressure (BP).

Potassium-Sparing Diuretics (e.g., Spironolactone)

Spironolactone blocks aldosterone receptors, conserving potassium.
Used to treat hypertension, nephrotic syndrome, ascites, heart failure, and edema.
Side effects include dizziness, headache, fluid and electrolyte imbalance, and breast tenderness.

Osmotic Diuretics (e.g., Mannitol)

Mannitol acts on the proximal and descending loop of Henle.
Promotes water diuresis, reducing swelling.
Used for glaucoma and intracranial pressure reduction.

Carbonic Anhydrase Inhibitors (e.g., Acetazolamide)

Acetazolamide reduces intraocular pressure, used to treat glaucoma.
Also used to reduce swelling and treat intracranial hypertension.

Antispasmodics (e.g., Oxybutynin)

Oxybutynin blocks muscarinic acetylcholine receptors, relaxing bladder muscles, reduced urgency and urination frequency.
Indicated for overactive bladder and neurogenic bladder disorders.
Side effects include dry mouth, urinary retention, dizziness, drowsiness and blurred vision.

Urinary Tract Analgesics (e.g., Phenazopyridine)

Phenazopyridine provides local anesthetic effect on urinary tract mucosa to relieve burning pain associated with urinary tract irritations/infections/surgery/injury.

Immune System

The immune system is a complex network of organs, WBCs, proteins, and chemicals.
It differentiates foreign substances from non-foreign ones.
It activates/mobilizes/attacks/kills foreign invaders.
It learns about invaders after exposure to mount a future defense (antibodies).

Inflammation

Inflammation is a body defense mechanism.
It occurs in response to various stimuli.
The purpose is to contain/destroy invaders, remove debris, and promote healing.
The acute inflammatory response has distinct signs: swelling, pain, warmth, and redness.

Treatment of Inflammation

Treatments can be non-pharmacological (e.g., RICE – rest, ice, compression, elevation) or pharmacological (e.g., NSAIDs, steroids).
It's essential to identify the cause (e.g., injury, infection) so targeted treatment can be applied.

Anti-Inflammatory Drugs (e.g., NSAIDs, Corticosteroids)

NSAIDs (e.g., ibuprofen, naproxen) block prostaglandin synthesis.
Corticosteroids (e.g., prednisone) suppress the immune response.

Pathogens

Pathogens are microorganisms (bacteria, viruses, parasites, fungi) that cause diseases.
The immune system responds to pathogens in various ways.
Types of germs that cause diseases (bacteria, viruses, protozoans, multicellular parasites, fungi).

Anti-Infective Drugs

Anti-infective (antimicrobial) drugs target pathogen's metabolism and life cycle.
Anti-infective drugs reduce or eliminate the pathogen.
Example classes such as penicillin, cephalosporins, tetracyclines, macrolides, aminoglycosides, fluoroquinolones.

Patient Teaching

Patient teaching is crucial to avoid complications and promote adherence to therapy.
For all types of anti-infective drugs, it's important not to discontinue prematurely and not share medication.

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Description

Test your knowledge on the primary mechanisms of action and considerations for non-steroidal anti-inflammatory drugs (NSAIDs) and hydrochlorothiazide. This quiz covers important concepts including specific drug indications, potential adverse effects, and nursing considerations. Perfect for nursing and pharmacology students!