Pharmacology - Nephrology PDF

Bullet Point Nursing Pharmacology – Nephrology Disclaimer: These notes are designed to provide the key points of each topic and may not contain all necessary information. Every effort is made to ensure this content is up to date and accurate at the time of writing. No liability is assumed for the c...

Bullet Point Nursing Pharmacology – Nephrology Disclaimer: These notes are designed to provide the key points of each topic and may not contain all necessary information. Every effort is made to ensure this content is up to date and accurate at the time of writing. No liability is assumed for the content or its relation to current standards and practices. This should not replace comprehensive nursing educational resources. Pathophysiology review  Blood enters the nephron and continues until it is either reabsorbed back into the body or goes out to the bladder as urine  Aldosterone is a hormone that increases sodium and water reabsorption back into the body  Antidiuretic hormone pulls water out of filtrate into the body  Labs to assess kidneys include BUN, creatinine, GFR Drug class: Loop diuretics  Drugs: o Bumetanide (Bumex) o Furosemide (Lasix)  MOA: Blocks reabsorption of sodium and chloride in the loop of Henle  Indications: Edema related to heart failure liver failure, kidney failure, alternative for hypertension  SE/AE: Ototoxicity, hypokalemia  Black Box warning: can cause fluid and electrolyte imbalances  Most potent class of diuretics  Patient education: Do not increase your sodium intake Drug class: Thiazide Diuretics  Drugs: o Hydrochlorothiazide (HCTZ) o Chlorthalidone  MOA: Blocks reabsorption of sodium and chloride in the early distal convoluted tubule  Indications: HTN and edema  Most prescribed class of diuretics  SE/AE: Hypokalemia, hyperglycemia, dehydration, orthostatic hypotension  Patient education: Do not increase your sodium intake Drug class: Potassium sparing diuretics (Aldosterone antagonist)  Drug: o Spironolactone  MOA: Blocks aldosterone (aldosterone increases sodium and water reabsorption)  Indications: Hypertension, edema and heart failure  SE/AE: Hyperkalemia  Caution with drugs that increase your potassium Bullet Point Nursing © 2023  Bullet Point Nursing Drug class: Osmotic diuretic  Drug: o Mannitol  MOA: Interferes with water reabsorption in the kidneys, acts as hypertonic solution  Indications: Reduction of ICP and IOP, increase diuresis related to renal failure  Monitor for neuro, cardiac, electrolyte, or volume adverse effects Drug name: Antidiuretic hormone (ADH)  MOA: Decreases urine output and vasoconstriction  Indication: Shock and cardiac arrest  Off label use: Diabetes insipidus Drug class: Carbonic anhydrase inhibitor  Drug: o Acetazolamide  MOA: Increased renal excretion of sodium, potassium, bicarbonate, and water  Indications: Glaucoma, edema, and acute mountain sickness Educate patients to expect side effect of increased urine output with all diuretics Avoid taking later in the day, if possible, to avoid nocturia **Many medication dosages need to be adjusted in the presence of kidney disease** Bullet Point Nursing © 2023  Bullet Point Nursing References Adams, M., Holland, N., & Urban, C. (2020). Pharmacology for nurses; a pathophysiologic approach. Pearson Burchum, J., & Rosenthal, L. (2022). Lehne's pharmacology for nursing care. Elsevier Mccuistion, L., Vuljoin-DiMaggio, K., Winton, M., & Yeager, J. (2023) Pharmacology: A patient centered nursing process approach. Elsevier Scott, J., Menouar, M. & Dunn, R. (2022) Physiology, Aldosterone. StatPearls Publishing Tenny, S., Patel, R., & Thorell, W. (2022) Mannitol. StatPearls Publishing Bullet Point Nursing © 2023