nephrolithiasis - drug study

7/30/2019 Nephrolithiasis - Drug Study

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X. Drug Study

Name of the

drug

Specific Action Mechanism of

Action

Indication Adverse Effects/

Side Effects

Contraindications Nursing Responsibilities

Captopril AntihypertensiveACE inhibitor

Thought to inhibitACE, preventing

conversion ofangiotensin I to

angiotensin II, apotent

vasoconstrictor.Reduced formation

of angiotensin IIdecreases peripheral

arterial resistance,decreasing

aldosteronesecretion, which

reduces sodium andwater retention and

lowers BP

HypertensionHeart failure

Diabeticnephropathy

Left ventriculardysfunction after

MI

TachycardiaGastric irritations

RashPruritus

ulcersPeptic ulcers

ProteinuriaCough

Hypersensitivity Monitor BP and RRfrequently Assess for signs and

symptoms of

angioedema

Take drug 1 hourbefore meals

Inform to patient thatlightheadedness is

possible

Report fever, skin rash,sore throat, mouth

sores, fast/irregularheartbeat, chest pain,

and cough.

May develop dizziness,fainting,lightheadedness;

usually disappear oncebody adjust. Avoid

sudden changes isposture,

activities/exercise inhot weather; prevent

dizziness/fainting.Consume of plenty of

fluids; prevent


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dehydration.

Avoid OTC agentswithout approval.

Clopidogrel Antiplatelet

Adenosine

diphosphate (ADP)inhibitor

Inhibits plateltes

aggregation by

blocking ADPreceptors on

platelets, preventing

clumping of platelets

Ischemic events

Acute coronary

syndrome

Headache

Dizziness

RashPruritus

Nausea

GI distress

Allergy to clopidogrel,

active pathological

bleeding such as pepticulcer or intracranialhemorrahge

Provide client withsmall frequent

feedings if GI upsetoccurs

Provide comfortmeasures and arrange

for analgesics ifheadaches occurs

May developdizziness,

lightheadedness;headache which

usually disappear in acool environment and

rest; nausea whichdisappear with small

frequent meals; gastricdistress and prolonged

bleeding

Cefuroxime Inhibits bacterialcell wall synthesis

Antibiotic;Cephalosporin (2nd

generation)

Treatment ofinfection caused

by susceptibleorganism in the

lower resp. tract

Hypersensitivity tocephalosporin and

penicillin

Stomach upset, diarrhea,anorexia nausea, headache,

dizziness

Observe the 10 rightsupon giving

medication.

Give with meals;arrange for small,frequent feedings if GI

complications occur.

Perform skin testingprior to drug

administration.


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Take full course oftherapy.

Avoid foods,beverages or

medicines that containalcohol while taking

this drug. Report severe diarrhea

with blood, pus ormucus; rash, DOB,unusual tiredness,

fatigue, unusualbleeding or bruising,

unusual itching or

irritation.

Acalka

(PotassiumCitrate)

Antiurolithic to restore the level of

the urinary citrateand to increase the

pH of urine to 6-7

Treatment of

patients withrenal lithiasis and

hypocitraturia,chronic formers

of calciumoxalate, phospate

calculia.

Slight

gastrointestinaldisorders may appear

which can bepalliated by means of

the jointadministration of

food.

Renal insufficiency

Persistent alkaline urinaryinfections

- Obstruction of the urinarytract

- HyperpotassemiaAdrenalinsufficiency

- Respiratory or metabolicalkalosis

- Active peptic ulcer- Intestinal obstruction

- Patients submitted toanticholinergic therapy

- Patients with slow gastricemptying

The tablets must not bemasticated or diluted

It is recommended thatthe patients intreatment with Acalka

follow a diet w/o saltand increase the intake

of fluids.

Must not beadministered to

patients receivingpotassium-sparing

diuretics (traimterene,spirolactone, or

amyloride)

Ketorolac Nonsteroidal anti-

inflammatoryagents, nonopioid

Inhibits

prostaglandinsynthesis, producing

Short term

management ofpain (not to

Hypersensitivity

History of GIbleeding

CNS:

drowsinessabnormal thinking

Assess forhypersensitivity

reactions


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analagesics peripherallymediated analgesia

- Also has antipyreticand anti-

inflammatoryproperties.

- Therapeuticeffect:Decreased

pain

exceed 5 daystotal for all routes

combined)

Renal impairment(dosage reduction

may be required)Cardiovascular

disease

dizzinesseuphoria

headache-- RESP:

asthmadyspnea

- CV:edema

pallorvasodilation

- GI:GI Bleeding

abnormal tastediarrhea

dry mouthdyspepsia

Assess pain (note type,location, and intensity)

prior to and 1-2 hrfollowing

administration.

Oral therapy should beused only as acontinuation of

parenteral therapy.

Caution patient toavoid concurrent useof alcohol, aspirin,

NSAIDs,acetaminophen, or

other OTCmedications without

consulting health careprofessional..

HNBB(Hyoscine-n-

butylbromide)

Antispasmodic;Anticholinergic

Hyoscine-N-butylbromide(HNBB) acts by

interfering with thetransmission of nerve

impulses byacetylcholine in the

parasympatheticnervous system.

Buscopan exerts a

spasmolytic action

on the smoothmuscle of thegastrointestinal,

Buscopan Tabletsare indicated forthe relief of

spasm of thegenito-urinary

tract or gastro-intestinal tract

and for thesymptomatic

relief of IrritableBowel Syndrome

CNS: dizziness,anaphylacticreactions,

anaphylactic shock,increased ICP,

disorientation,restlessness,

irritability, dizziness,drowsiness,

headache, confusion,hallucination,

delirium, impaired

memory CV:hypotension,tachycardia,

Buscopan Tablets shouldnot be administered to

patients with myasthenia

gravis, megacolon andnarrow angle glaucoma. In

addition, they should notbe given to patients with a

known hypersensitivity tohyoscine-N-butylbromide

or any other component ofthe product.

Avoid driving &operating machinery

after parenteraladministration.

Avoid strict heat Raiseside rails as a

precaution because

some patients becometemporarily excited ordisoriented and some

develop amnesia orbecome drowsy.

Reorient patient, asneeded, Tolerance maydevelop when therapy


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biliary and urinarytracts.

palpitations, flushingGI: Dry mouth,

constipation, nausea,epigastric distress

DERM: flushing,dyshidrosis GU:

Urinary retention,urinary hesitancy

Resp: dyspnea,bronchial plugging,

depressed respirationEENT: mydriasis,

dilated pupils,blurred vision,

photopobia,increased intraocular

pressure, difficultyof swallowing.

is prolonged Atropine-like toxicity may cause

dose related adversereactions. Individual

tolerance varies greatly

Overdose may causecurare-like effects,such as respiratory

paralysis. Keepemergency equipment

available.

nephrolithiasis - drug study

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