Diuretics
basic diuretic MOA
blocking of sodium and chloride reabsorption causing water and solutes to be retained within the nephron and thereby promote the excretion of both
Medication error prevention
(1) help and encourage patients and their families to be active, informed members of the healthcare team
(2) give healthcare providers the tools and information needed to prescribe, dispense, and administer drugs as safely as possible
use of drugs for prevention, treatment, diagnosis, and modification of normal functions
pharmacotherapeutics aka pharmacodynamics
spironolactone: electrolytes
K sparing
age, weight, CYP450, gender, tolerance, drug history, illness
examples of what can affect physiologic responses to drugs
lasix: what it does to K and side effects
K wasting, orthostatic hypotension, dehydration
6 rights of medication administration
right patient, right time, right route, right dose, right med, right documentation
what is the difference between an antagonist and an agonist drug?
antagonist: bind to a target receptor but do not elicit a response
agonists: bind to a target receptor and change the receptor activity to produce a response)
hydrochlorothiazide: electrolytes
low sodium, low k
when drugs are minimally (blank) they can penetrate tissues much better than when they are high
protein bound
4 regions of the nephron
(1) the glomerulus, (2) the proximal convoluted tubule, (3) the loop of Henle, and (4) the distal convoluted tubule.
Purpose of blackbox warning
to educate/ show that this drug can cause serious adverse reactions or problems that can lead to death or serious injury
movement of drugs within the body
pharmacokinetics
used for prophylaxis of renal failure, reduction of ICP, and reduction of intraocular pressure
Mannitol
low solute concentration and high water concentration compared to body fluids
hypotonic
most effective diuretic available producing more fluid and electrolyte loss than any other diuretic
Loop diuretics (site of action in loop of henle ---> why they're called loop diuretics)
warfarin, fentanyl, lovenox, morphine, promethazine are all drugs that ...
have a blackbox warning
the chemical alteration of a drug by the body
metabolism
therapeutic use after excess amounts of potassium is excreted from diuretics
potassium chloride
Your patient has an ICP of 65, what type of solution in conjunction with Mannitol would we prepare to administer IV?
Hypertonic
adverse effects of diuretics
hyponatremia, hypochloremia, and dehydration
3 major causes of medication errors
human factors, communication mistakes, and name confusion
drugs journey from the site of administration to the site of action
absorption
which two drugs are given in adjunct to counteract potassium wasting and potassium sparing effects?
hydrochlorothiazide and spironolactone (read page 58 under Interactions Resulting From Actions at Separate Sites for reason why)
A patient comes in with a blood sugar of 650, ketones in their urine, and fruity breath. The nurse knows to prepare to administer what type of solution and what is it called?
Isotonic; 0.9% NS