Class Talk Fall 2016

Captopril is an ACE inhibitor that is used to manage HTN and HF. Half of it is metabolized by the liver while the other half is excreted unchanged in urine. It is to be used cautiously in patients with renal impairment, hyponatremia, and concurrent diuretic therapy. Possible, but not common side effects of this drug are proteinuria, hyperkalemia, and impaired renal function. Important lab tests to monitor are BUN, serum creatinine, AST, ALT, and serum bilirubin. (Skyscape: Davis’ Drug Guide)

Captopril is an ACE inhibitor that is used to manage HTN and HF. Half of it is metabolized by the liver while the other half is excreted unchanged in urine. It is to be used cautiously in patients with renal impairment, hyponatremia, and concurrent diuretic therapy. Possible, but not common side effects of this drug are proteinuria, hyperkalemia, and impaired renal function. Important lab tests to monitor are BUN, serum creatinine, AST, ALT, and serum bilirubin. (Skyscape: Davis’ Drug Guide)

Captopril is an ACE inhibitor that is used to manage HTN and HF. Half of it is metabolized by the liver while the other half is excreted unchanged in urine. It is to be used cautiously in patients with renal impairment, hyponatremia, and concurrent diuretic therapy. Possible, but not common side effects of this drug are proteinuria, hyperkalemia, and impaired renal function. Important lab tests to monitor are BUN, serum creatinine, AST, ALT, and serum bilirubin. (Skyscape: Davis’ Drug Guide)

Furosemide inhibits sodium and chloride reabsorption in the loop of Henle and in the distal renal tubule. Due to this blocking, the excretion of water and electrolytes (such as sodium, chloride, magnesium, potassium, and calcium) increases. With an increase in the excretion of excess fluid, blood pressure is lowered, which eases the strain on the kidneys. Overall the drug aids in the effectiveness of the kidneys for those who have impaired renal function.

When taken orally, about 60-67% is absorbed in the stomach. If administered by intramuscular injection, Furosemide is absorbed at the injection site.

For patients with renal impairment caution should be taken as this drug increases the risk of ototoxicity. The regular dose may need to be adjusted as the half life of Furosemide increases for renal patients. The regular initial dose is 20-80 mg/day (PO). With renal patients, the dose can be increased to 2.5 gm/day.

Patients should have fluid status assessed as well as the electrolyte and lab values monitored. There can be decreased levels of potassium, sodium, calcium, and magnesium and increased BUN, serum glucose, creatinine, and uric acid levels. It is important for renal patients to be taught to monitor their daily body weight.

The medication I chose was Valganciclovir, also known as Valcyte. This medication is an antiviral and is used to treat cytomegalovirus retinitis in patients with AIDS. It is also used for prevention of CMV disease in kidney, kidney/pancreas, and heart transplant patients at risk.

Valcyte is rapidly absorbed following oral administration and is converted to Ganciclovir, which is excreted by the kidneys. Patients who are taking this particular drug along with other drugs that affect the kidneys have an increased risk of renal failure. Since this drug is excreted by the kidneys there may be a possibility of accumulation of metabolites in patients with renal impairment.

This medication is to be cautiously used in those with renal impairment. Patients with a creatinine clearance rate of <60 mL/min are given a decreased maintenance dose compared to those who have no renal issues.

Penicillin G Potassium  is excreted by the kidneys. The administration of large amounts given by IV has been associated with renal tubular damage and interstitial nephritis.

Sources:

-http://www.rxlist.com/penicillin-g-potassium-side-effects-drug-center.htm

-Skyscape

Penicillin G Potassium  is excreted by the kidneys. The administration of large amounts given by IV has been associated with renal tubular damage and interstitial nephritis.

Sources:

-http://www.rxlist.com/penicillin-g-potassium-side-effects-drug-center.htm

-Skyscape

Penicillin G Potassium  is excreted by the kidneys. The administration of large amounts given by IV has been associated with renal tubular damage and interstitial nephritis.

Sources:

-http://www.rxlist.com/penicillin-g-potassium-side-effects-drug-center.htm

-Skyscape

Penicillin G Potassium  is excreted by the kidneys. The administration of large amounts given by IV has been associated with renal tubular damage and interstitial nephritis.

Sources:

-http://www.rxlist.com/penicillin-g-potassium-side-effects-drug-center.htm

-Skyscape

Penicillin G Potassium  is excreted by the kidneys. The administration of large amounts given by IV has been associated with renal tubular damage and interstitial nephritis.

Sources:

-http://www.rxlist.com/penicillin-g-potassium-side-effects-drug-center.htm

-Skyscape