Class Talk Fall 2016

Generic name: Acyclovir

Brand name: Zovirax

Class: Antivirals

Indications: Recurrent genital herpes

Nursing implications:

• For IV route maintain adequate hydration(2000-3000ml/day).
• Dilute in at least 100 ml of D5W, 0.9% NaCl, or LR.
• Administer via infusion pump over 1 hr to minimize renal tubular damage.

Affect on kidneys: Acute renal failure.

Can cause transient oliguria (decrease urine output up to 400 ml/day), edema in the perirenal capsule  microscopic hematuria,proteinuria, and high serum creatinine.

Generic name: Acyclovir

Brand name: Zovirax

Class: Antivirals

Indications: Recurrent genital herpes

Nursing implications:

• For IV route maintain adequate hydration(2000-3000ml/day).
• Dilute in at least 100 ml of D5W, 0.9% NaCl, or LR.
• Administer via infusion pump over 1 hr to minimize renal tubular damage.

Affect on kidneys: Acute renal failure.

Can cause transient oliguria (decrease urine output up to 400 ml/day), edema in the perirenal capsule  microscopic hematuria,proteinuria, and high serum creatinine.

Generic name: Acyclovir

Brand name: Zovirax

Class: Antivirals

Indications: Recurrent genital herpes

Nursing implications:

• For IV route maintain adequate hydration(2000-3000ml/day).
• Dilute in at least 100 ml of D5W, 0.9% NaCl, or LR.
• Administer via infusion pump over 1 hr to minimize renal tubular damage.

Affect on kidneys: Acute renal failure.

Can cause transient oliguria (decrease urine output up to 400 ml/day), edema in the perirenal capsule  microscopic hematuria,proteinuria, and high serum creatinine.

Generic name: Acyclovir

Brand name: Zovirax

Class: Antivirals

Indications: Recurrent genital herpes

Nursing implications:

• For IV route maintain adequate hydration(2000-3000ml/day).
• Dilute in at least 100 ml of D5W, 0.9% NaCl, or LR.
• Administer via infusion pump over 1 hr to minimize renal tubular damage.

Affect on kidneys: Acute renal failure.

Can cause transient oliguria (decrease urine output up to 400 ml/day), edema in the perirenal capsule  microscopic hematuria,proteinuria, and high serum creatinine.

Cyclosporine is an immunosuppressant drug with major adverse effects on the kidneys. This drug is absorbed in the gastrointestinal tract and widely distributed. After being metabolized by the liver, small bits of it are excreted in urine.

Ironically, this nephrotoxic drug is used to prevent rejections of new kidney transplants. Blood levels of this drug must be periodically assessed to ensure that it hasn’t reached toxic levels, and BUN and serum creatinine levels are monitored for kidney damage. Rise in either of these kidney lab values, however, must be further assessed to determine wether the cause is due to kidney damage or rejection of the kidney transplant. Patients who have both renal impairment and rheumatoid arthritis or psoriasis may not receive this drug. Patients who have only renal impairment, or the other two conditions without the renal impairment, may receive this drug, but kidney function must be closely monitored and the dosage may need to be adjusted.

Due to its nephrotoxic effects, patients must be educated on what to report. This includes an increase in blood pressure, hematuria, an increase urinary frequency, decrease in urine output, or cloudy urine.

 

Cyclosporine is an immunosuppressant drug with major adverse effects on the kidneys. This drug is absorbed in the gastrointestinal tract and widely distributed. After being metabolized by the liver, small bits of it are excreted in urine.

Ironically, this nephrotoxic drug is used to prevent rejections of new kidney transplants. Blood levels of this drug must be periodically assessed to ensure that it hasn’t reached toxic levels, and BUN and serum creatinine levels are monitored for kidney damage. Rise in either of these kidney lab values, however, must be further assessed to determine wether the cause is due to kidney damage or rejection of the kidney transplant. Patients who have both renal impairment and rheumatoid arthritis or psoriasis may not receive this drug. Patients who have only renal impairment, or the other two conditions without the renal impairment, may receive this drug, but kidney function must be closely monitored and the dosage may need to be adjusted.

Due to its nephrotoxic effects, patients must be educated on what to report. This includes an increase in blood pressure, hematuria, an increase urinary frequency, decrease in urine output, or cloudy urine.

 

Cyclosporine is an immunosuppressant drug with major adverse effects on the kidneys. This drug is absorbed in the gastrointestinal tract and widely distributed. After being metabolized by the liver, small bits of it are excreted in urine.

Ironically, this nephrotoxic drug is used to prevent rejections of new kidney transplants. Blood levels of this drug must be periodically assessed to ensure that it hasn’t reached toxic levels, and BUN and serum creatinine levels are monitored for kidney damage. Rise in either of these kidney lab values, however, must be further assessed to determine wether the cause is due to kidney damage or rejection of the kidney transplant. Patients who have both renal impairment and rheumatoid arthritis or psoriasis may not receive this drug. Patients who have only renal impairment, or the other two conditions without the renal impairment, may receive this drug, but kidney function must be closely monitored and the dosage may need to be adjusted.

Due to its nephrotoxic effects, patients must be educated on what to report. This includes an increase in blood pressure, hematuria, an increase urinary frequency, decrease in urine output, or cloudy urine.

 

Cyclosporine is an immunosuppressant drug with major adverse effects on the kidneys. This drug is absorbed in the gastrointestinal tract and widely distributed. After being metabolized by the liver, small bits of it are excreted in urine.

Ironically, this nephrotoxic drug is used to prevent rejections of new kidney transplants. Blood levels of this drug must be periodically assessed to ensure that it hasn’t reached toxic levels, and BUN and serum creatinine levels are monitored for kidney damage. Rise in either of these kidney lab values, however, must be further assessed to determine wether the cause is due to kidney damage or rejection of the kidney transplant. Patients who have both renal impairment and rheumatoid arthritis or psoriasis may not receive this drug. Patients who have only renal impairment, or the other two conditions without the renal impairment, may receive this drug, but kidney function must be closely monitored and the dosage may need to be adjusted.

Due to its nephrotoxic effects, patients must be educated on what to report. This includes an increase in blood pressure, hematuria, an increase urinary frequency, decrease in urine output, or cloudy urine.

 

Gentamicin has a faster absorption rate when it is given by IM injection, IV administration or by topical agents. It is very poorly absorbed orally. It is excreted through the kidneys at >90% unchanged, which makes it very toxic to the kidneys. Specifically gentamicin causes nephrotoxicity, so if there is renal impairment dose adjustments need to be changed, and blood levels need to be monitored to insure nephrotoxicity is not taking place. Other nursing considerations should be to look out for other nephrotoxic drugs when administering gentamicin, since the incidence may be raised in combination with these types of drugs. Also patients taking this medication should be well hydrated in order to help counteract the nephrotoxic factors.

Gentamicin has a faster absorption rate when it is given by IM injection, IV administration or by topical agents. It is very poorly absorbed orally. It is excreted through the kidneys at >90% unchanged, which makes it very toxic to the kidneys. Specifically gentamicin causes nephrotoxicity, so if there is renal impairment dose adjustments need to be changed, and blood levels need to be monitored to insure nephrotoxicity is not taking place. Other nursing considerations should be to look out for other nephrotoxic drugs when administering gentamicin, since the incidence may be raised in combination with these types of drugs. Also patients taking this medication should be well hydrated in order to help counteract the nephrotoxic factors.