Class Talk Fall 2016

• How does it affect the kidneys?
  • Eliminated primarily by the kidneys. In patients with renal impairment, halve-lives of the drug increase dramatically
  • It can injure cells of the proximal renal tubules
  • High trough levels increase toxicity
  • It can induced nephrotoxicity that manifest as acute tubular necrosis
  • Symptoms: proteinuria, casts in urine, dilute urine, increased creatinine and BUN
• Where is it absorbed?
  • Crosses membranes poorly, very little of oral dose is absorbed.
  • Well absorbed after IM and IV administration and distributed to the ECF
• Nursing considerations for renal patients?
  • Dosage adjustment is necessary for renal impairment
  • Increase dosage interval in patients with kidney disease
  • Monitor blood levels, serum creatinine & BUN to prevent nephrotoxicity
  • Do not combine with other nephrotoxic drugs

• How does it affect the kidneys?
  • Eliminated primarily by the kidneys. In patients with renal impairment, halve-lives of the drug increase dramatically
  • It can injure cells of the proximal renal tubules
  • High trough levels increase toxicity
  • It can induced nephrotoxicity that manifest as acute tubular necrosis
  • Symptoms: proteinuria, casts in urine, dilute urine, increased creatinine and BUN
• Where is it absorbed?
  • Crosses membranes poorly, very little of oral dose is absorbed.
  • Well absorbed after IM and IV administration and distributed to the ECF
• Nursing considerations for renal patients?
  • Dosage adjustment is necessary for renal impairment
  • Increase dosage interval in patients with kidney disease
  • Monitor blood levels, serum creatinine & BUN to prevent nephrotoxicity
  • Do not combine with other nephrotoxic drugs

• How does it affect the kidneys?
  • Eliminated primarily by the kidneys. In patients with renal impairment, halve-lives of the drug increase dramatically
  • It can injure cells of the proximal renal tubules
  • High trough levels increase toxicity
  • It can induced nephrotoxicity that manifest as acute tubular necrosis
  • Symptoms: proteinuria, casts in urine, dilute urine, increased creatinine and BUN
• Where is it absorbed?
  • Crosses membranes poorly, very little of oral dose is absorbed.
  • Well absorbed after IM and IV administration and distributed to the ECF
• Nursing considerations for renal patients?
  • Dosage adjustment is necessary for renal impairment
  • Increase dosage interval in patients with kidney disease
  • Monitor blood levels, serum creatinine & BUN to prevent nephrotoxicity
  • Do not combine with other nephrotoxic drugs

• How does it affect the kidneys?
  • Eliminated primarily by the kidneys. In patients with renal impairment, halve-lives of the drug increase dramatically
  • It can injure cells of the proximal renal tubules
  • High trough levels increase toxicity
  • It can induced nephrotoxicity that manifest as acute tubular necrosis
  • Symptoms: proteinuria, casts in urine, dilute urine, increased creatinine and BUN
• Where is it absorbed?
  • Crosses membranes poorly, very little of oral dose is absorbed.
  • Well absorbed after IM and IV administration and distributed to the ECF
• Nursing considerations for renal patients?
  • Dosage adjustment is necessary for renal impairment
  • Increase dosage interval in patients with kidney disease
  • Monitor blood levels, serum creatinine & BUN to prevent nephrotoxicity
  • Do not combine with other nephrotoxic drugs

Allopurinol (Aloprim, Lopurin, or Zyloprim) is an anti-gout agent (xanthine oxidase inhibitor) that is used to prevent gouty arthritis and secondary hyperuricemia. It works by lowering serum uric acid levels. It is absorbed in the gastrointestinal tract and metabolized in the liver.

Although it can greatly reduce serum uric acid levels and lead to improvement in patients treated for gout, Allopurinol should be used cautiously in patients with dehydration and renal insufficiency, and the dose should be decreased if the creatinine clearance (CCr) is less than 20 mL/min. It also has multiple GU side effects, including renal failure and hematuria.

For patients taking Allopurinol, nurses should monitor intake and output ratios because renal impairment can cause the drug to accumulate to toxic levels. They should ensure and encourage adequate fluid intake to prevent kidney stone formation. It is also important to monitor creatinine clearance, BUN, and serum creatinine, as elevations in these values may indicate nephrotoxicity (which is usually reversible after discontinuing allopurinol therapy).

        As we’ve been learning, the kidneys take on a vital role of filtering substances, and electrolytes, and also to help excrete wastes. When asked to think of a drug that affects the kidneys minimally, or extensively, I thought of vancomycin.

        Acting as an anti-infective to eliminate bacteria, vancomycin attaches to the bacterial cell wall, and causes death of the cell. It is used when less toxic medications are contraindicated, therefore making it clear that vancomycin is among the toxic drugs to our bodies. One of the adverse reactions it may lead to, is nephrotoxicity, which is a condition that affects renal function. It is important to monitor intake and output during medical therapy, as well as monitoring the urine for a cloudy or pink appearance, which would indicate nephrotoxicity (Skyscape, 2015). Pertinent lab values to check frequently, are BUN levels which may increase with vancomycin, specific gravity of the urine, and complete blood counts. It is extremely important to note that an individual with renal impairment is monitored closely, and that the dosage of vancomycin is reduced as long as the creatinine clearance rate is less than, or equal to 80mL/min (Skyscape, 2015).

                                               References

Skyscape. (2015). Skyscape Medical Resources (Version 2.3.0) [Mobile application software].

The lab value i “like” the most would be Magnesium (1.3-2.3 mEq/L) because it plays important roles throughout our bodies (just like all the other electrolytes) and is not talked about as often as some of the other lab values. The lab value I “like” the least is Sodium because almost every single blog post is about it! (including mine) >.<

The lab value i “like” the most would be Magnesium (1.3-2.3 mEq/L) because it plays important roles throughout our bodies (just like all the other electrolytes) and is not talked about as often as some of the other lab values. The lab value I “like” the least is Sodium because almost every single blog post is about it! (including mine) >.<

The lab value i “like” the most would be Magnesium (1.3-2.3 mEq/L) because it plays important roles throughout our bodies (just like all the other electrolytes) and is not talked about as often as some of the other lab values. The lab value I “like” the least is Sodium because almost every single blog post is about it! (including mine) >.<

The lab value i “like” the most would be Magnesium (1.3-2.3 mEq/L) because it plays important roles throughout our bodies (just like all the other electrolytes) and is not talked about as often as some of the other lab values. The lab value I “like” the least is Sodium because almost every single blog post is about it! (including mine) >.<