Transcript Urinary Medications

Urinary Medications
Copyright © 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.
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Urinary Tract Infections (cont’d)
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Lower UTI
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Acute cystitis
• Frequently in females
• E. coli, Staph, Klebsiella, Pseudomonas
• Symptoms
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Pain and burning on urination, frequency, urgency
Urethritis, prostatitis
• Same symptoms
Copyright © 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.
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Urinary Analgesics
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Phenazopyridine (Pyridium)
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Dose is usually 100 mg PO BID X 7 – 10 days
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Action
• Relieves pain, burning sensation, frequency, urgency
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Side effects/adverse reactions
• GI upset
• Red-orange urine
• Blood dyscrasia
• Nephrotoxicity, hepatotoxicity
Copyright © 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.
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Urinary Antispasmodics
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Oxybutynin (Ditropan)
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Usual dose is 5 mg PO BID or TID
Extended release dose is 5 – 10 mg daily
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Action
• Direct action on smooth muscles to relieve spasms
Side effects/adverse reactions
• Drowsiness, tachycardia, dizziness, fainting, blurred vision, dry mouth,
constipation
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Caution
• Avoid in narrow-angle glaucoma, cardiac, renal, hepatic, prostate problems
Copyright © 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.
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Antiemetics (cont’d)
 Nonprescription antiemetics
 Antihistamines
 Diphenhydramine (Benadryl)
 Side effects (similar to anticholinergics):
 Drowsiness, dry mouth, constipation, urinary
retention, risk for falls
 Bismuth subsalicylate (Pepto-Bismol)
 Action
 Acts directly on gastric mucosa to suppress vomiting
 Will turn stools black
 In diarrhea, it adsorbs and slows GI motility
Antiemetics (cont’d)
 Serotonin receptor antagonist
 Ondansetron (Zofran) – covered previously
 Dose is 4 – 8 mg PO BID or q6h as needed for nausea
 Action
 Blocks serotonin receptors in the gut and afferent vagal nerve terminals in
chemoreceptor zones in the brain
 Use
 Post-operative nausea, chemotherapy, general nausea
 Side effects
 Headache (most common side effect), diarrhea, dizziness, fatigue. If
neurological changes occur, STOP THE DRUG!
 Please treat the nausea before it progresses to vomiting!
Antiemetics (cont’d)
 Glucocorticoids
 Dexamethasone (Decadron) – covered already KNOW THE SIDE
EFFECTS
 Dose is 2 – 10 mg PO BID
 Cannabinoids YOU WILL NOT BE TESTED ON THIS ONE BUT
YOU NEED TO KNOW IT
 Dronabinol (Marinol) This is synthetic THC; this is used in health
care settings in place of medicinal marijuana
 Side effects
 Drowsiness, dizziness, dry mouth, impaired thinking, euphoria, mood
changes, headaches, confusion, depersonalization, nightmares,
incoordination, memory lapse, anxiety
Antiemetics (cont’d)
 Nursing interventions
 Provide mouth care.
 Monitor vital signs, bowel sounds.
 Monitor for dehydration.
 Warn client not to consume alcohol when taking
an antiemetic.
 Warn pregnant clients to avoid antiemetics.
 Avoid driving motor vehicles.
Diarrhea
 Causes
Spoiled foods or excessively spicy foods
Bacteria (Escherichia coli), virus, toxins
Drug reactions
Fecal impaction, laxative abuse
Malabsorption disorders, bowel tumor,
inflammatory bowel disease
 Stress, anxiety
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Antidiarrheals (cont’d)
Loperamide (Imodium)
Dose is usually 2 – 4 mg (1 to 2 capsules) four
times a day as needed
Do not exceed 8 capsules in a day – this can
cause significant bowel injury
Antidiarrheals (cont’d)
 Nursing interventions
 Monitor BP, R.
 Report more than 10 to 15 mm Hg decrease in BP.
 Monitor frequency of bowel movements and
bowel sounds.
 Assess for evidence of dehydration.
 Monitor electrolytes.
 Avoid fried foods, milk, and sedatives.
 If diarrhea persists after 48 hours, notify
healthcare provider.
Constipation
 Causes
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Bowel obstruction, fecal impaction
Chronic laxative use, ignoring urge to defecate
Neurologic disorders
Side effect of drugs
Lack of exercise
 Insufficient consumption of fiber and/or water
Constipation (cont’d)
 Laxatives
 Laxatives: soft stool
 Cathartics: soft to watery stool with cramping
 Purgatives: watery stool with cramping
 Types of laxatives
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Osmotic (saline)
Stimulant (irritants)
Bulk-forming
Emollient (stool softeners)
Stimulant (Irritant)
Laxatives
 Bisacodyl (Dulcolax)
 Dose is 5 – 10 mg po daily as needed
 Action
 Increase peristalsis by irritating sensory nerve endings in
intestinal mucosa
 Results
 Orally 6 to 12 hours, suppository (rectal) 15 to 60 minutes
 Side effects
 Abdominal cramps, weakness, reddish brown urine,
diarrhea
 There is also a bisocodyl that is a softener as well
Emollients (Stool
Softeners)
 Docusate (Colace)
 Dose is 100 mg PO BID
 Action
 Lowers surface tension
 Promotes water accumulation in intestine
 Emulsifies and lubricates feces for easier passage
 Used whenever someone is on opioids
 Use with caution around children. It looks like a
jelly bean and children have eaten them!
Emollients (Stool Softeners)
(cont’d)
 Use
 Prevent constipation
 Reduce straining post surgery or myocardial
infarction
 Side effects
 Abdominal cramping, nausea, vomiting, diarrhea