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57 Cards in this Set

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The principal organ of the body involved in water balance
Kidney
If the output of water from the body exceeds the water intake, the body is said to be in a _______________
Negative water balance

Note:
This imbalance leads to dehydration of the body
This occurs when the intake of water exceeds the output
Positive water balance
Functional units of the kidney
Nephrons
A disease characterized by the formation & excretion of increased amounts of urine
Diuresis
Is a drug that increases the flow of urine
Diuretics

Note:
If sodium & fluids are retained in excessive amounts in extremities, there is edema
Fluid accumulation in the lungs result in pulmonary edema
Classes of diuretics
Thiazide (Benzothiadiazine) diuretics

Steroid antagonists

& other misc. diuretics
Examples of thiazide (benzothiadiazine) diuretics
thiazide

chlorothiazide (Diuril)

hydrochlorothiazide (HydroDIURIL)

polythiazide (Renese, Minizide)
A diuretic drug that inhibits the enzyme carbonic anhydrase & promote the excretion of sodium, potassium, chloride, & bicarbonate along with the necessary excretion of water
thiazide diuretics

Note:
Have an additional effect as an antihypertensive drug
Potassium supplements or food rich in potassium must be added to the diet.

Warning:
Are generally contraindicated in pregnant women
Should be used with caution in patients known to have gout, liver, or kidney disorders
Side effects of thiazide diuretics
Hypokalemia
Hypochloremic alkalosis
Hypotension
Tachycardia
Aplastic anemia
Jaundice
Hyperuricemia
Glycosuria
Muscle cramps
Weakness
A thiazide diuretic that is used in heart failure, during pregnancy, & in premenstrual fluid retention, or as an adjunct in the treatment of HTN
chlorothiazide (Diuril)

Route(s):
Oral
A thiazide diuretic that provides effect comparable to those of chlorothiazide when doses are greatly decreased
hydrochlorothiazide (HydroDIURIL)

Route(s):
Oral

Diuretics that inhibit aldosterone, an adrenal hormone that promotes the retention of sodium & excretion of potassium
Steroid antagonists
Examples of steroid antagonist
spironolactone (Aldactone)

hydrochlorothiazide plus spironolactone (Aldacthiazide)
A steriod antagonist diuretic that is useful in tx of edema associated with CHF, hepatic cirrhosis with ascites & nephritis
spironolactone (Aldactone)

Route(s):
Oral
Side effects of spironolactone (Aldactone)
Mild headache
Confusion
Dermatitis
Drowsiness
Ataxia
Mild abdominal pain
Examples of misc. diuretics
triamterene (Dyrenium)

triamterene plus hydrochlorothiazide (Dyazide), (Oral)

furosemide (Lasix)

ethacrynic acid (Edecrin)

metolazone (Zaroxolyn, Mykrox)

amiloride hcl (Midamor)
Side effects of triamterene
Nausea
Vomiting
Headache
Weakness
Is a diuretic that has been shown to act throughout the collecting tubules of the nephron, particulary on the ascending limb of the loop of henle
furosemide (Lasix)

Route(s):
Oral, IM, IV

Note:
It may be used in CHF associated with liver or kidney disease
Side effects of furosemide (Lasix)
Electrolyte depletion
Dizziness
Weakness
Jaundice
Leg cramps
Vomiting
Confusion
Side effects of metolazone (Zaroxolyn, Mykrox)
Nausea
Vomiting
Headache
Weakness
Hyperuricemia
Gout
Fluid depletion
A potassium sparing diuretic drug
amiloride hcl (Midamor)

Route(s):
Oral

Note:
It does not cause potassium depletion when used as diuretic
Side effects of amiloride hcl (Midamor)
Nausea
Flatulence
Mild rash
Examples of urinary antiseptic drug
nitrofurantoin (Furadantin)

methanamine mandelate (Mandelamine)

Urised

phenazopyridine hcl (Pyridium)

co-trimoxazole (trimethoprim-sulfamethoxazole; TMP/SMX (Bactrim, Septra)
This antiseptic synthetic drug has a spectrum of activity that encompasses the majority of UTI infective agents
nitrofurantoin (Furadantin)

Route(s):
Oral

Note:
After oral administration, 45% of the dose is excreted in the urine
Side effects of nitrofurantoin (Furadantin)
Nausea
Vomiting
Sensitivity reactions
A urinary antiseptic drug that is useful for chronic, resistant, or recurrent UTI infections
methanamine mandelate (Mandelamine)

Route(s):
Oral
A commercially prepared antiseptic drug that is relatively effective in treating mild urinary infections
methanamine and methylene blue

Note:
Patients should be warned that the methylene blue tab will turn urine blue

Warning:
It is contraindicated in myasthenia gravis & glaucoma
Side effects of commercially prepared methenamine & methylene blue drug
Dryness of mouth
Dizziness
Rapid pulse
Blurred vision
This antiseptic drug acts promptly (usually in 30 mins.) to produce an analgesic effect on the Urinary tract mucosa.
phenazopyridine hcl (Pyridium)

Route(s):
Oral

Note:
Patient should be informed that the urine will turn a reddish color
Signs & symptoms of UTI
Pain
Burning
Urgency
Frequency
This antiseptic drug is very effective against chronic UTI, primarily pyelonephritis, pyelitis, & cystitis
co-trimoxazole (trimethoprin-sulfamethoxazole; TMP/SMX) (Bactrim, Septra)
Signs & Symptoms of co-trimoxazole (trimethoprin-sulfamethoxazole; TMP/SMX) (Bactrim, Septra)
Sore throat
Fever
Pallor
Purpura
Jaundice

Note:
Adequate fluid intake should be maintained during therapy to prevent the formation of Renal calculi.

Contraindicated in Pregnant women
Is the involuntary discharge of urine & generally occurs at night, often referred to as "nighttime bedwetting"
Enuresis


Note:
Is a fairly common problem in children
Examples of drugs used for the treatment of enuresis
imipramine hcl(Tofranil)

oxybutynin chloride (Ditropan)
This agent which acts an antidepressant, may improve the symptoms of enuresis in children
imipramine hcl(Tofranil)

Route(s):
Oral
This agent has a direct anitspasmodic effect on the smooth muscles & relaxes bladder smooth muscle in patients with involuntary bladder symptoms
oxybutynin chloride (Ditropan)

Route(s):
Oral

Note:
It may be used for day & night wetting.
Side effects of oxybutynin chloride (Ditropan)
Drowsiness
Decreased tearing
Dry mouth
Constipation
Palpitations
This is an antidiuretic agent that affects renal water conservation. It is an analog of vasopressin (ADH) that is used as a spray
desmopressin acetate (DDVAP Nasal Spray)
Side effects of desmopressin acetate (DDVAP Nasal Spray)
Headache
↑ blood pressure
Nosebleed
Sore throat
The inability to control the discharge of excretions, either urine or feces
Incontinence
Factors that increase the risk of incontinence
Nocturia, or excessive urination during the night
Decline in bladder capacity
Decrease in urethral pressure
Increase in postvoiding
Loss of elasticity or stiffening of the bladder
Benign prostatic hypertrophy
Decrease pelvic muscle tone after childbirth
Examples of drugs used for the treatment of incontinence
oxybutynin chloride (Ditropan XL)

tolterodine tartate (Detrol, Detrol LA)
This agent exerts a direct antispasmodic effect on smooth muscle, relaxing the bladder smooth muscle
oxybutynin chloride (Ditropan XL)

Route(s):
Oral
Drug used to treat incontinence
Side effects of oxybutynin chloride (Ditropan XL)
Dry mouth
Dry eyes
Somnolence
Constipation
This agent increases bladder capacity & decreases urge urninary incontinence
tolterodine tartrate (Detrol, Detrol LA)

Route(s):
Oral

Side effects:
Same as for oxybutynin
Drug for treatment of incontinence
Is an abnormal enlargement of the prostate gland that occurs in most men 55 years of age or older
Benign prostatic hypertrophy (BPH) or hyperplasia
Signs & Symptoms of BPH
Weakened urinary stream
Difficulty in initiation of urination
urinary frequency & urgency
Examples of drugs used for the treatment of BPH
finasteride (Proscar)

tamsulosin hcl (Flomax)
The drug that is used to reduce prostate size & the associated symptoms of urinary obstruction
finasteride (Proscar)

Route(s):
Oral
For the treatment of BPH
Side effects of finasteride (Proscar)
Impotence
↓ volume of ejaculate
Abdominal pain
Diarrhea
Flatulence
This agent is used to relieve mild to moderate obstructive manifestations of prostatic hypertrophy
tamsulosin hcl (Flomax)
Side effects of tamsulosin hcl (Flomax)
Rash
Urticaria
Angioedema of the tongue, lips, & face
Examples of drugs used for the treatment of erectile dysfunction
sildenafil citrate (Viagra)

vardenafil HCl (Levitra)

tadalafil (Cialis)
An oral agent that is effective in the temporary treatment of erectile dysfunction. It acts as vasodilator & ↑ the tumescence & duration of the penile erection
sildenafil citrate (Viagra)

Note:
Before this agent is used, it is important to obtain a careful medical history
It potentiates the vasodilating effects of nitrites, producing potentially life-threatening hypotension
This agent is also prolongs the duration of penile erections. Many drugs are incompatible with this agent.
vardenafil HCl (Levitra)

Note:
This should be avoided in patients with unstable angina, hypotension, recent history of stroke, arrythmia, or MI
This agent has an advantage over sildenafil citrate (Viagra) & vardenafil HCl (Levitra) because the duration of action is up to 36 hours
tadalafil (Cialis)

Route(s):
Oral

Note:
Priapism may occur