40x more potent that furosemide

    - inhibits the reabsorption of sodium and chloride in the loop of Henle and distal renal tubule.

- increases excretion of water, sodium, chloride, magnesium, hydrogen, and calcium 

Aldactone

     (patient teaching)

- potassium sparing diuretic

- immediately report signs of hyperkalemia (irritability, anxiety, abdominal cramping, or irregular heartbeat) 

- avoid potassium substitutes and potassium rich foods 

-avoid direct sunlight and mental alterness may be a problem at beginning 

- aldactone is a potassium sparing diuretic and lisinopril is an ACE inhibitor (lowers bp)

- interact to cause severe hypotension and hyperkalemia 

-used to treat metabolic acidosis

- helps to make stomach less acidic and in turn helps to make urine less acidic

- treats heatrburn, indigestion, and other stomach disorders, kidney disorders 

- pH lower than 7.35

- CNS lethargy, confusion, and maybe depression

- Deep, rapid breathing to get rid of acid 

- pH higher than 7.45

- CNS excitablity, anxiety, hyperactive reflexes, nervousness, convulsions 

-slow shallow breaths to rid body of basics 

Fluid Treatment for Hyponatremia

- given 0.45% or 0.9% sodium solutions

- examples would be Normal Saline or Lactated Ringers 

- lower dosage of diuretics especially potassium sparing; may need to switch drug completely

- change diet to avoid potassium rich foods

- administer glucose or insulin in cases of severe to quickly reduce extracellular potassium 

-used to treat hypokalemia

- pushes cells into extracellular space

- assess potassium levels before admin

- ALWAYS give when patient sitting upright to avoid GERD or esophigitis

- watch for hyperkalemia 

- used to treat bronchospasm

- help reduce inflammation (histamines) so that asthma attacks are lessened

- ONLY GOOD FOR DAILY USE CAN NOT BE GIVEN PROPHYLACTICLY 

- rebound congestion

- do not use for more than 3-5 days 

- H-1 in smooth muscles except stomach (cause inflammation and allergies):   antagonists may be used to treat allergies or inflammation

- H-2 in stomach (create peptic ulcers by secreting HCl) only: antagonists used to treat peptic ulcers 

-used to relax bronchial smooth muscles in airways for breathing. 

- treats bronchospam associated with REVERSIBLE obstructive airway disease such as Asthma 

Isuprel (isoproterenol) SE/ADR

- stimulates beta 1 and beta 2 receptors used to treat astham

- causes palpitations, tachycardia, dry mouth, nervousness, cough, hyperglycemia, tremor, headache, insomnia, rebound bronchospasm, chest pain, respiratory distress 

- bronchodilator
- take 30-60 min before exercise AND NOT FOR ACUTE BRONCHOSPASMS
- hold in breath 10 sec for inhaler use

Atrovent (Ipatrprium Bromide) patient Teaching

- bronchodilator/ anticholonergic

- used to treat asthma or COPD

- if inhaled wait 5 min before other inhaled meds

- wash mouth after use

- report changes in urinary pattern

-report change in color or amount of sputum 

Beconase (Beclomethasone) MDI administration

- glucocorticoid for prophylactic care of asthma

- reduces inflammation

- taken on daily schedule 4-8 weeks best results 

-used to treat PUD

- produces a thick gel that secretes over ulcer and protects it from acids

- DOES NOT STOP SECRETION OF ACIDS 

Cytotec (misoprotol) mechanism of action

- treats PUD

- deminishes secretion of gastric acids and creates thick gel that covers peptic ulcer

- USED MOSTLY WITH PATIENTS USING NSAIDS OR GLUCOCORTICOIDS 

- reduces weight by blocking absorption of fat in GI tract

- decreases absorption of other things

- SEVERE GI DISCOMFORT, gas and diarrhea