Drug of Choice: Chronic Kidney Disease


S/N
Drugs
Group
Mode of Action
Route
Dosage
Indication
Contraindication
Nursing Responsibilities
1.
Flagyl (Metronidazole)
Anti-biotics, Anti-amoebic, Anti-microbial, Anti-protozoal, Anti-trichomonal drug.
It alters the biosythesis of cell wall of the protozoon or microbe thereby altering cell permeability with loss of intracellular constituents.
Orally, Suppositorily, Intravenously.
400mg 3times daily.
Metronidazole is used for treatment of Amoebic dysentry, Liver abscess, vaginal and urethral Abortion, Diverticulitis, Septicaemia, pre and post operatively.
CNS diseases, Blood Dyscrasis, Pregnancy, known hypersensitivity reaction, Hepatic Leucopenia.
Monitor for seizures and peripheral neuropathy.
Not to be administered to pregnant, Lactating mothers or patients with known hypersensitivity reactions, Hepatic encephalopathy and central Nervous system disease. Intake of Alcohol is to be avoided within 24 hours of intake because it may produce Disulfiram.
2.
Lipitor
(Atorvastatin)
A synthetic lipid-lowering drug or a statin drug.
Helps to lower the plasma cholesterol and Lipoprotein levels by inhibiting an enzyme called 3-Hydroxy-3 Methylglutaryl co enzyme A (HMG coA) reductase, that is involved in Cholesterol synthesis especially in the Liver.
Orally
(in tablet form)
10mg daily.
Homozygous familiar hypercholestereolaemia, Non-Insulin dependent diabetes mellitus or for the prevention of cardiovascular events in type-2 Diabetes or in patients who have not responded adequately to diet and other measures.
Porphyria, Hepatic disorder, Pregnancy, Breast feeding and Hypersensitivity.
Advise patient to report promptly unexplained muscle pain, tenderness or muscle weakness particularly if accompanied by malaise or fever and treatment is to be discontinued if such complaints are reported.
Monitor Liver function tests before the commencement of treatment.
Efforts should be made to control hypercholesterolemia with appropriate diet, exercise and body weight reduction in obese patients before commencement of Astorvastatin.
3.
Lasix
(Frusemide)
Loop or Potent Diuretics
It acts on the Loop of Henle and even the Distal Convoluted Tubule, preventing reabsorption into the blood stream of sodium, chloride, water and potassium, thereby increasing the urinary output, and reducing the Oedema.
Orally, Intramuscularly, Intravenously.
40mg 2times daily
Toxaemia of pregnancy, pre-eclampsia, congestive cardiac failure, pulmonary oedema, Nephrotic syndrome, Ascites in liver cirrhosis, hypertension.
Renail failure, Burns, Shock, Cholera, Gastricenteritis, precomastose states associated with liver cirrhosis.
Monitor intake and output chart for the patient.
Give the prescribed potassium supplement to prevent Hypokalemia.
Weigh the patient daily.
Advise on low or restrict of salt (sodium) intake in the diet to enable effectiveness of Frusemide.
4.
Lisinopril
(Lisiofil)
Anti-Hypertensive drug.
It inhibits Angiotensin converting enzyme, thereby reducing the peripheral resistance, dilating the blood vessels and reducing the blood pressure.
Orally
5mg daily
Hypertension, Myocardial infarction, Heart failure.
Hypersensitivity reaction to Lisinopril, History of angiodema related to previous treatment with Angiotensin Convertung Enzyme, Aortic Stenosis.
Lisinopril should not be given to patients with Aortic Stenosis, Urinary tarct obstruction, and impaired renal function.
Patients with existing renal disease, or taking high doses should be regularly monitored for proteinuria.
5.
Spironlactone
(Aldactone)
Potassium-sparing (or conserving) Diuretic.
It antagonizes Aldosterone and then promotes the excretion of sodium chloride and water in the urine with little loss of potassium ions. Hence, helps to conserve adequate quantity of potassium in the body without any need for potassium supplement.
Orally
50mg 2times daily.
Congestive heart failure, hypertension, Primary Aldosteronism if surgery is not feasible, Hepatic cirrhosis, Idiopathic Oedema, Nephrotic Syndrome.
Renal impairment, Anuria, Hyperkalaemia, Lactation, Addison’s disease, Shock, Cholera, Gastroenteritis, burns.
Aldactone should not be given concomitantly with potassium salts.
Maintain intaje and output chart for the patient.
Observe the vital signs.
Weigh the patient daily.
Do  not give potassium supplements to prevent hyperkalaemia in patient.
6.
Ferosoft



2.5mg daily





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