Medication Information and Glossary

Transcription

1 Patient Education Chapter 12 Page 1 Medication Information and Glossary Objectives: 1. Understand guidelines for taking medication and why it is critical for patients with kidney disease to follow doctor s orders about taking medications. 2. Refer to terms related to kidney disease and dialysis, defined in the glossary (see page 4), Some medications damage the kidneys. Many medications are excreted by the kidneys. When kidney function decreases, dosage of medications may need to be changed. There are two key reasons to follow what your doctor tells you about taking your medications: 1. Most medications have side effects in addition to the desired effects. 2. Some medications have undesireable effects when taken with other medications. Be sure to take the right dosage of your medication at the right time. Follow all instructions for taking medications. Do not take medications without your doctor s approval. This chapter describes medications most often prescribed for people with kidney disease. as needed. American Nephrology Nurses Association Greater Puget Sound Chapter

2 Chapter 12 Page 2 Phosphate Binders Renagel (sevelamer), Phos-Lo (calcium acetate), Tums (calcium carbonate), aluminum hydroxide (Alu-cap, Alu-tab, Amphojel, Dialume), aluminium carbonate (Basaljel) These drugs are used by people on dialysis to treat high phosphorous levels in the blood. They prevent the absorption of phosphorus into the blood and soft tissue, by binding it in your intestines. It then passes from your body in the stool. These binders help prevent bone disease by maintaining the proper calcium-phosphorus balance. When these medications are used as phosphate binders, they should be taken when you eat to be effective. Erythropoietin (EPO) Procrit, Aranesp This is a hormone normally made in the kidney that stimulates bone marrow to produce red blood cells. It is a shot that can be given intravenously (by IV) or injected under the skin. Iron Supplements Ferrous sulfate (Feosol, Fer-In-Sol, Fero-Gadument), Ferrous gluconate (Fergon), Ferrous fumerate (Femiron, Feostat, Fumerin, Ircon), Tabron (iron/vitamin supplement), or Chromagen Forte Supplement iron pills that provide the building blocks for the body to make new blood. Injectable Iron Supplement Iron gluconate (Ferrlecit), iron sucrose (Venofer) Used to replace iron in people who cannot take oral forms or in people in which the oral form is not effective when rapid replacement is needed. Anticoagulants (prevents blood clotting) Warfarin (Coumadin), Heparin, Lovenox Used to decrease the clotting of blood. Often called a blood thinner. An anticoagulant is used during hemodialysis to prevent the blood from clotting in the blood access, blood lines, and dialyzer. Heparin is also placed in dialysis catheters to prevent clotting while the catheter is not in use.

3 Chapter 12 Page 3 Antihypertensive Drugs (blood pressure medications) Antihypertensive drugs are drugs or agents that reduce or control high blood pressure. There are groups that act on different parts of the body to decrease blood pressure including: ACE inhibitors: lotensin, lisinopril, captopril, monopril, zestril, Vasotec, ramapril Beta Blockers: Metopolol, Atenolol, Propranolol, Coreg Diuretics: Hydrochlorothiazide, Spironolactone ARBs: Avapro, Cozaar, Diovan, Atacand, Micardis Calcium Channel Blockers: Plendil, Norvasc, Adalat, Cardizem Drugs Used to Control Calcium Balance Oscal: This medication is made from oyster shells, and contains 250 mg of calcium and 125 units of vitamin D per tablet. Tums: A calcium replacement. 25-Dihydroxycholecalciferol or Calcitriol (Rocaltrol) Zemplar An active form of vitamin D3. For the control of hyperparathyroidism in ESRD patients. Used in the management of calcium problems in chronic dialysis patients. Hypnotics (relaxants and sleeping pills) Diazepam (Valium), Lorazepam (Ativan) Used to relieve nervousness or tension, to relax muscles or relieve muscle spasms, and to induce sleep. Take only as prescribed. Laxatives and Stool Softeners Psyllium mucilloid (Metamucil): Bulk-forming laxative. Docusate sodium (Colace): Stool softener. Dulcolax (Bisacodyl): Laxative. Miralax: Gentle laxative.

4 Chapter 12 Page 4 Immunosuppressives (suppress the immune system) Deltasone (Prednisone), cycophosphamide (Cytoxan), cyclosporine (Sandimmune, Neoral), azathioprine (Imuran), OKT 3, ATG, FK 506 (Tacrolimus), MMF (Mycophenolate or cellcept), Sirolimus (Rapimmune) Used to prevent or reduce rejection of transplanted organs. Vitamins Nephrocaps, Nephrovits, or Diatx The B and C vitamins are water soluble. During dialysis, these watersoluble vitamins are removed, so they are replaced by taking oral supplements. Check with your doctor before taking any vitamins. Glossary anemia A condition where you have a low number of red blood cells in your body. It can make you tired and cold. artery Blood vessels that carry blood from the heart to the tissues. artificial kidney (dialyzer) A semipermeable membrane that removes waste from the blood and restores chemical balance in the body. Used with hemodialysis. blood access The site used during hemodialysis to remove and return your blood from the machine. Surgery is needed to prepare the site. blood pressure The pressure within the arteries. It reaches its peak when the heart beats and drops to its lowest level between beats. bruit A murmur or buzzing sound that can be heard at the fistula or graft site. cadaveric transplant A transplant that uses a kidney donated by a person who has recently died. continuous ambulatory peritoneal dialysis (CAPD) The most common type of peritoneal dialysis. With CAPD, the blood is always being cleaned. The procedure uses a system of bags and tubing. No machine is required. continuous cycling peritoneal dialysis (CCPD) A form of peritoneal dialysis that uses a cycling machine. The machine automatically performs the exchanges while the person sleeps and usually involves 3 to 5 exchanges per night. chronic renal failure (CRF) The stage of kidney failure that requires dialysis or kidney transplant to maintain life and health.

5 Chapter 12 Page 5 daily short dialysis A term used to describe frequent hemodialysis. It is usually 5 to 7 treatments per week, each lasting 2 to 3 hours. deciliter A measure of volume equal to one-tenth of a liter. dialysate (bath) The solution used in dialysis to remove metabolic waste products from the blood. dialysis The process of maintaining the chemical balance of the blood when the kidneys have failed (cleansing the blood). dialysis access Any device used to connect a person to dialysis. This includes peritoneal catheters, fistulas, artificial vessels, and hemodialysis catheters. dialyzer A part of the hemodialysis machine that removes wastes and extra fluid from the blood, also called the artificial kidney. dry weight (tissue weight) A range of normal weight when no excess fluid is present. Your dry weight changes when your tissue body weight changes. edema An abnormal accumulation of fluid in body tissues. You can check yourself for edema or swelling on your ankles, hands, face or eyelids. erythropoietin A hormone made mainly by the kidneys that instructs your bone marrow to make red blood cells. fistula A patient s own vein, that is changed by joining an artery (which has high blood flow), to a vein (which has lower blood flow), causing the vein to enlarge and the vein walls to become strengthened for hemodialysis access. fluoroscopy An X-ray procedure that makes it possible to see internal organs in motion. graft An artificial vessel implanted under the skin and joined to the vascular system for access. hematocrit The percentage of volume of blood that is red blood cells. hypertension High blood pressure. hypotension Low blood pressure. interventional radiologist A clinician who uses fluoroscopy to perform procedures such as inserting and removing catheters and dilating or stenting vessels and fistulas/grafts.

6 Chapter 12 Page 6 kidney disease programs (KDPs) State-funded programs that assist CKD patients with expenses related to their treatment. KDPs serve as payors of last resort. kilogram A measure of weight. One kilogram equals 2.2 pounds. liter A measure of volume. One liter equals 1.06 quarts. living related donation A person who is willing to donate a kidney, and is related to the person needing it. living unrelated donation A person who is willing to donate a kidney, but isn t related to the person needing it. milli (m) A prefix used in the metric system meaning one-thousandth. milligram (mg) A measure of weight equal to one-thousandth of a gram. milliliter (ml) - A measure of volume. One milliliter equals onethousandth of a liter. nephrologist A doctor who treats patients with kidney problems and hypertension. peritoneum The smooth sac which lines the cavity of the abdomen. peritoneal catheter A soft tube, about one-quarter inch in diameter and 13 to 15 inches long, which is inserted into the peritoneal cavity through the skin of the abdomen, providing a small opening through which dialysate can be placed. peritoneal membrane A sac, resembling cellophane with holes, which serves as the lining of the abdominal cavity and holds organs in place within the peritoneal cavity. peritonitis An inflammation or infection of the peritoneal membrane. Peritonitis is treated with antibiotics that are included in a special type of peritoneal fluid. phosphorus (phosphate) binder A medication taken with food that binds with phosphorus so the phosphorus doesn t get into the blood. Bound phosphorous goes out of the body in the stool. protein A nutrient used by the body to replace old or damaged tissues and to build new tissues such as muscle and blood. residual renal function The degree of kidney function remaining in patients with chronic kidney disease. serum The fluid portion of the blood remaining after clot formation.

7 Chapter 12 Page 7 shunt Another name for fistula or graft blood access. stent A tube made of metal or plastic that can be inserted into a vessel to keep it open. thrill A vibrating feeling found in a fistula or graft where the arterial blood enters the vein. transplantation Surgically placing a kidney (or other organ) from a donor to a recipient. ultrafiltration The process of removing water from the blood by exerting pressure on the blood in the dialyzer during hemodialysis, and by using higher glucose concentrations in PD. uremia The accumulation of waste products in the blood that the kidney normally filters into the urine. vascular Refers to the blood vessels and blood carrying system of the body. vascular catheter A synthetic tube or catheter inserted through the skin into a vessel to access the blood supply for hemodialysis. vein (venous) Blood vessels that carry blood from the body tissues to the heart. waste products (metabolic end-products) Chemicals produced by normal body functions that are not needed by the body.

8 Chapter 12 Page 8 Questions? Your questions are important. Call your doctor or health care provider if you have questions or concerns. Notes American Nephrology Nurses Association Greater Puget Sound Chapter University of Washington Medical Center 07/2004