Question

Furosemide, sodium polystyrene sulfonate and sevelamer hydrochloride are used to treat chronic kidney disease; provide the therapeutic classification, discuss how the medication improves CKD signs/symptoms and nursing actions for safe administration

Answer 1

1.Furosemide

Furosemide is also called as lasix belongs to the drug classification of loop diuretics. It is used in the treatment of CKD ,it act by inhibiting the reabsorption of sodium,water and chloride in ascending loop of henle , promotes diuresis thus fluid overload and edema is prevented in CKD. It is also used for the excretion of potassium ( hyperkalemia) which is seen in CKD.Loop diuretics also act as a anti hypertensive drug thus reduces the renal vascular resistance, check the vital signs .monitor for orthostatic hypotension ,implement fallrisk precautions. Monitor the weight of the patient, check electrolytes like potassium and sodium daily. Monitor for ototoxicity, hypokalemia, hyponatremia, hypocalcemia, hypomagnesemia and hyperglycemia. Take diuretics 6-8 hours before bedtime to prevent nocturia. Monitor the intake output.

2. Sodium polystyrene sulfonate

It is also called as kayexalate is used for the treatment of hyperkalemia in CKD.Sodium polystyrene sulfonate is a cation exchange resin that works by exchanging sodium for potassium in the gastrointestinal tract and increases the fecal elimination of potassium. It is usually given as retention enema in CKD patients. Strictly monitor serum potassium levels and institute continuous cardiac monitoring. Monitor the bowel movements of the patient. Use warm fluid for enema.Administer at body temperature and introduce by gravity in case of retention enema.

3.Sevelamer hydrochloride

This is a drug that act as a phosphate binders used in the treatment of hyperphosphatemia in CKD .It act by binding to the excess intestinal phosphate and thus reduces the excess phosphorus level in CKD .monitor the serum phosphorus level. Administer the drug with food ,monitor for any sideeffects. Protect the drug from moisture.