Download pharmacy technician chapter twenty three

PHARMACY TECHNICIAN
CHAPTER TWENTY THREE
1
Amino Acids
• The body can produce 11 types of amino
acids, referred to as nonessential
• There are 9 types of amino acids that the body
requires, but cannot produce
– These are referred to as essential amino acids (See
table 23.9)
• Essential amino acids have to be derived from
food intake
2
Vitamin A (Retinol)
• Helps with eyesight and epithelial cells and
tissues (skin cells)
• Deficiencies in vitamin A may cause:
– Night blindness
– Xerosis (dryness) of the conjunctiva and cornea
– Xerophthalmia and keratomalacia
– Keratinization of lung, GI tract, and urinary tract
– Increased susceptibility to infections
• DRI is 900 µg/day for males and 700 µg/day for
females
3
Vitamin D
• Helps with the absorption of calcium from the
intestine to make stronger bones and teeth
• Deficiency causes metabolic bone softening:
– Called rickets in children
– Called osteomalacia in adults
• DRI is 5 µg/day (ages 19–50) for both males
and females
• DRI is 10 µg/day (ages 51–70) for both males
and females
4
Vitamin E
• A strong antioxidant for lipids
• Deficiency is generally caused by malabsorption rather than
lack of ingestion
• Vitamin E deficiency may cause:
– Disorders of the reproductive system
– Abnormalities of muscle, liver, and bone marrow
– Hemolysis of RBCs
– Defective embryo genesis
– Brain dysfunction
– A disorder of capillary permeability
• DRI is 15 mg/day for both males and females
5
Vitamin K
• Necessary for blood coagulation
• Controls formation of coagulation factors II,
VII, IX, and X in the liver
• Also needed for calcium uptake in bones
• Can be used as an antidote for coumadin
overdoses
• Deficiency is rare
• DRI is 120 µg/day for males and 90 µg/day for
females
6
Vitamin B1 (thiamine)
• Necessary for carbohydrate metabolism
• Deficiency causes the disease beriberi
– Affects the peripheral neurologic, cerebral,
cardiovascular, and GI systems
• DRI is 1.2 mg/day for males and 1.1 mg/day
for females
7
Vitamin B2 (riboflavin)
• Necessary for the health of the mucous membranes
in the digestive tract
• Aids absorption of iron and vitamin B6
• Deficiency leads to:
–
–
–
–
Oral, eye, skin, and genital lesions
Hair loss
Light sensitivity
Retarded growth
responses
– Burning feet
- Dizziness
- Insomnia
- Poor digestion
- Slow mental
8
Vitamin B3 (niacin)
• Important in oxidation-reduction reactions
• Vital in protein metabolism
• Deficiency leads to the disease pellagra:
– Affects skin, mucous membranes, GI, and brain/CNS
systems
– Causes photosensitive rash, scarlet stomatitis, glossitis,
diarrhea, and mental aberrations
• Deficiency found in diets high in corn
• DRI is 16 mg/day for males and 14 mg/day for
females
9
Vitamin B5 (pantothenic acid)
• Important for secretion of hormones such as
cortisone
• Important for maintenance of healthy skin, muscles,
and nerves
• B5 deficiency extremely rare
• Symptoms of B5 deficiency include:
–
–
–
–
–
Insomnia
Depression
Nausea
Headache
Muscle spasm
10
Vitamin B6 (pyridoxine)
• Needed for:
– Red blood cell formation
- Antibody
production
– Cell respiration
- Cell growth
– Conversion of tryptophan to niacin
– Helps convert stored carbohydrate to glucose to maintain
normal blood sugar levels
– Synthesis of neurotransmitters such as serotonin and
dopamine
• Deficiency can cause:
–
–
–
–
Anemia similar to iron-deficiency anemia
Decreased antibody production
Suppressed immune response
Symptoms such as dermatitis, a sore tongue, depression,
confusion, and convulsions
11
Vitamin B9 (folic acid)
• Important for:
–
–
–
–
–
Energy production
-Formation of red blood cells
Strengthening immune system
Promoting healthy cell division and replication
Protein metabolism
Preventing depression and anxiety
• Deficiency can be serious and may result in:
–
–
–
–
–
Anemia
Digestive disturbances
Growth impairment
Labored breathing
Paranoia
- Apathy
- Fatigue
- Insomnia
- Memory problems
- Weakness
12
Vitamin B12 (cyanocobalamin)
• Needed for healthy nerve cells, to make DNA, and for the
formation of RBCs
• Deficiency leads to irreversible nerve damage
• Signs and symptoms include:
– Fatigue
- weakness
– Nausea
- constipation
– Flatulence
- loss of appetite
– weight loss
- depression
– Confusion
- poor memory
13
Vitamin C (ascorbic acid)
•
•
•
•
•
•
Antioxidant
Essential for collagen formation
Maintains integrity of connective tissue, bone, and teeth
Important for wound healing and recovery from burns
Helps the absorption of iron
Severe deficiency results in scurvy:
– Characterized by general weakness, bleeding gums,
anemia, and skin bleeding
• The DRI is 90 mg/day for males and 75 mg/day for
females
14
Water
• 60% of an adult’s body weight is water
• Forms a major portion of every tissue
• Provides the medium in which most of the
body’s activities are conducted
• Facilitates many of the metabolic reactions
that occur in the body
• Helps transport vital materials to the cells
• Vehicle in which glycogen is transported into
muscle cells
15
PHARMACY TECHNICIAN
CHAPTER TWENTY FOUR
16
Bone
• Composed of two different kinds of bony tissue
– Cancellous or “spongy” bone—porous, inner bone that
provides volume
– Compact bone—hard, outer covering that provides
strength and shape
• The rounded end of a bone is covered with smooth,
slippery articular cartilage
• Many bones are hollow, and contain marrow:
– Red marrow in children
– Fatty yellow marrow in adults
17
Bone and Muscle
18
Types of Muscle
• Skeletal muscles—attached to bones; provide body
movement
– Voluntary, striated in shape, contain multiple peripheral
nuclei
• Cardiac muscle—tissue that composes the heart
– Contracts rhythmically, coordinated by transmission of
electrical impulses from nerve to muscle fibers
Smooth or “visceral” muscle—attached to or lines
other organs such as the stomach, intestines,
lungs, and blood vessels
19
Five Categories of Bone:
• Flat bones—generally more flat than round
• Irregular bones—have no defined shape
• Sesamoid bones—have cartilage or fibrous tissue
mixed in
• Short bones—generally cube-shaped
• Long bones—the most common bone
• Epiphysis (the rounded end of the bone)
• Diaphysis (the main shaft or central part of the
bone)
20
Disorders of the Bone
Osteomyelitis
• Bacterial Infection Inside the Bone Destroys bone tissue
• Original site of infection is frequently in another part of body
• Infection spreads to the bone via the blood
Osteoporosis—bone brittleness due to lack of calcium
• Prevalent in postmenopausal women because of estrogen
deficiency
Paget’s disease—changes the normal process of bone growth
• Causes bone to break down more quickly and grow back
softer than normal bone
21
Musculoskeletal
Diseases/Disorders
• Bursitis—inflammation of the small, fluid-filled
pouches between bones
• Tendonitis—inflammation of the cords of connective
tissue that attach muscle to bone
• Myalgia—muscle pain
22
Bone Marrow Disorders (cont.)
• Anemia—failure of the bone marrow to produce red blood
cells
– Most common cause is lack of iron
– Lack of red blood cells leads to a systemic decrease in oxygen
– Causes fatigue
• Leukemia—blood-borne cancer; cancer of the blood
– Begins when DNA of white blood cells is damaged or mutated
– Damaged DNA is copied and passed on to subsequent
generations of cells
– Abnormal, cancerous cells do not die off like normal cells
– Multiply unchecked within the body
23
Arthritis—Inflammation of a Joint
• Rheumatoid—an autoimmune disorder
• Osteoarthritis—caused by physical
degeneration of connective tissue
• Gout—caused by crystals of uric acid in blood
24
Treatments
Osteomyelitis
• Anti-infective agent is best treatment for
osteomyelitis
Osteoporosis
• Vitamin D and mineral calcium replacement therapy
• Hormone therapy (estrogen, calcitonin) and
bisphosphonates
• SERMs for postmenopausal women
• Gold compounds used to treat osteoarthritis
25
Treatments
Gout
• Colchicine used to alter ability of phagocytes to
attack uric acid crystals
• Anti-inflammatory analgesics can be used to reduce
pain and inflammation
Inflammation
• Salicylates relieve inflammation by inhibiting the
synthesis of prostaglandin
• Topical corticosteroids treat most causes, including
chemical, mechanical, microbiological, and
immunological
26
Treatments
Multiple Sclerosis
• Autoimmune disease in which body’s immune
system begins to attack normal body tissue
• Treatment of MS includes steroidal antiinflammatory agents and corticosteroids
Cerebral Palsy
• Affected person has poor control of the brain,
muscles, and joints
• Pharmaceutical therapy includes drugs to prevent
seizures and spasticity
27
Musculoskeletal Pharmaceuticals
• ASA (acetylsalicylic acid)
– Relieves inflammation by inhibiting the synthesis of
prostaglandin
– Salicylates are also used as analgesics and antipyretics
• NSAIDs (nonsteroidal anti-inflammatory drugs)
– Inhibit or block the enzyme that starts the reaction of
inflammation by making prostaglandin
• COX-2 inhibitors
– Block only the cyclooxygenase II that makes PGE-2, but not
C-1 (PGE-1)
– Inflammation is inhibited, but not the viscosity of the
mucosal linin
28
Musculoskeletal Pharmaceuticals
(cont.)
• Antigout agents—may be hypouricemic agents or uricosuric
agents
– Hypouricemic agents decrease production of uric acid in
the blood
– Uricosuric agents increase the excretion of uric acid
through urination
• Calcitonin—indicated for fragile or soft bones
– Inhibits bone resorption
– Decreases the number of bone fractures from low bone
density
29
Musculoskeletal Pharmaceuticals
• Bisphosphonates—indicated for osteoporosis
– Mimic the natural organic bisphosphonate salts found in
the body
– Inhibit bone resorption and osteoclast activity
– Restore bone mass and density
• SERMs (selective estrogen receptor modulators)
– Indicated for postmenopausal women
– Protective effect on bones and heart
• Skeletal muscle relaxants—used to relax specific muscles in
the body
– Relieve pain, stiffness, and discomfort
– Block muscle contraction at the neuromuscular junctio
30
PHARMACY TECHNICIAN
CHAPTER TWENTY FIVE
31
The Respiratory System
• Divided into the upper respiratory tract and
the lower respiratory tract
• The upper respiratory tract consists of:
– Nose or nasal cavity
– Paranasal sinuses
– Pharynx and larynx
32
The Respiratory System (cont.)
• The lower
respiratory tract
consists of:
– Trachea
– Two lungs
– Two main bronchi
33
The lower respiratory tract.
34
Respiration
• Diaphragm—dome-shaped layer of muscle
that lies across bottom of chest cavity
• Breathing occurs as diaphragm contracts and
relaxes
• Carbon dioxide pushed out of the lungs during
relaxation
• Oxygen pulled into the lungs during
contraction
35
Structure of Lungs
• About 10 percent solid tissue
• Remainder of structure filled with air and
blood
• The functional structure can be divided into
two parts:
– Conducting airways (bronchi and bronchioles)—
tubes lined by cilia and respiratory mucosa
– Cartilage—supports and cushions the bronchi
36
Common Cold
• Caused by a viral infection that inflames the membranes in
nose and throat
• Antibiotics will not cure a cold or any other viral infection
• Treatment is considered symptomatic
Cough
• May be a symptom of a cold, flu, respiratory problems, or
nonrespiratory diseases
• Most likely begins with an irritation of nerves in the
respiratory tract
• Nonproductive cough treated with cough suppressant
• Productive cough treated with an expectorant
37
Allergies and Asthma
Allergies
• Caused by the immune system reacting to a substance that
does not cause disease
• Treatment may be palliative, with antihistamines and
antitussives
• Treatment may be preventive, with mast cell stabilizers
Asthma
• Chronic respiratory disease
• Characterized by inflammation of airways, tightening of
muscles around airways
• Treatment is palliative with albuterol and other
bronchodilators
38
Emphysema
• Chronic destruction of alveoli
• External exchange interrupted when alveoli
become permanently damaged
• Treatment may be palliative, with stimulant
inhalers
• Treatment may be preventive, with antiinflammatory corticosteroids
39
Nasal Congestion and Rhinitis
Nasal Congestion
• Inflamed, stuffy nose
• Treatment may be palliative, to promote easier breathing
• Indications for use of decongestants are nasal and bronchial
congestion
Rhinitis
• Inflammation of nasal membranes, and/or runny nose
• Common component of colds and allergies
• Treatment is considered symptomatic
40
Bronchoconstriction
• Occurs when the smooth muscles encircling
the airways or tubes tighten, causing the
airways to spasm
• Treatment may be palliative
• Treatment may be preventive
41
Chronic Obstructive Pulmonary
Disease (COPD)
• Umbrella term for emphysema and chronic
bronchitis
• Characterized by partially blocked bronchi and
bronchioles
• Causes shortness of breath
• Treatment may be palliative, with
bronchodilators
• Treatment may be preventive, with mast cell
stabilizers
42
PHARMACY TECHNICIAN
CHAPTER TWENTY SIX
43
The heart.
44
Anatomy of the Heart
• Composed of four chambers: two upper and
two lower
• Atria—top two chambers
• Ventricles—bottom two chambers
• Septum—divides heart into right and left sides
45
Valves of the Heart
• Tricuspid valve—located between the right
atrium and the right ventricle
• Pulmonary valve—located between the right
ventricle and the pulmonary artery
• Mitral or bicuspid valve—located between the
left atrium and the left ventricle
• Aortic valve—located between the left
ventricle and the aorta
46
Layers of the Heart
• Pericardium—fluid-filled sac that surrounds
and protects the heart
– Permits free movement of the heart during
contraction
• Endocardium—innermost wall layer; covers
the inside surface of the heart
• Myocardium—surrounds heart and causes
chamber contractions
47
Function of the Heart
• Provides oxygenated blood throughout the
body by a pumping mechanism
• Oxygenated blood deposits materials
necessary for growth and nourishment
• Receives from tissues the waste products
resulting from metabolism
48
Hypertension
• Sustained elevation of systemic arterial blood
pressure
• Symptoms include:
– Severe headache
– Chest pain
– Irregular heartbeat
– Fatigue
• Pharmaceutical treatment includes diuretics,
vasodilators, ACE inhibitors, beta blockers, and
calcium channel blockers
49
Congestive Heart Failure
• Heart pumps out less blood than it receives
• Results in weakened and enlarged heart
• Symptoms of CHF include:
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–
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Upright posture or leaning forward
Anxiety and restlessness
Cyanotic and clammy skin
Persistent cough
Rapid breathing
Fast heart rate
Edema of the lower limbs
• Pharmaceutical treatment includes cardiac glycosides, diuretics,
vasodilators, ACE inhibitors, beta-adrenergic blockers, and
phosphodiesterase inhibitors
50
Coronary Artery Disease
• Occurs when there is insufficient blood flow to the heart
• Can lead to:
– Angina
– Heart attack
– Arrythmias
– Stroke
– Pulmonary embolism
– Heart failure
• Pharmaceutical treatment includes platelet aggregation
inhibitors, anticoagulants, tissue plasminogen activators, and
thrombin inhibitors
51
Cardiovascular Pharmaceuticals
• Antiarrhythmic drugs—restore normal rhythm patterns
but do not cure the cause of the irregular heartbeat
• Cardiac glycosides—used to increase the force of
myocardial contraction, without causing an increase in
the consumption of oxygen
• Diuretics—used to eliminate excess sodium and water via
the urinary tract
• Vasodilators—allow more blood to exit the heart,
preventing or mitigating congestion; lower blood
pressure
52
Cardiovascular Pharmaceuticals
(cont.)
• Angiotensin-converting enzyme inhibitors (ACE
inhibitors)—lower high blood pressure; thought to
reshape the heart; prevent the body from producing
natural vasodilators
• Angiotensin II receptor blockers—similar to ACE
inhibitors; block the body’s natural vasodilators
• Beta-adrenergic blockers—used to block cells from
receiving natural vasoconstrictors
• Antiadrenergic agents—interfere with the manufacture
of vasoconstrictors at nerve endings
• Platelet aggregation inhibitors—reduce the ability of the
blood to coagulate
53
Cardiovascular Pharmaceuticals
(cont.)
• Anticoagulants—prevent clots from forming or existing
clots from getting bigger
• Tissue plasminogen activators—break down blood clots
by reversing the clotting order and interfering with the
synthesis of various clotting factors
• Thrombin inhibitors—inactivate bound thrombin by
binding to the enzyme and blocking its interaction with
its substrates of fibrin
• Antihyperlipidemics—help prevent the progression of
coronary artery disease by lowering plasma lipid levels
54
Anticoagulants
•
•
•
•
Do not thin out the blood
Prevent clots from forming
Prevent existing clots from getting bigger
Cannot dissolve existing blood clots
55
Warfarin
• Oral drug of choice
• Works by preventing the synthesis of clotting factors II, VII, IX,
and X
• Used in the long-term prevention or management of venous
thromboembolic disorders, including:
– Deep vein thrombosis
– Pulmonary embolism
– Clotting associated with atrial fibrillation and prosthetic
heart valves
• Vitamin K may be used as an antidote when too much
warfarin has been given
56
Heparin
• Parenterally administered drug of choice
• Works by inactivating clotting factors IX, X, XI, and XII
• Used prophylactically to:
– Prevent and treat deep vein thrombosis
– Prevent and treat pulmonary embolism
– Treat thrombophlebitis
– Prevent clotting during cardiac and vascular
surgery
• The only antidote for heparin overdose is protamine
sulfate
57
Cholesterol and Triglycerides
• HDL—high-density lipoproteins or “good”
cholesterol
• LDL—low-density lipoproteins or “bad”
cholesterol
• Triglycerides—a form of energy stored in
adipose and muscle tissues
– Often measured to depict fat ingestion and
metabolism
– Can be used to assess CAD risk factors
58
Lymphatic System
• Complex system of lymph organs, nodes,
ducts, tissues, vessels, and capillaries
• Transports lymph fluid to the circulatory
system
• Cardiovascular and lymphatic systems work in
tandem
– Joined by a capillary system through which lymph
and blood move
59
Lymphatic System (cont.)
• Lymphatic system supports the immune
system by:
– Filtering out organisms that cause disease
– Producing specific white blood cells
– Manufacturing antibodies
– Distributing fluids and nutrients throughout the
body
– Draining excess fluids and protein so that tissues
do not swell or become inflamed
60
PHARMACY TECHNICIAN
CHAPTER TWENTY SEVEN
61
Nonspecific Defenses
• Considered a “first line of defense” against
disease and infection
• Nonspecific defense mechanisms include:
– Physical barriers (unbroken skin)
– Natural deterrents (fluids and immune cells that
attack invaders)
– Inflammatory process
62
Specific Defenses
• Specific defense mechanisms are called the
immune system
• Immune system has specialized molecules and
cells that fight foreign invaders
• Immune system molecules consist of two
types of protein molecules:
– Antibodies—identify foreign particles
– Complement—destroys foreign particles
63
Parasites
• Multicellular organisms or single-celled organisms that are
not bacteria or fungi
• Asymmetrical symbiotic relationship:
– Parasite benefits from host
– Host receives no benefit from or is harmed by relationship
• Most common parasites in the United States are:
– Pinworms
– Roundworms
– Tapeworms
• Transmission usually occurs via ingestion of contaminated
food or soil
64
Bacteria and Virus
Bacteria
• Unicellular, prokaryotic microorganisms
• May be round (coccus/cocci), rod (bacillus/bacilli), or spiralshaped
• May cause disease; may also have beneficial relationships (E.
coli, etc.)
Virus
•
•
•
•
Ultramicroscopic infectious pathogen
Can replicate itself only within cells of a living host
Uses the DNA and RNA of the host
Antibiotics are ineffective against viruses
65
HIV (Human Immunodeficiency
Virus)
• Can be categorized as either HIV-1 or HIV-2
• Most references to HIV refer to HIV-1, the most common
worldwide
• Both types are transmitted:
– By sexual contact
– Through bodily fluids
– At birth from mother to child
• Both types of HIV cause clinically indistinguishable AIDS
– Acquired immune deficiency syndrome
– Immune system becomes severely suppressed
– Body cannot fight opportunistic infections or cancers
66
Five Stages of HIV Progression to
AIDS
• Stage 1—initial transmission and infection with HIV
• Stage 2—infected without presentation of signs or
symptoms (10 or more years)
• Stage 3—signs and symptoms of HIV begin to appear
• Stage 4—AIDS opportunistic infections lead to a CD4
cell count or level below 200 per cubic millimeter of
blood
• Stage 5—last and final stage of wasting to death
67
Classes of HIV Drugs
• Vaccine
– Not yet developed
– Would enable immune system to destroy HIV
before infection occurs
• Attachment inhibitors
– Not yet developed
– Would prevent HIV from attaching to host cells
• Inhibitors
– Block the synthesis of copies of the viral RNA
– Virus cannot duplicate itself
68
Autoimmune Disease
• Occurs when immune system mistakenly
attacks the cells, tissues, and organs of its own
body
• Immune system cells and molecules
accumulate at a target site
– This gathering is broadly referred to as
inflammation
• Autoimmune diseases are not contagious and
are not related to AIDS or cancer
69
Drug Resistance
• Defined as a microorganism’s ability to live and grow
in the presence of an anti-infective or antimicrobial
drug
• Is a result of genetic mutation during cell division
• Allows the pathogen to evade or avoid the
destructive mechanism of a drug
• Bacteria are especially prone to develop drug
resistance
• The increasing use of antibiotics contributes to this
action and is called antibiotic resistance
70
Preventing Antibiotic Resistance
•
•
•
•
•
Avoid unnecessary antibiotic use in humans
Avoid unnecessary antibiotic use in animals
Use most specific antibiotic possible
Complete an antibiotic regimen (no leftover pills)
There may be no ultimate cure for antibiotic
resistance
• However, development of resistance can be slowed
down
71
Anti-Infectives
• Umbrella name under which various types of drugs
are then subclassified
• Also called antimicrobial—against the growth of a
microorganism or microbe
– Antibacterials—treat bacteria only
– Antivirals—treat viruses only
– Antifungals—treat fungi only
– Metronidazole—amoebicidal, bactericidal, and
trichomonacidal
72
Tuberculosis
• Caused by Mycobacterium tuberculosis bacterium
• May attack any part of the body, but usually attacks
the lungs
• Spread by breathing air into which infected people
have coughed or sneezed
• Drug of choice for treatment is isoniazid (INH)
– Taken for at least six to nine months
– Longer if the patient has a weakened immune
system
73
Malaria
• Transmitted by parasites found in malaria-infected
mosquitoes
• Can be cured with prescription drugs
• Type of drug used and duration of treatment depend
on:
–
–
–
–
Which type of malaria is diagnosed
Where the patient was infected
Age of the patient
Orogression of the disease at the start of treatment
74
PHARMACY TECHNICIAN
CHAPTER TWENTY EIGHT
75
The renal system.
76
The Renal System
• Composed of two kidneys, two ureters, one bladder, and
the urethra
• Filtering system of the kidneys is composed of millions of
nephrons
• Waste from food and drug metabolization is filtered
through the nephrons
• Wastes exit the kidneys as urine via the ureters
• Ureters lead to the bladder, where urine is stored until
released
• The kidneys are located in the posterior abdomen just
above the waist
77
Nephron
• Smallest, most basic part of the kidney
• Filters the blood that passes through the
kidneys
• Produces urine through the processes of
filtration, reabsorption, and secretion
• Enables blood to reabsorb water, electrolytes,
and nutrients
78
Kidney and Bladder
Kidney
• Built almost entirely of nephrons
• Organ that filters blood and produces urine
• Urine produced by the kidneys is conducted to the
bladder
Bladder
• Organ used for waste storage
• Can collect approximately 350 mL to 500mL of urine
• Allows for discretionary voiding
79
Urinary Incontinence
• Inability of the body to hold urine
• Treatment will depend on the cause
• Medications tend to increase the contraction of the
urethral sphincter muscle
• Treatment tends to be more successful in patients
with mild to moderate stress incontinence
• Estrogen replacement therapy can be used to
decrease urinary frequency, urgency, and burning in
postmenopausal women
80
Urinary Retention
• Inability to urinate
• Bladder is not able to release the urine even
though the urge may exist
• Treated with insertion of a Foley catheter
• Antibiotics may be used to avoid or treat
urinary tract infection
81
Urinary Tract Infections
• Bacterial infections of the urinary system
• Symptoms include:
– Frequent urge to void
– Burning sensation when voiding
– Cloudy or strong-smelling urine
– Blood in the urine
82
Treating UTIs
• Cranberry juice:
– A substance in cranberry juice keeps infectioncausing bacteria from attaching to the walls of the
urethra
– Also makes the urine more acidic
• Anti-infectives
– Destroy or inhibit bacterial growth
• Phenazopyridine (200 mg tid pc)
– Can be used to manage the symptoms of a
burning and itching urethra
83
Kidney Stones
• Common and painful urinary tract disorder
• Solid mineral deposits accumulate in the
urinary tract
• Treatment is palliative, with pain management
– Oral analgesics for mild to moderate pain may be
used
• Treatment is preventative, with diet
– Mineral and vitamin supplements
– Increased fluid intake
84
Edema and Hypertension
• Consistently elevated blood pressure levels
– Lead to damage of the kidney arteries
• Treatment is with diuretics
– Reduce high blood pressure
85
Diabetes Mellitus
• Can cause diabetic kidney disease (diabetic
nephropathy)
– Leads to end-stage renal disease
• ESRD requires dialysis or a kidney transplant
86
Homeostasis
• Means “balance” or “equilibrium”
• Water follows a high concentration of
minerals and ions
• The kidneys help with homeostasis by
eliminating some ions and returning others to
the blood
• Keeps the blood at a proper pH level
87