Now, nephrotoxicity. Hey, there's our signal again. The 60 second overview.
Look at the bold there: antibiotics, ACE inhibitors, NSAIDs,
radiocontrast media, lithium salts and chemotherapy.
Okay, that would be the first pass through that you would take a look at that.
So, we got the names listed for you there,
but you're gonna have to come back and really review this.
You make sure that you have those names rock solid.
Now, how will I evaluate kidney function?
Take a look at this, you're learning way more than just pharmacology here.
We're gonna teach you how to keep patients safe in different body systems.
So, you know whether you're in a patho question,
whether you're in a physiological adaptation question,
whatever you're in, you need to know how to evaluate kidneys.
So, watch down there, it says "watch for".
You see that red box, that's another clue to you.
We're gonna be looking for elevated serum creatinine.
That's a sign that the kidneys are struggling.
Elevated BUN, that's a sign that kidneys are struggling.
So, you've got the normal levels there for you.
And you're welcome. Just kidding.
I know it's so frustrating in nursing school because every text book, every class,
and sometimes, it felts like every faculty looks at a different range as being normal.
Okay, that's true. So, you gotta Elsa that, you know what the means? Let it go.
I've put a nice general range in here
but if you already have a very specific one memorized, go with that.
Because it's hard to relearn simple numbers like that.
But I also wanna give you a heads up for practice.
When you are in practice, every laboratory has different exact results.
Now, they'll post them with your patients results,
but keep that mind, whatever you're looking in evaluating lab work,
you need to know what that particular lab sees as normal.
So, I've put some ranges up there.
If you don't have these memorized yet, make sure you come back and do that.
If you do, and your memorized values are a little different, run with it.
You just stick with that.
In fact, you can even write them in if it's a little different just to remind yourself,
this is the one my brain is going to remember.
Okay. So far, we've looked at bad for ears, ototoxicity; bad for kidneys, nephrotoxicity.
So, make sure you have these, that you're looking at.
I just wanna say one thing about the middle column. Okay, I lied.
I wanna say a couple things about the middle column.
NSAIDs, are particularly challenging for the elderly
because they take a lot of them and their kidneys really can suffer.
So, you know for any patient that's had some renal problems in the past,
and these medications, bad combo.
But really, write yourself a note about NSAIDs and the elderly,
and then radiocontrast media for any patient who's on metformin.
Very common oral medication for type II diabetics.
So, if they're gonna take radiocontrast media, they need a two-day window before
and after they receive the metformin.
So, they have to stop it two days before they get the media
and then they can't start taking it again for an additional two days after they've received it.
So, keep those things in mind.
Also, look for drugs that are bad for multiple organs.
I think you've seen one already.
Based on ototoxicity and nephrotoxicity,
which drug name have you seen come up on both lists?
Yeah, I'm not gonna tell you.
It's your job to make sure you look back at that
because your brain will remember much more effectively
if you've done the work of sorting through that.