Dialysis and medication administration

[mercyrn02]

I am a tele RN and frequently work with pts. on hemodialysis. Usually my pts. have a boatload of meds especially antihypertensives, nephrocaps, renagel,etc.

I have been a nurse for 1.5 years and have asked everyone I know ,which meds should not be given before dialysis and I always get varied ,if any, answers. I am very concerned and do not want to make any mistakes, I have even surfed the web trying to find the answer but have not come up with anything are there any guidelines for this. My current practice is to give or hold antihypertensives before dialysis based on the bp. help!

[Valerie Salva, BSN, RN]

Most HD pts should have all BP meds held before dialysis- not because they will dialyze out but because they will cause the pt's BP to be too low to accomodate sufficient fluid removal during dilalysis. There are exceptions, though.

[workingmomRN]

I agree with Valerie Salva's post about bp meds. I have never heard anything regarding diuretics being taken pre or post treatment. Renal vitamins & most oral antibiotics should be taken after dialysis.