contraindications in hemodialysis patient

[game over]

are the following meds contraindicated for a patient who is being dialyzed 3x/week?

1. TUMS every 4 hours prn?

2. Kaopectate 30 cc prn, not to exceed 5 doses in 24 hours?

for dietary restrictions, is milk contraindicated?

Thank you very much.

[Allaroundnurse]

are the following meds contraindicated for a patient who is being dialyzed 3x/week?

1. TUMS every 4 hours prn?

2. Kaopectate 30 cc prn, not to exceed 5 doses in 24 hours?

for dietary restrictions, is milk contraindicated?

Thank you very much.

Tums can be used as a binder, it binds with phosphorus to be gotten rid of in the stool, if it is being used as a binder it is not PRN, it is with meals, if you give it at any other time it does not act as a binder and will increase calcium levels. You don't mention what the patients calcium level is but: if it is low they may be using it to raise the level so, if given with meals it will act as a binder and will not raise calcium. It is better to give it between meals or at bedtime if you are trying to raise the calcium level. This is not the norm for dialysis patients but it can happen.

Milk is OK but there is a limit of usually 1/2 glass a day, again it will depend on the calcium levels. The unit that the patient dialyzes at will have the labs. They are usually drawn at the least every month but can be every week so give them a call. http://www.davita.com is a great resouce tool to get current information regarding chronic kidney disease and end stage renal disease.

[chedrn]

[FROM MY EXPERIENCE, THESE MEDS ARE FREQUENTLY RX'D THIS WAY( FOR HD PATIENTS)MILK IS CONTRAINDICATED DUE TO HIGH PO4 CONTENT. :)

QUOTE=game over]are the following meds contraindicated for a patient who is being dialyzed 3x/week?

1. TUMS every 4 hours prn?

2. Kaopectate 30 cc prn, not to exceed 5 doses in 24 hours?

for dietary restrictions, is milk contraindicated?

Thank you very much.

[wmarat, BSN, RN]

Hi!

Tumps is used as PO4 binder and as a Ca suppliment, up to 9 tabs daily.

Kaopectate is not used in Israel, we would rather loperamide.

Milk is not contrindicated, but limited to 1 glass daily

[jnette, ASN, EMT-I]

Agree with the first response.

Tums are USUALLY prescribed as a phosphate binder and are to be taken directly WITH meals.. not in between. Many docs are leaning twd. Phoslo or Renagel instead of Tums, however.

I have not known too many dialysis pts. to have low ca+ levels in my experience (not to say it can't happen), but have had quite a few whose ca+ is elevated.

And yes, limit milk/dairy items as they contain phosphorus.