Your patient is scheduled to go to dialysis at 0930 and you are giving their 0900 meds beforehand. Which of the following medications would you need further clarifcation about?

 

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Correct

- 100 mg Metoprolol PO

- Sevelamer 800 mg PO

- 5000 units subcutateous heparin

- docustate sodium 100 mg PO

Rationale

Hypotension is a concern with hemodialysis, therefore administering a large dose of an antihypertensive just before dialysis could cause an unsafe drop in BP and/or prevent them from removing as much fluid as planned. Phosphate binders (Sevelamer), stool softeners (docusate sodium), and a subcut heparin for DVT prophylaxis are all appropriate orders.

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