Ch. 34 - Drugs of Urinary Tract Disorder Flashcards Preview

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Flashcards in Ch. 34 - Drugs of Urinary Tract Disorder Deck (27):
1

Urinary Tract Disorders (1):

Urinary tract infections (UTI):
--> Most common causative organism = Escherichia coli (E. coli)

2

Urinary Tract Disorders (2):

Upper UTIs: Lower UTIs:
Pyelonephritis (kidney) Cystitis
Urethritis
Prostatitis

3

Urinary Antiseptics/Antiinfectives:

Bacteriostatic effect:
1.) Lower dosages
2.) Prevents bacterial growth in kidneys & bladders
3.) Not for systemic infections

4

Urinary Antiseptics/Antiinfectives (1):

Bactericidal effect:
-Higher dosages
-For systemic infections

5

Urinary Antiseptics/Antiinfectives (2):

Urine pH

6

Common Agents for Tx UTIs (1):

Urinary antiinfectives:
-nitrofurantoin (Furadantin, Macrodantin)


Sulfonamides:
-trimethoprim-sulfamethoxazole (Bactrim/Septra)
-Beware of allergy to sulfa!

7

Common Agents for Tx UTIs (2):

Fluoroquinolones:
-nalidixic acid (NegGram)
-ciprofloxacin (Cipro)

Penicillins:
-amoxicillin/clavulanic acid (Augmentin)

8

Common Agents for Tx UTIs cont...

Third-generation cephalosporins:
-cefixime (Maxipime)

9

Treatment:

One double-strength dose of a specific drug

-Short-term 3-day course
-7-14 days of drug

Severe UTIs:
IV --> oral

10

nitrofurantoin (UTI)(Furadantin, Macrodantin) (1) :

-Urinary antiinfective
-Bacteriostatic or bactericidal
-(E. coli)

11

nitrofurantoin (Furadantin, Macrodantin) (2):

Tx:
-Acute & chronic UTIs

Po:
-50-100mg qid w/ meals & HS

Take with food

12

nitrofurantoin (Furadantin, Macrodantin) Side Effects:

1.) Anorexia, n/v
2.) Rust/brown discoloration of urine
3.) Diarrhea
4.) Rash, pruritis

13

Adverse Reactions:

Peripheral neuropathy:
-May be irreversible

14

Nursing - Assessment:

S/S of UTI:
(frequency, urgency, burning)
-Urine culture & sensitivity (C&S)
-Renal/hepatic function

15

Monitor:

Urinary output & specific urine gravity

Side effects / adverse reactions

Urine culture prior to initiating drug therapy

16

Teach:

1.) Do not crush tablets
2.) Rinse mouth well (may stain teeth)
3.) Avoid antacids (disrupt absorp of drug)
4.) Urine may turn brown
5.) Report signs of secondary infection

17

Urinary Analgesics:

phenazopyridine HCl (Pyridium):
1.) Relieves symptoms
2.) Does not tx cause
3.) Can take w/ antibiotic/antiinfective

18

phenazopyridine HCl (Pyridium):
Side Effects:

1.) GI disturbances
2.) Nephrotoxicity, hepatotoxicity
3.) Urine turns reddish-orange
4.) Can alter urine glucose test

19

Urinary Stimulants (1):

1.) Increase muscle tone of urinary muscles
2.) For hypotonic or atonic bladder

20

Urinary Stimulants (2):

3.) Bladder function may be decreased d/t:
-Neurogenic bladder
-Spinal cord injury
-Severe head injury

21

Urinary Stimulants (3):

Parasympathomimetic:
-Stimulates micturation

22

bethanechol (Urecholine):

1.) Drug of choice
2.) Direct-acting parasympathomimetic

3.) Increases bladder tone = produces contraction strong enough to STIMULATE URINATION

23

Urinary Antispasmodics/Antimuscarinics:

Antispasmodics:
-flavoxate HCl (Urispas)
-oxybutynin (Ditropan)

24

Antispasmodics:

Direct action on smooth muscles of the urinary tract

Contraindicated:
-Urinary or GI obstruction
-Glaucoma

25

Antispasmodics - Side Effects:

Anticholinergic effects =
1.) May increase intraoccular pressure
2.) Dry mouth
3.) Constipation
4.) Urinary retention

26

Antimuscarinic/anticholinergic:

tolterodine tartrate (Detrol):
-Overactive bladder
-Decreases urge urinary incontinence

Same SE as antispasmodics

27

Teach (Antispasmodics/Antimuscarinics):

Report:
1.) Urinary retention
2.) Severe dizziness
3.) Blurred vision
4.) Palpitations
5.) Confusion