Pharmacology For UTI's And Renal System Infections Flashcards Preview

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Flashcards in Pharmacology For UTI's And Renal System Infections Deck (10)
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1

Common UTI infection classifications

Urethritis
- infection/inflammation of the urethra

Cystits
- lower UTI (bladder and lower ureter)

Pyelonephritis
- upper UTI (kidney itself)

Prostatitis
- infection of the prostate

Symptomatic abacteria
- UTI symptoms without bacteria in urine or ability to culture bacteria

Asymptomatic bacteriuria
- presence of bacteria in urine without any symptoms

2

What are the factors used to determine treatment of UTIs

Severity of symptoms

Causative agents/organisms

Antibiotic susceptibility

Location and classification of the infection

3

Complicated vs uncomplicated UTIs

Uncomplicated
- acute UTI in an otherwise healthy person
- there is no functional or structural abnormalities of the urinary tract
- no comorbidities, no pregnancy, premenopausal, not preadolescent], non immunocompromised
- no history of childhood UTIs

Complicated
- acute UTI in the presence of either a structural abnormality and/or comorbidity
- very common in males, but females can also get it
- every UTI is considered this if it is not uncomplicated

4

Recurrent vs reinfection vs relapse infection

Recurrent = two or more UTIs in a 6 month time frame (or 3+ within 1 year)

Reinfection = infection with a different organism

Relapse = infection with the same organism, refractory to treatment
- common in upper UTIs or resistant strains

5

Effective UTI treatment requires what factors to be taken into account?

Must use agents that can accumulate in the urine
- just because it has serum concentration does not always mean it will accumulate in urine

Agent must be excreted in the kidney (not the liver or GI tract)

Less severe infections = oral
Severe infections = parenteral

6

Most common causative organisms for UTIs

E-coli = by far #1 (75-90% cases)

Others:
- staphylococcus saprophyticus
- klebsiella
- proteus (usually uncomplicated)
- pseudomonas (usually complicated
- enterococcus species
- serratia marcans

7

What is the most common medications for uncomplicated UTIs

TMP-SMX is #1
- cant give in sulfa allergies though

Urinary antiseptics are #2
- Fosfomycin
- nitrofurantoin
- methenamine
- quinolones

8

What are common non-pharmacological treatments for prophylaxis against UTIs?

1) Lactobacillus probiotics
- competitively competes with E.coli and does minimal damage to normal gut flora

2) cranberry juice
- thought to reduce adherence of bacteria in urinary tract (not much evidence though)

3) increase fluid intake = reduces time for bacteria to build up residence in Urinary tract (you have to pee a lot)
- **caveat is that diuretic treatments actually increase UTI risk since it decreases urines acidity overall

9

what is the one bacteria that is highly resistant to TMP-SMX?

P. Aeruginosa

10

What UTI pathogen is cephalosporins not functional against?

Enterococci species

**note P. Aeruginosa is only affected by ceftazidime and cefepime**