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Pharmacology- Exam #4 > UTI's > Flashcards

Flashcards in UTI's Deck (30)
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1

How do elderly patient's commonly present with UTI's?

1. AMS
2. Changes in eating habits
3. GI sx's

2

How do patient's with indwelling catheters or neuro disorders commonly present with UTI's?

1. Flank pain
2. Fever
3. Commonly won't have lower tract sx's

3

What does a Common dipstick test detect?

Presence of nitrites

4

Causes for a false-negative urine dipstick? (common)

1. P.aeruginosa- Do not reduce nitrates
2. Dilute urine
3. Urinary pH
4. Frequent voiding

5

What does leukocyte esterase dipstick test detect?

pyuria

6

What is the most reliable diagnostic method for UTI's?

Urine culture

7

Uncomplicated UTI treatment

1. Trimethoprim-Sulfamethoxazole (Bactrim) x3 days
2. One dose of Fosfomycin
3. Nitrofurantoin x 5 days

8

Complicated or suspected Pyelonephritis treatment

Fluoroquinolones x3 days:
1. Ciprofloxacin
2. Levofloxacin

9

What is TMP-SMX highly effective against?

Most aerobic enteric bacteria

10

What is TMP-SMX not effective against?

P. aeruginosa

11

TMP-SMX ADEs

1. Rash
2. Steven-Johnson Syndrome
3. Photosensitivity
4. Renal failure
5. Hematologic: Neutropenia, anemia

12

What is the main advantage of Nitrofurantoin

Lack of resistance even after long courses of therapy

13

Nitrofurantoin ADE's

1. GI intolerance
2. Pulmonary rxns
3. Neuropathies

14

Fosfomycin trometamol ADEs

1. Headache
2. Angioedema
3. Diarrhea

15

What are the advantages of Fosfomycin trometamol

1. Single-dose therapy for uncomplicated infections
2. Low levels of resistance

16

Who do you need caution use of Fosfomycin trometamol?

Patients with hepatic dysfunction

17

Fluoroquinolones (Ciprofloxacin and Levofloxacin) ADE's

1. Skin- Hypersensitivity, Photosensitivity
2. GI sx's
3. Neuro-Dizzines, Confusoin
4. Tendonitis-Black Box warning

18

What is the main advantage of Fluoroquinolones?

Greater spectrum of activity= + P. aeruginosa coverage

19

What are Fluoroquinolones effective in treating?

1. Pyelonephritis
2. Prostatitis

20

Who should we avoid treating with Fluoroquinolones?

1. Pregnant women
2. Children

21

What is the preferred treatment for uncomplicated cystitis? Why?

Amoxicillin-Clavulanate (Augmentin)
D/T increasing E. coli resistance

22

Amoxicillin-Clavulanate (Augmentin) ADE's

1. Hypersensitivity: Rash, anaphylaxis
2. Diarrhea
3. Superinfection
4. Seizure

23

Cephalosporins (Cefaclor
Cefpodoxime-proxetil) ADE's

1. Hypersensitivity: Rash, anaphylaxis
2. Diarrhea
3. Superinfection
4. Seizure

24

Disadvantages of Cephalosporins (Cefaclor
Cefpodoxime-proxetil)

1. No major advantage of these over other agents
2. Not active against enterococci

25

Who do need avoid treating with TMP-SMX with?

Avoid in third trimester of pregnancy

26

Lactobacillus possible advantages

Help keep vaginal pH in normal range to regulate genitourinary bacteria and prevent UT's

27

POSSIBLE clinical benefits of cranberry juice

Decreases adherence of bacteria to bladder epithelial cells
Possible clinical benefit in sexually active women w/ recurrent UTI's

28

Main benefit of Phenazopyridine HCL

Urinary anesthetic/analegesic- Helps with dysuria

29

Disadvantage of Phenazopyridine HCL

Mask si/sx's of UTI's NOT responding to abx therapy

30

What is the main SE of Phenazopyridine HCL

Red-orange body fluids, including soft contact lenses