Ch. 34 - Drugs of Urinary Tract Disorder

Question 1

Urinary Tract Disorders (1):

Answer 1

Urinary tract infections (UTI):

–> Most common causative organism = Escherichia coli (E. coli)

Question 2

Urinary Tract Disorders (2):

Answer 2

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

Question 3

Urinary Antiseptics/Antiinfectives:

Answer 3

Bacteriostatic effect:

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

Question 4

Urinary Antiseptics/Antiinfectives (1):

Answer 4

Bactericidal effect:

• Higher dosages
• For systemic infections

Question 5

Urinary Antiseptics/Antiinfectives (2):

Answer 5

Urine pH

Question 6

Common Agents for Tx UTIs (1):

Answer 6

Urinary antiinfectives:
-nitrofurantoin (Furadantin, Macrodantin)

Sulfonamides:

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

Question 7

Common Agents for Tx UTIs (2):

Answer 7

Fluoroquinolones:

• nalidixic acid (NegGram)
• ciprofloxacin (Cipro)

Penicillins:
-amoxicillin/clavulanic acid (Augmentin)

Question 8

Common Agents for Tx UTIs cont…

Answer 8

Third-generation cephalosporins:

-cefixime (Maxipime)

Question 9

Treatment:

Answer 9

One double-strength dose of a specific drug

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

Severe UTIs:
IV –> oral

Question 10

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

Answer 10

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

Question 11

nitrofurantoin (Furadantin, Macrodantin) (2):

Answer 11

Tx:
-Acute & chronic UTIs

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

Take with food

Question 12

nitrofurantoin (Furadantin, Macrodantin) Side Effects:

Answer 12

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

Question 13

Adverse Reactions:

Answer 13

Peripheral neuropathy:

-May be irreversible

Question 14

Nursing - Assessment:

Answer 14

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

Question 15

Monitor:

Answer 15

Urinary output & specific urine gravity

Side effects / adverse reactions

Urine culture prior to initiating drug therapy

Question 16

Teach:

Answer 16

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

Question 17

Urinary Analgesics:

Answer 17

phenazopyridine HCl (Pyridium):

1. ) Relieves symptoms
2. ) Does not tx cause
3. ) Can take w/ antibiotic/antiinfective

Question 18

phenazopyridine HCl (Pyridium): 
Side Effects:

Answer 18

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

Question 19

Urinary Stimulants (1):

Answer 19

1. ) Increase muscle tone of urinary muscles

2. ) For hypotonic or atonic bladder

Question 20

Urinary Stimulants (2):

Answer 20

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

Question 21

Urinary Stimulants (3):

Answer 21

Parasympathomimetic:

-Stimulates micturation

Question 22

bethanechol (Urecholine):

Answer 22

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

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

Question 23

Urinary Antispasmodics/Antimuscarinics:

Answer 23

Antispasmodics:

• flavoxate HCl (Urispas)
• oxybutynin (Ditropan)

Question 24

Antispasmodics:

Answer 24

Direct action on smooth muscles of the urinary tract

Contraindicated:

• Urinary or GI obstruction
• Glaucoma

Question 25

Antispasmodics - Side Effects:

Answer 25

Anticholinergic effects =

1. ) May increase intraoccular pressure
2. ) Dry mouth
3. ) Constipation
4. ) Urinary retention

Question 26

Antimuscarinic/anticholinergic:

Answer 26

tolterodine tartrate (Detrol):

- Overactive bladder
- Decreases urge urinary incontinence

Same SE as antispasmodics

Question 27

Teach (Antispasmodics/Antimuscarinics):

Answer 27

Report:

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