Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Renal Week 3 > Drugs for Infections of the Urinary Tract > Flashcards

Drugs for Infections of the Urinary Tract Flashcards

1
Q

How common is UTI recurrence?

A

30-44% of women will have a second UTI within six months of an initial infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the most common causative bugs of uncomplicated UTIs?

A
  • UPEC
  • K. pneumoniae
  • S. saprophyticus

These originate in the patients GI or, in the case of Staph. saprophytic, are transmitted during sexual activity

No need to culture here, only in complicated (typically intercourse causes uncomplicated cystitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What patient population is most at risk for uncomplicated UTI?

A
  • women
  • children
  • elderly

all healthy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the most common causative bugs of complicated UTIs?

A
  • UPEC
  • Enterococcus
  • K. pneumoniae

Need to culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What patient population is most at risk for complicated UTI?

A

those:

  • with catheters
  • on immunosuppression
  • with urinary tract abnormalities
  • with antibiotic exposure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How can bacteremia occur from periurethreal infection?

A

If a pathogen is able to ascend the ureters and evade host immune systems, it can potential cross the tubular epithelial barrier in the kidneys to progress to bacteremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

T or F. The bladder must be compromised in order for urethral bacteria to colonize and cause infection in the bladder

A

T. The most common cause of a compromised bladder is catheterization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does the body respond to UT infection?

A

epithelial cells contain sentinel mast cells and macrophages that function to attract macrophages and neutrophils to the infected area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How is the immune response in the bladder different from other organs?

A

The bladder is containing toxic excretory products and, as such, functions primarily to maintain the integrity of its physical barrier even in the face of infection. Thus, the bladder is more cautious in how intense of an immune response it will mount since an intense one will promote inflammation and loss of epithelial integrity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How can the bladder maintain its physical integrity?

A

the superficial epithelial surface can be sloughed and the immune response can be attenuated quickly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why is neurogenic bladder (NGB) so infection promoting?

A

bladder voiding eliminates almost 99.9% of bacteria and so incomplete /infrequent voiding promotes bacterial colonization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a major management strategy for patients with NGB?

A

clean intermittent catheterization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the DOC for non-pregnant acute uncomplicated cystitis?

A
  • SMX-TMP
  • Nitrofurantoin
  • single dose Fosfomycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the DOC for non-pregnant acute uncomplicated pyelonephritis?

A
  • Ciprofloxacin
  • Levofloxacin
  • SMX-TMP
  • IV Ceftriaxone followed by 7-14 d PO antibiotic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the DOC for complicated UTIs in outpatients?

A
  • Ciprofloxacin or Levofloxacin
  • SMX-TMP
  • Amoxicillin-Clavulanate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the DOC for complicated UTIs in hospitalized patients?

A
  • Cefepime
  • Ceftriaxone
  • Levofloxacin
  • Ticaracillin-Clavulanate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the DOC for acute prostatitis?

A

Cipro/Levo

-SMX-TMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the DOC for severe prostatitis?

A

give IV treatment

Flouroquinolone
Ceftriaxone or Ceftazidime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the DOC for recurrent UTIs?

A
  • Nitrofurantoin

- SMX-TMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the DOC for Candiduria?

A

PO Fluconazole

PO Flucytosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the MOA of SMX-TMP?

A

synergistic sequential inhibition of enzymes involved in bacterial synthesis of tetrahydrofolic acid (avoid in patients with folate deficiency)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How is SMX-TMP given?

A

PO or IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Adverse effects of SMX-TMP?

A

GI, N/V, rash, pruritis

blood dyscrasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is seen upon administration of SMX-TMP to someone with G6-PD deficiency?

A

dose-related hemolysis (same with nitrofurantoin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Can SMX-TMP be given in pregnancy?
typically only in 2nd-trimester
26
Why cant SMX-TMP be given in the 1st trimester?
effects on folic acid
27
Why cant SMX-TMP be given in the 3rd trimester?
it increases free bilirubin levels which increases risk of neonatal kemicterus (brain damage)
28
Can SMX-TMp be given to a breast-feeding mother?
Yes
29
How does nitrofurantoin work?
metabolically activated by bacterial flavoproteins to reactive intermediates that inactivate or alter bacterial ribosomal proteins
30
What are the AEs of nitrofurantoin?
- inappetence - N/V - brown urine - blood dyscrasia
31
Can nitrofurantoin be given in pregnancy and with breastfeeding?
Yes
32
How long is nitrofurantoin given for?
5 days PO
33
What is the MOA of Fosfomycin?
single dose PO-antimetabolite inhibitor of bacterial cytosolic enolpyruate transferase which blocks N-acetylmuramic acid production
34
T or F. Resistance to Fosfomycin develops quickly
T. via mutations in drug target proteins and decreased active uptake transporter activity
35
What are some AEs of fosfomycin?
- GI pain, headache, rash - peripheral neuropathy - renal, hepatic, and pulmonary toxicity
36
Can fosfomycin be given in pregnancy and with breastfeeding?
only in pregnancy, not in breastfeeding
37
What are the quinolone drugs?
Ciprofloxacin and Levofloxacin (and others)
38
What is the MOA of the quinolones?
block bacterial topoisomerase (DNA gyrase)
39
What are the AEs of the quinolones?
mild anorexia, N/V, abdominal discomfort tendonitis, tendon rupture, and chondrogenesis
40
When can quinolone not be given?
children and pregnancy (but can give in breastfeeding)
41
What is a potential cardiac interaction of quinolone?
can see increased QT intervals with cipro but not likely with levo
42
How long is cipro given for? Levo
Cipro- 7 days | Levo- 5 days
43
How does ceftriaxone work?
binds to PBPs, inhibiting bacterial wall synthesis
44
AEs of ceftriaxone?
- injection site (given single dose IV) - upset GI - blood dyscrasia - anaphylaxis - SJS and renal failure
45
Can ceftriaxone be given in pregnancy and with breastfeeding?
yes, both
46
T or F. Amoxicillin is susceptible to beta-lactamases
T.
47
As of amoxicillin?
- rash and upset GI - anaphylaxis - hepatotoxicity - SJS
48
Can amoxicillin be given in pregnancy and with breastfeeding?
Yes, both
49
Are candida species normal gut microflora?
Yes, isolated from the GI in 10+-30% of healthy adults they are usually held in check by competing microbial populations
50
What can cause candida species to proliferate?
occurs commonly in hospital settings followed anti-microbial treatment, especially broad-spectrum anti-biotics
51
What is the MOA for fluconazole?
blocks 14a sterol demethylase disrupting ergosterol synthesis and causing damage to fungal cell membranes
52
As of fluconazole?
headache, N/V, hepatotoxicity
53
Could you use another AZOLE for GU fungal infections?
No, fluconazole is the only one eliminating really
54
Can fluconazole be given in pregnancy and with breastfeeding?
No (although some new evidence says there aren't any negative AEs if given short course in early pregnancy), but can be given with breastfeeding
55
What is the MOA of flucytosine?
converted to 5-FU to inhibit nucleic acid and protein synthesis
56
Does resistance occur with flucytosine?
Yes, very rapidly
57
AEs of flucytosine?
headache, N/V, hallucinations/confusion bone marrow suppression
58
Can flucytosine be given in pregnancy and with breastfeeding?
pregnancy category C; insufficient date on safety in breastfeeding
59
What is AmphoB rarely used for fungal infections of the UT?
because of renal toxicity but may be given intravesically via a catheter
60
How can you prevent recurrent UTIs?
- urinate before and after sex - dont use spermicides - take cranberry if pre-menopausal - use prescription vaginal estrogen cream if post-menopausal -antibiotic prophylaxis
61
T or F. There is evidence suggesting that post-coital prophylaxis to UTI is just as effective as pre-coital
T. Take within 2-3 hrs
62
What does lactobacilli do?
it can interfere with adherence, growth and colonization of uropathogenic bacteria NOTE: After menopause, only 20-30% of women have lactobacilli in the vagina
63
What part of cranberry juice is anti-bacterial?
the proanthrocyanidin component

Renal Week 3 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions