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Pharmacology (Dale Turley) > GU and Mens Health pt.2 > Flashcards

GU and Mens Health pt.2 Flashcards

1
Q

Causes of Epididymitis, Orchitis, Prostatitis and Urethritis?

A

Mostly bacterial

Viral and fungal possible

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2
Q

Urinalysis usually provides answers like?

A

C&S takes time (24 - 48 hours)

Empirical treatment based o H&P

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3
Q

Orchitis follows ________.

A

epididymitis

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4
Q

Epididymitis and Orchitis mostly in men how old?

A

Men 14 to 35 years old

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5
Q

Epididymitis and Orchitis common pathogens?

A

Neisseria Gonorrhoeae and

Chlamydia trachomatis

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6
Q

Epididymitis and Orchitis: older and younger pathogen?

A

e. coli

especially catheter patients

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7
Q

Obtain culture and sensitivity with ?

A

urethral swab

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8
Q

Epididymitis and Orchitis tx?

Suspected GC or Chlamydia infections

A

Rocephin 250 mg IM single dose and
azithromycin (Zithromax) 1 gram PO

or

Doxycycline (Vibramycin) 100 mg twice daily for 10 days
outpatient

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9
Q

If enteric infection suspected? what pathogens?

A

Escherichia coli

Klebsiella spp.

Enterobacter spp

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10
Q

If enteric infection suspected

what is tx?

A

fluoroquinolones

ofloxacin 300 mg by mouth twice a day for 10 days or

levofloxacin 500 mg by mouth once daily for 10 days

resistance is a big problem with these drugs

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11
Q

Urinary Tract Infections specimens ?

A

Voided clean catch specimens

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12
Q

When it affects the lower urinary tract it is known as a____________.

A

bladder infection(cystitis)

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13
Q

When it affects the upper urinary tract it is known as____________.

A

kidney infection (pyelonephritis)

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14
Q

Symptoms from a lower urinary tract infection

A

pain withurination (dysuria) - H ion on tip of urethra

frequent urination

feeling the need to urinate despite having an empty bladder (urgency)

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15
Q

Symptoms of a kidney infection?

A

feverandflank pain(CVA tenderness) usually in addition to the symptoms of a lower UTI.

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16
Q

Urinary Tract Infections

most common cause of infection is ?

A

Escherichia coli (E-coli)

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17
Q

risk factors for UTI?

A

female anatomy - less complete emptying

sexual intercourse

Incomplete emptying / lack urination

Obesity

catheter

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18
Q

Although sexual intercourse is a risk factor, UTIs are not classified as_______.

A

sexually transmitted infections(STIs)

**STI’s can mimic UTI’s sometimes so be careful **

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19
Q

Kidney infection usually follows a bladder infection but may also result from a__________,

A

bacteremia blood infection

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20
Q

UTI tx?

A

UTIs are treated with a short course ofAbx

21
Q

UTI ABS?

A

Nitrofurontin

TMP/SMZ

Cephalexin

Resistance high to many of the antibiotics used i.e. Ciprofloxacin

22
Q

complicated cases of UTI tx?

A

longer course orIVantibiotics

Phenazopyridine (Pyridium) may help with symptoms

GIVES SOME RELIEF with uncomplicated UTI until C&S comes back

23
Q

Pyelonephritis Tx?

A

Ceftriaxone

24
Q

Pyelonephritis facts?

A

Out patient longer therapy

Bacteriogram (local resistance patterns)

Urine cultures for complicated, recurrent or bacteremia

dirty urine with stone - treat them aggressively cause it can back up and kill the kidney , dont get lost in a fever, sometimes the fever means nothing when it comes to kidney

25
Q

Ceftriaxone (Rocephin) class?

A

Cephalosporin, 3rd generation

**can use even if PCN allergy cause extremely low cross over **

26
Q

Ceftriaxone (Rocephin)

MOA?

A

bactericidal; inhibits cell wall mucopeptide synthesis

27
Q

azithromycin (Zithromax)

class?

A

Macrolides

28
Q

azithromycin (Zithromax)

MOA?

A

binds to 50S ribosomal subunit, inhibiting protein synthesis

29
Q

azithromycin (Zithromax)

adverse rxn?

A

Caution QT-prolongation

30
Q

doxycycline (Vibramycin)

class?

A

Tetracyclines

31
Q

doxycycline (Vibramycin)

MOA?

A

Mechanism of Action
bacteriostatic; binds to 30S and possibly 50S ribosomal subunit(s), inhibiting protein synthesis

32
Q

doxycycline (Vibramycin)

adverse rxn?

A

Doxycycline can cause permanent yellowing or graying of the teeth in children younger than 8 years old.

33
Q

Levofloxacin (Levaquin)

class?

A

Fluoroquinolones

34
Q

Levofloxacin (Levaquin)

MOA?

A

bactericidal; inhibits DNA gyrase and topoisomerase

35
Q

Levofloxacin (Levaquin)

BBW?

A

Tendinitis/Tendon Rupture assoc. w/ incr. tendinitis/tendon rupture risk in all ages; risk further incr. in older pts >60 yo,

Avoid in Myasthenia Gravis fluoroquinolones may exacerbate muscle weakness in pts w/ myasthenia gravi

36
Q

Acute prostatitis generally caused by the same organisms that cause ?

A

UTI

37
Q

Most commonly gram-negative bacteria, especially ?

A

Enterobacteriaceae (typically Escherichia coli or Proteus species).

38
Q

Sexually transmitted pathogens, such as ___________ and _______________, are possible etiologies in sexually active men, who may have concomitant urethritis or epididymitis

A

Neisseria gonorrhoeae

Chlamydia trachomatis

39
Q

Patients with acute bacterial prostatitis are typically acutely ___.

A

ill

40
Q

A urine Gram stain and culture should be obtained in all men suspected of _____________ to identify the bacterial etiology

A

having acute prostatitis

41
Q

Prostatitis then think?

A

Think HIV, immunocompromised

especially in young man with prostatitis

42
Q

Prostatitis tx?

A

Treatment with trimethoprim-sulfamethoxazole (Bactrim) or a fluoroquinolone (Levaquin), unless drug resistance is suspected.

Longer treatment 4 to 12 weeks

43
Q

Prostatitis IV ampicillin therapy if?

A

sepsis or co-morbidities

44
Q

trimethoprim/ sulfamethoxazole (Bactrim)

class?

A

Sulfonamides

45
Q

trimethoprim/ sulfamethoxazole (Bactrim)

MOA?

A

Selectively inhibits dihydrofolate reductase (folate antagonist) and sulfamethoxazole competes with para-aminobenzoic acid (PABA), inhibiting folic acid synthesis

46
Q

trimethoprim/ sulfamethoxazole (Bactrim)

caution if ?

A

Sulfur allergy

methemoglobinemia

photosensitivity

47
Q

ampicillin/ sulbactam (Unasyn) class?

A

Penicillins

IV therapy

48
Q

ampicillin/ sulbactam (Unasyn) MOA?

A

bactericidal; inhibits cell wall mucopeptide synthesis / inhibits beta-lactamases

49
Q

ampicillin/ sulbactam (Unasyn) caution / interaction?

A

alters GI flora

bactericidal activity requires bacterial growth

lowers seizure threshold

Pharmacology (Dale Turley) (31 decks)

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