urinary tract infection Flashcards
3 defense mechs for UTI
- urethra itself
- constant flushing of urine
- urethral valves
purpose of urethral valves
Ensures urine flows in 1 direction
2 lower UTI infections
cystitis and urethritis
Difference between cystitis and urethritis
cystitis is the infection of bladder
urethritis is the infection of urethra
Why are UTIs more common in females than males?
The urethra is a defense mech, and females have a shorter urethra than males
Sx of a cystitis UTI (6)
- burning on urination
- frequent desire to urinate
- cloudy/bloody urine
- urine smells like ammonia
- lower abdominal pain/pressure
- fever (rare)
Which diabetic meds class can cause UTI and how?
SGLT2 inhibitors - bc it can cause glucose to spill over into urine
Some factors contributing to UTIs (9)
- bacteria coming from outside to inside from poor hygiene
- wiping back to front
- sexual activity
- contraceptives
- anything foreign in vagina
- disease states (menopause, use of SGLT2 inhibitors)
- prostate problems
- pregnancy
- anything sitting in the way of urine flowing from kidney to ureter into bladder (e.g. kidney stones)
name of upper UTI condition?
Pyelonephritis
Define pyelonephritis
Infection of kidney from poorly treated lower UTI or premature valves where urine reflexes up urinary tract
Sx of pyelonephritis
- nausea, vomiting
- flank/abdominal pain
- burning on urination
2 ways to diagnose UTIs
- mid-stream urine sample/dip stick measurements
- urinalysis
How to perform mid-stream urine sample
Catch mid-stream of urine, so epithelial cells come out first and we don’t want that
What to look for in a mid-stream urine sample
Cloudy urine and smell
First-line tx for UTIs
Trimethoprim
When is the best time to take trimethoprim and why?
Night, because you’re not going to the bathroom and flushing out the urine with the drug, allowing it to have more time for contact with bladder
3 first line drugs taken for UTIs for non preg women, in order from first-line to third-line
- Trimethoprim
- Nitrofurantoin
- Cefalexin
2nd line drugs for acute cystitis in non-preg women (3)
- amoxicillin
- amox + clavulaunic acid
- trim + sulfamethoxazole
3rd line drugs for non-preg women (3)
- fosfomycin
- norfloxacin
- ciprofloxacin
Drug to use in mild-mod acute pyelonephritis
Amox+clavulaunic acid or ciprofloxacin if allergic to penicillin
What to do during severe pyelonephritis
go hospital for IV antibiotics and po antibiotics
Why does it burn when urinating during UTI?
Because the urethra and bladder is inflamed, so when urine (which is acidic) touches it, its painful
Drug class of Ural?
Urinary alkalinisers
2 drug-drug interactions with ural and what it does
- nitrofurantoin - this drug needs an acidic environment to work
- ciprofloxacin - forms crystals in basic urine and peeing crystals = more pain
