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Pharm I ( Melicia) > Urinary Tract Infections > Flashcards

Urinary Tract Infections Flashcards

1
Q

What are the sxs of a lower UTI? upper UTI?

A

Dysuria, urgency, frequency, nocturia, and suprapubic heaviness

flank pain, fever, N/V, malaise

either can have gross hematuria

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2
Q

PE finding in upper UTI?

A

CVA tenderness

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3
Q

UTI lab findings?

A

pyuria (leukocytosis)

nitrite positive urine

leukocyte esterase positive urine

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4
Q

Presenting sxs for elderly pt with UTI?

A

freq. NO urinary sxs

AMS, change in eating habits, GI sxs

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5
Q

presenting sxs for UTI in patient with indwelling catheters or neuro disorders?

A

flank pain, fever

commonly will not have lower tract sxs

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6
Q

What types of tests can you use to check for a UTI

A

common dipstick- checks for nitrites

leukocyte esterase dipstick

urine culture - most reliable!

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7
Q

What can give you a false (-) for UTI on urine dipstick?

A

gram + organisms that do not reduce nitrate

low urine PH

freq voiding

dilute urine

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8
Q

What are the goals of UTI tx?

A
  • get rid of invading organism
  • prevent/tx systemic consequences of infx
  • prevent recurrence
  • decrease potential for damage with too broad of abx therapy
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9
Q

Most uncomplicated UTIs are caused by…

A

e. coli (75-95%)

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10
Q

Besides e coli, what other organisms can cause UTI?

A

Staphylococcus saprophyticus

Klebsiella pneumoniae

Proteus spp.

Pseudomonas aeruginosa

Enterococcus spp.

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11
Q

What can cause complicated UTIs?

A

gram (-) organisms

enterococcus faecalis

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12
Q

Tx for uncomplicated UTIs?

A

Trimethoprim-sulfamethoxazole (Bactrim) x3 days

or

Fosfomycin x 1 dose

or

Nitrofurantoin x 5 days

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13
Q

Fluroquinolones should be reserved for….. examples?

A

pyelonephritis or complicated infx

Ciprofloxacin
Levofloxacin
both x 3 d

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14
Q

ADEs of trimethoprim-sulfamethoxazole?

A

Rash, Stevens–Johnson Syndrome, renal failure, photosensitivity, hematologic (neutropenia, anemia, etc.)

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15
Q

What should you monitor on patient taking trimethoprim-sulfamethoxazole?

A

Serum creatinine, BUN, electrolytes, signs of rash, and CBC

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16
Q

trimethoprim-sulfamethoxazole works well for most aerobic enteric bacteria except…

A

p. aeruginosa

17
Q

ADEs of Nitrofuratoin?

A

GI intolerance, neuropathies, and pulmonary reactions

18
Q

main advantage of Nitrofurantoin?

A

lack of resistance even after long courses of therapy

19
Q

ADEs of Fosfomycin trometamol?

A

diarrhea, HA, angioedema

20
Q

ADEs of Fluroquinolones: ciprofloxacin/levofloxacin?

A

Hypersensitivity, photosensitivity, GI symptoms, dizziness, confusion, and tendonitis (black box warning)

21
Q

When should you avoid fluroquinolones?

A

pregnancy and children

22
Q

What is the preferred penicillin for uncomplicated cystitis?

A

amoxicillin-clavulanate

23
Q

When should you avoid trimethoprim-sulfamethoxazole?

A

during 3rd trimester of pregnancy

24
Q

What pathogens cause prostatitis?

A

E. coli
K. pneumoniae
Proteus spp.
P. aeruginosa

25
Q

Tx for prostatitis?

A

Trimethoprim–sulfamethoxazole × 4-6wks

Quinolone × 4-6 wks

26
Q

Presentation of stevens-Johnson syndrome?

A

begins with flu sxs

facial/tongue swelling, hives, skin pain

red/purple skin rash that spreads within hrs to days, blisters on skin, mm, eyes, nose, genitals

shedding of your skin

27
Q

role of cranberry juice in UTIs?

A

lactobacillus potentially helps keep vag PH norm

possible benefits in sexually active adult women with recurrent UTIs by decreasing adherence of bacteria to bladder epithelial cells

28
Q

What is Phenazopyridine HCL

A

urinary anesthetic/analgesic

Azo dye, no antimicrobial properties

brand: Pyridium, Uristat, Azo-standard

29
Q

Potential consequence to using Phenazopyridine HCL?

A

may mask s/s of UTI not responding to antimicrobial therapy

30
Q

ADEs of Phenazopyridine HC

A

red-orange discoloration of body fluids

rash, anaphylaxis, rare hemolytic anemia, methemoglobinemia, acute renal failure

31
Q

When should you tx for UTI in pregnancy? What can you use?

A

if pt has significant bacteriuria, regardless of sxs

7 day course of one:
Cephalexin
Amoxicillin
Amoxicillin/clavulanate

Pharm I ( Melicia) (18 decks)

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