Urologic Problems and Drugs Flashcards
common urological problems
- uncomplicated UTI
- overactive bladder
- incontinence
UTI
urinary tract infection of the lower urinary tract or bladder
- most common in women due to short urethra, incomplete emptying, irritation
most common bacteria causing UTI
e. coli
bacteriuria
bacteria in the urine that is NOT causing infection
urethritis
infection of the urethra
cystitis
infection of the bladder
s/s of UTI
- asymptomatic
- urgency
- frequency
- dysuria
- hematuria
- cloudy/foul urine
- fever/chills/fatigue
diagnosis of UTI
- H&P
- UA
- urine culture
- CBC
treatment of UTI
- antibiotics
- inc fluids
- avoid irritants
- loose cotton clothes
- frequent urination
- probiotics
protection against UTI
- acidic urine
- presence of urea
- sex specific factors (men have prostatic secretion, women have urethral gland secretions)
- urine flow is unidirectional (one way valve)
- immune system
UTI risk factors
- catheterization
- females (perineal irritation)
- older age
- pregnancy
- sexual activity (spermicide use w diaphragm or condom)
- urinary obstruction or reflux
- immobility
- incontinence
- dec cognition
- bad personal hygiene
- men more likely to have recurrent bc hides deep in prostate
lower UTI clinical manifestations
urethritis: dysuria, asymptomatic
cystitis: frequency, urgency, suprapubic discomfort, dysuria
hematuria possible
atypical UTI symptoms children
- fever
- irritability
- poor feeding
- vomiting
- D
- ill appearance
- understand if they are able to verbalize
atypical UTI symptoms elderly
- anxiety
- confusion
- lethargy
- anorexia
- hx of falling
pharm for lower UTI
- trimethoprim sulfamethoxazole
- ciprofloxacin
- nitrofurantoin
which drug is used for UTI when ppl have sulfa allergies
ciprofloxacin
which drug is used as first line for UTI
trimethoprim-sulfamethoxazole
- no sulfa allergies
which drug is used for recurrent UTIs
nitrofurantoin
urinary tract analgesic
phenazopyridine
phenazopyridine moa
local analgesic action
- a dye used in paint
phenazopyridine se
well tolerated
reddish-orange urine
phenazopyridine therapeutic use
relief of pain due to UTI
manifestations of overactive bladder
sudden urge to urinate
may experience urgency incontinence
inc frequency, usually 8 or more times in 24 hrs
nocturia, wake up more than 2 times in the night
causes of overactive bladder
neurological disorders
DM
UTIs
hormonal changes
tumor/stones
obstructions
mirabegron class
antispasmatic (urinary)
mirabegron moa
selectively stimulates beta-3 adrenergic recepetors relaxing bladder smooth muscles
mirabegron se
- HTN
- urinary retention
- UTI
- headache
mirabegron nc
contraindicated for ppl with HTN
urinary incontinence
involuntary leakage of urine immediately after a sudden sensation to urinate
causes of incontinence
overactive detrusor muscle that suddenly contracts which inc w age
- bladder infection that irritates bladder lining
- bladder outlet obstruction (enlarged prostate)
- CNS condition
- drugs
stress incontinence
occurs when urine is involuntarily lost w incs in intra abdominal pressure
causes of stress incontinence
- loss of pelvic floor and/or loss of fascial support of bladder and urethra
- inc intra abdominal pressure caused by sneezing
- w/out support, changes normal angle btw bladder and urethra
risk factors of stress incontinence
- age
- obesity
- child birth related trauma
- pelvic surgery
other types of incontinence
- mixed: urge and stress
- overflow: bladder too full
- functional: physical and env limitations and inability to get to toilet in time
- transient: sudden onset that is reversible, related to UTI, constipation, fecal impaction
why is urinary incontinence a problem
- can cause inflammation of the skin
- damage skin vulnerable to infection
- damp, warm skin is breeding ground for bacteria and fungi
- areas at risk are genitals, btw buttocks, inner thighs
oxybutynin class
anti cholinergic
oxybutynin moa
blocks the action of ACh which activates smooth muscles
oxybutynin indications
over active bladder
incontinence
oxybutynin se
dry mouth
constipation
oxybutynin nc
only PO
- can be found as extended release
