Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ID PHARM 152 > UTI > Flashcards

UTI Flashcards

1
Q

Classification of UTIs

A

lower and upper

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

Define Lower UTI

A

infection of the bladder (cystitis)

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

Define Upper UTI

A

infection involving the kidneys (pyelonnephritis)

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

Uncomplicated UTI

A

no structural or functional abnormalities

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

Complicated UTI

A

Predisposing lesion of the urinary tract- congenital abnormality or distortion of urinary tract, stone, indwelling catheter, prostatic hypertrophy, obstruction or neurological deficit that interferes with normal urinary flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What types of UTI can males have?

A

males only have complicated

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

Predisposing Factors

A

Age
Gender
Pregnancy
Use of Spermicides and diaphragms
Instrumentation of urinary system
Urinary tract obstruction- including drugs like anticholinergics
Incomplete bladder emptying
Neurologic dysfunction – stroke, diabetes, spinal cord injury
Vesicoureteral reflux
Renal disease

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

Which organisms most commonly cause UTI?

A

S. pneumoniae
S. aureus
E. coli
Enterococcus species
Pseudomonas aeruginosa

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

What is the most common etiology in uncomplicated UTI?

A

E.coli 80%

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

What are other common etiology in uncomplicated UTI?

A

Staph saprophyticus, K. pneumoniae, Proteus spp., Enterococcus spp.

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

What are etiology in complicated UTI?

A

E.coli 50%
Staph saprophyticus, K. pneumoniae, Proteus spp., Enterococcus spp.

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

How to diagnosis UTI?

A

urinalysis - bacteriuria and pyuria
urine culture
you have to have enough in the urine to get the diagnosis

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

Tests for urine dipsticks

A

for nitrite
- not all bacteria convert nitrates to nitrites
for leukocyte esterase
- esterase activity for WBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clinical Presentation lower UTIs

A

dysuria, urgency, frequency, nocturia, suprapublic heaviness/pain, gross hematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clinical Presentation upper UTIs

A

flank pain, fever nausea, vomiting, malaise, costovertebral tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What to consider for treatment for UTIs?

A

Site of infection – cystitis vs pyelonephritis
Renal function
Causative organism
Concurrent disease
Ability to penetrate urine or kidneys
Drug interactions
Adverse effects and allergies
cost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the first line for UTI uncomplicated?

A

TMP/SMX
TMP
nitrofurantoin

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

Which antibiotic is hepatic metabolized?

A

erythromycin

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

What antibiotics hepatically eliminated?

A

moxifloxacin

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

How long is nitrofuratoin used for?

A

5 days

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

what is the dose for TMP/SMX for uncomplicated UTI

A

1 DS bid for 3 days

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

What is the dose for TMP for uncomplicated UTI?

A

100 mg BID
200 mg daily

for 3 days

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

What are some alt for first line uncomplicated UTI?

A

cephalexin
fosfomycin

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

What is the dose for cephalexin for uncomplicated UTI?

A

250 mg QID for 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the dose for fosfomycin for uncomplicated UTI?

A

3 g single dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the second line for uncomplicated UTI?

A

amoxicillin
norfloxacin
ciprofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the dose for amoxicillin for uncomplicated UTI?

A

500 mg TID for 3-7 days
875 mg BID for 3-7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the dose for norfloxacin for uncomplicated UTI?

A

400 mg BID for 3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the dose for ciprofloxacin for uncomplicated UTI?

A

250 mg BID
500 mg ER daily
for 3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is factors looked at treatment of recurrence?

A

Culture
Re-assess for upper tract infection
Re-treat for 7 to 14 days
Same antibiotic choices, however tailor based on C&S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Define frequent recurrences

A

short course self treatment at onset of symptoms if less than 3 infections per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Treatment opinions for frequent recurrences

A

TMP/SMX
TMP
Macrobid
Second line - FQ

33
Q

Dose for frequent recurrent UTI for TMP/SMX

A

1 tab or 1/2 DS tab
qhs 3 times weekly or post-coital if associated with intercourse

34
Q

Dose for frequent recurrent UTI for TMP

A

100 mg qhs
or post coital

35
Q

Dose for frequent recurrent UTI for macrobid

A

100 mg qhs
or post coital

36
Q

Dose for frequent recurrent UTI for FQ

A

3 times weekly or every other day or post coital

37
Q

List some non-antibiotic therapy

A

cranberry juice
topical (vaginal) estrogen

38
Q

What are factors needed for pharmacist prescribing?

A

not first episode
not pregnant
uncomplicated
not relapse

39
Q

Which antibiotics have poor renal tissue concentration?

A

cefotaxime and nitrofurantoin

40
Q

Explain factors for uncomplicated UTI in men

A

uncommon but an occur
urine cultures recommended
length is longer 2 wks

41
Q

What are the opinions for non-obstructive mild pyelonephritis?

A

TMP/SMX (14 d)
TMP (14d)
norfloxacin
ciprofloxacin (7d)
levofloxacin (5d)
amox/clav (10-14d)

42
Q

What are the opinions for non-obstructive severe pyelonephritis?

A

Gentamicin + ampicillin
ciprofloxacin
levofloxacin
ceftriaxone + gentamicin

43
Q

Dose for gentamicin for pyelonephritis for gentamicin

A

4-7 mg/kg q 24 h

44
Q

Dose for gentamicin for pyelonephritis for ampicillin

A

1-2 g q 4-6 h (IV)

45
Q

Dose for gentamicin for pyelonephritis for ciprofloxacin

A

400 mg IV q 12 h

46
Q

Dose for gentamicin for pyelonephritis for levofloxacin

A

250-500 mg q 24h

47
Q

Dose for gentamicin for pyelonephritis for Ceftriaxone

A

1-2 g IV q24h

48
Q

What is the etiology for bacterial prostatitis?

A

e.coli 75%
other gram negative organisms

49
Q

What is needed for diagnosis for bacterial prostatitis?

A

urine culture
in chronic prostatitis
quantitative localization culture

50
Q

List some symptoms of acute bacterial prostatitis

A

fever, chills, tenderness/pain, malaise, myalgia, frequency, urgency, nocturia and retention

51
Q

List some symptoms of chronic bacterial prostatitis

A

urinating difficulty, low back pain, perineal and suprapubic pressure

52
Q

Define bacterial prostatitis

A

Inflammation of the prostate gland and surrounding tissue due to infection
Reflux of infected urine into prostate gland

53
Q

Treatment for acute bacterial prostatitis

A

TMP/SMX, TMP, norfloxacin, levofloxacin , ciprofloxacin

54
Q

Treatment for severe bacterial prostatitis

A

ampicillin or ceftriaxone IV PLUS gentamicin or tobramycin or amikacin

55
Q

Duration for acute bacterial prostatitis

A

Total duration minimum 2 weeks; total course should be 4 weeks to prevent chronic infection

56
Q

Treatment for chronic bacterial prostatitis

A

4 – 12 weeks
Fluoroquinolones have better cure rate than TMP/SMX
More difficult to get antibiotic penetration into prostate

57
Q

First line for UTI in pregnancy

A

cephalexin
amoxicillin
nitrofurantoin

58
Q

Second line for UTI in pregnacy

A

TMP/SMX
TMP
avoid in first trimester and in last 6 weeks of pregnacy

59
Q

Dose for UTI for pregnancy for cephalexin

A

250-500 mg QID 7 days

60
Q

Dose for UTI for pregnancy for amoxicillin

A

500 mg TID 7 days

61
Q

Dose for UTI for pregnancy for nitrofurantoin

A

100 mg bid x 5 days

62
Q

When should nitrofurantoin be avoided in pregnancy?

A

Avoid at term (36-42 weeks gestation and during labor and in neonates)

63
Q

When should TMP/SMX or TMP be avoided in pregnancy?

A

avoid in first trimester and in last 6 weeks of pregnancy

64
Q

How does Catheterization and UTI relate?

A

catheterization increase the rate of UTI
direct route for bacteria

65
Q

Asymptomatic bacteriuria

A

Except during pregnancy and/or pre-operative genitourinary procedures, there are no indications for screening or therapy for asymptomatic UTI

there is no benefit for elderly may cause harm

66
Q

Nitrofurantoin MOA

A

damages bacterial DNA/proteins

67
Q

Nitrofurantoin resistance

A

very slow to develop

68
Q

Nitrofurantoin spectrum

A

e. coli
staphylococci
enterococcus faecalis
citrobacter
klebsiella

69
Q

Nitrofurantoin uses

A

first line for uncom. cystitis and prophylaxis
do not use for pyelonephritis and prostatitis

70
Q

Nitrofurantoin AE

A

gi upset
nausea
headache
darkens urine

71
Q

Nitrofurantoin rare AE

A

SJS/TEN

72
Q

Nitrofurantoin AE with long term use

A

neuropathy
pulmonary fibrosis
hepatic fibrosis

73
Q

Fosfomycin MOA

A

inhibits cell wall formation
bactericidal

74
Q

Fosfomycin resistance

A

uncommon
unqiue class

75
Q

Fosfomycin spectrum

A

Enterobacteriaceae including ESBL producers, Enterococcus; does not reliably cover P. aeruginosa

76
Q

Fosfomycin uses

A

uncomplicated UTI; reserve for allergy or resistance to nitrofurantoin or TMP/SMX; NOT pyelonephritis; considered safe in pregnancy

77
Q

Fosfomycin AE

A

GI upset, diarrhea, headaches, hypokalemia

78
Q

Fosfomycin dosing

A

3 gram oral powder x 1 dose; dissolve the powder in ½cup water and drink immediately

79
Q

Nitrofurantoin DI

A

may increase K combined with spironolactone

ID PHARM 152 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions