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Pharmaco > UTI > Flashcards

UTI Flashcards

1
Q

What are the medications used for UTI

A

Phenazopyridine (pain analgesic)
Beta-lactam + oxapenem/aminopenicillins (Amoxicillin-Clavulanate)
2nd gen fluoroquinolones (Ciprofloxaxin)
Sulfonamides (Trimethoprim-sulfamethoxazole/TMP-SMZ/Bactrim)
Novel class (Fostomycin)
DNA synthesis inhibitors (Nitrofuratoin)

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2
Q

Names of Beta-lactam abx + oxapenem/aminopenicillin

A

Amoxicillin/Clavulanate

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3
Q

Name of 2nd gen fluoroquinolone

A

Ciprofloxacin

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4
Q

Name of sulfonamides

A

Trimethoprim-Sulfamethoxazole (TMP-SMZ/Bactrim)

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5
Q

Name of novel class

A

Fosfomycin

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6
Q

Name of DNA synthesis inhibitors

A

Nitrofurantoin

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7
Q

MOA of beta-lactam abx + oxapenem/amoxicillin+clavulanate

A

Inhibit bacterial cell wall synthesis (inhibit transpeptidation)

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8
Q

Why is amoxicillin/clavulanate used

A

For its extended spectrum action

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9
Q

AE of amoxicillin/clavulanate

A

Generally well tolerated
Rash & diarrhoea are most common AE
1-4% get allergic reaction - severe hypersensitivity that are potentially fatal (SJS)
Thrombophlebitis (inflammation @ injection site)

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10
Q

MOA of ciprofloxacin/2nd gen fluoroquinolones

A

DNA synthesis inhibitor

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11
Q

Why is ciprofloxacin used for

A

Broad spectrum action - concentration-dependent killing

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12
Q

Why is ciprofloxacin not used anymore as a first choice drug

A

Increasing resistance

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13
Q

AE of ciprofloxacin

A

Nausea, diarrhoea, vomiting, headache, restless, pain & inflammation @ injection site, anaphylaxis, tendon rupture, superinfection, photosensitivity, pseudomembrane colitis, seizure, peripheral neuropathy & hepatotoxicity

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14
Q

Who should not use ciprofloxacin

A

Elderly with tendonitis & athletes with tendon rupture

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15
Q

MOA of trimethoprim-sulfamethoxazole (TMP-SMZ/Bactrim)

A

Inhibit folate synthesis - synergistically inhibit folate synthesis (2 step process: sulfamethoxazole inhibit dihydropteroate synthase [1st step to making nucleic acid] trimethorpim inhibit dihydrofolate reductase [2nd step to making nucleic acid]) & kill bacteria effectively

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16
Q

Why is trimethoprim-sulfamethoxazole not used as a first choice urinary septic drug

A

Due to increasing resistance of drug

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17
Q

AE of trimethoprim-sulfamethoxazole

A

Nausea, vomiting, anorexia, rash, photosensitivity, crystalluria, anaphylaxis, blood dyscrasia, fulminant hepatic necrosis, hyperk, SJS

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18
Q

MOA of fosfomycin

A

Inhibit bacteria cell wall synthesis - inhibit transglycosylation

19
Q

Why is fosfomycin used

A

Specific for urinary system
Safe for pregnant women
Can be used if pt is resistant to ciprofloxacin (fluoroquinolones)/trimethoprim-sulfamethoxazole
Can also be used in place of amoxicillin-clavulanate

20
Q

AE of fosfomycin

A

Nausea, diarrhoea, headache, back pain, anaphylaxis, superinfection

21
Q

MOA of nitrofurantoin

A

DNA synthesis inhibitor which disrupt nucleic acid synthesis via oxidative stress (work like metrodinazole)

22
Q

Why is nitrofurantoin used

A

Specific coverage for UTI infections

23
Q

AE of nitrofurantoin

A

Nausea, vomiting, anorexia, dark brown urine, anaphylaxis, superinfections, hepatic necrosis, interstitial pneumonitis, SJS

24
Q

Which classes are susceptible to SJS

A

Nitro & sulfa groups (nitrofurantoin & trimethoprim-sulfamethoxazole)

25
Q

Why are oxapenems used with beta lactam abx

A

To prevent beta lactam abx from being destroyed by beta-lactamase produced by bacteria (combat resistance)

26
Q

Popular combinations of beta-lactam + oxapenem

A

Amoxicillin/Clavulanic acid or Clavulanate
Ticarcillin/Clavulanate
Pipericillin/Tazobactam
Ampicillin/Sulbactam

27
Q

Which medications can be used for pregnant women

A

Amoxicillin & fosfomycin

28
Q

What can be used to treat MRSA

A

Vancomycin & sulphonamides

29
Q

What is the empirical treatment of pyelonephritis

A

IV Ceftriaxone

30
Q

What is the alternative treatment for pyelonephritis

A

Pipericillin/tazobactam

31
Q

What is the ideal pH for urinary system when taking nitrofurantoin to exert its greatest effect

A

5.5

32
Q

What is a single dose (100mg) of nitrofurantoin good for

A

Prevent recurrent uncomplicated UTI in some women

33
Q

What is the empirical treatment for cystitis

A

Nitrofurantoin

34
Q

What are the alternative treatment for cystitis

A

Trimethoprim-sulfamethoxazole (TMP-SMZ/Bactrim)
Fosfomycin

35
Q

Why is fosfomycin a less efficacious drug

A

Pseudomonas & Acinebacter may be resistant to it

36
Q

What medication should be given to a female who got UTI for the first time without any hx of use of common abx

A

Amoxicillin-Clavulanate & Cotrimoxazole (trimethoprim-sulfamthoxazole)

37
Q

What medication should be given to a female who has gotten recurrent UTI and has been prescribed abx before

A

Nitrofurantoin

38
Q

What medication should be given to a pregnant lady with UTI

A

Fosfomycin

39
Q

What mediation should not be given to a UTI patient with allergy to penicillin

A

Beta lactam abx

40
Q

What medication should not be given to a UTI patient with allergy to sulfa

A

Cotrimoxazole (Trimethoprim-Sulfamethoxazole)

41
Q

What medication should not be given to a UTI patient with G6PD

A

Cotrimoxazole (Trimethoprim-Sulfamethoxazole) & Nitrofurantoin

42
Q

What medication should not be given to an elderly patient with UTI and cardiac dysrhythmia

A

Fluoroquinolone (Ciprofloxacin)

43
Q

What to do when all treatment has failed and there is bacterial resistance

A

Refer to hosp guidelines & check resistance patterns

Pharmaco (11 decks)

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