UTI pharmacology Flashcards
UTI risk factors
- adults 25-29
- women, especially elderly
- sexual activity
- poor hygiene
- dirty pools
- taking baths
how do UTIs develop
bacteria usually from anus enters the urethra and swims into bladder where it grows
health factors that make people prone to UTI
- dehydration
- structural malformations
- diffculty urination
- catheters
symptoms of UTI
- strong urge to urinate
- burning during urination
- low volume at high frequency
- cloudy or red/brown urin
- pelvic or rectal pain
- fever and chills
symptom of UTI seen in elderly
demential-like symptoms
bacteria responsible for UTI
- E.coli and other Gm- bacilli (85-95%
- staph. sp Gm+ cocci (5-15%)
preventative measures for UTI
- empty bladder when urinating
- urinate after sex
- wipe front to back
- drink lots of water
- avoid vaginal irritation
- circumcision
- shower
complicated UTI
associated with an underlying medical condition
treatment options for uncomplicated lower UTI
- TMP-SMX 160/800 mg bid x 3 days
- nitrofurantoin 100 mg bid x 5 days
- fosfomycin trometamol 1 3g dose
treatment options for mild-moderate catheter associated UTI
- cipro
- levofloxacin
- ceftriaxone
resistance to nitrofurantoin
generally low and it rarely develops
nitrofurantoin use
- uncomplicated UTI
- prevention of recurrent UTI
- long-term suppression
nitrofurantoin bioavailability
90%
nitrofurantoin elimination
rapidly done by kidney, which is why its great for UTI and nothing else (not enough gets to blood)
nitrofurantoin MoA
bacterial reductases form a radical on it which makes it cause DNA damage in the bacteria
nitrofurantoin adverse effects
- brown urine
- N/V
- pulmonary toxicities, especially in elderly
- hepatotoxicity
- headache, vertigo, drowsiness
nitrofurantoin contraindications
- term pregnant women due to anemia and jaundice
- reduced renal flow
- probenacid
methanamine features
- forms formaldehyde in body to kill bacteria
- lots of side effects
- only acts if pH is <5.5
- used for long term prophylaxis
phenazopyridine use
- analgesic for symptomatic relief of UTI pain
- don’t use more than 48 hours
phenazopyridine contraindications
- children
- pregnant women
- renal insufficiency
- hepatitis
phenazopyridine side effects
- orange urine
- GI effects
- headache
estrogen use in UTI
used to prevent recurrent UTI in elderly women who have had hysterectomy
estrogen function in UTI prevention
- reinvigorate tissue reducing spotting and uptake of bacteria
- encourages natural antimicrobial substance production
- makes UT tissue stronger, and more difficult for bacteria to penetrate
