Drugs for UTI ch. 93

What is the MOA of Phenazopyridine?

(Azo, Pyridium) -Excreted unchanged in the urine, where it has analgesic effects on the genitourinary mucosal structures Exact MOA is unknown

What are the adverse effects of Phenazopyridines?

-AKI -Urine color changes (orange/red color) GI discomfort

Adverse effects of Nitrofurantoin? (Furandatin, Macrodantin, Macrobid)

-GI effects -Pulmonary reactions (goes away one tx has ended) -Hematologic effects -Peripheral neuropathy: Demyelination and nerve degeneration can occur Hepatotoxicity -(must check liver enzymes)

What is Nitrofurantoin used for?

-Lower UTIs prophylaxis -recurrent lower UTIs

Trimethoprim/sulfamethoxazole (TMP/SMZ) AE:

-N/V/D -Hyperkalemia -Stevens-Johnson syndrome -Blood dyscrasias (leukopenia) -Kernicterus -Crystalluria leads to kidney damage

What is Nitrofurantoin MOA?

-Nitrofurantoin injures bacteria by damaging DNA. -the drug must first undergo enzymatic conversion to a reactive form. -Nitrofurantoin is selectively toxic to bacteria because bacteria possess relatively high levels of the enzyme needed for drug activation

Which drug does the nurse identify as a urinary tract antiseptic? A.Ciprofloxacin B.Ceftriaxone C.Nitrofurantoin D.Ceftazidime

C

Which patient would most likely need intravenous antibiotic therapy to treat a urinary tract infection? A.A patient with an uncomplicated urinary tract infection caused by Escherichia coli B.A patient with pyelonephritis with symptoms of high fever, chills, and severe flank pain C.A patient with acute cystitis who complains of dysuria, frequency, and urgency D.A patient with acute bacterial prostatitis with a mild fever, chills, and nocturia

B

Brand name of Trimethoprim/sulfamethoxazole (TMP/SMZ)

Brand name: Bactrim, Bactrim DS

Which drugs are the treatment of choice for oral therapy of UTIs?

Trimethoprim/sulfamethoxazole (TMP/SMZ) & Nitrofurantoin

T or F: Urinary Tract Analgesics relieves symptoms and treats the underlying cause

FALSE Analgesics only treat the symptoms

Which class of ABx is reserved for more severe UTI infections?

Fluoroquinolones

High concentrations of Nitrofurantoin effects on bacteria? Low concentrations on bacteria?

Low concentrations: Bacteriostatic High concentrations: Bactericidal

Trimethoprim/sulfamethoxazole (TMP/SMZ) MOA

MOA: Prevent the folic acid synthesis

Which drugs are the Urinary Tract Antiseptics?

Nitrofurantoin Methenamine

Which other drugg classes of ABx can be used for UTI?

Penicillins Aminoglycosides Cephalosporins Carbapenems Methanamine

Which medications are the Urinary Tract Analgesics?

Phenazopyridine (Azo, Pyridium)

What are the therapeutic uses of Phenazopyridines?

Relieves dysuria urinary frequency and urgency

When are Urinary Tract Antiseptics given?

UTA are given prophylactically to suppress further growth of bacteria

T or F: Urinary Tract Analgesics acts on the mucosal layer

TRUE