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Flashcards in Ch 46 UTIs Deck (22)
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What meds are used to treat UTIs

Urinary antiseptics

Other meds include;
Penicillins, aminoglycosides, cephalosporins, and fluoroquinolones


Sulfonamides and trimethoprim

Prototype drug;
Sulfamethoxazole- trimethoprim ( SMZ- TMP, Bactrim, Sentra, Co-trim)


What's the pharmalogical action of sulfonamide and trimethoprim

Inhibit bacterial growth by preventing the synthesis of folic acid which is essential for the production of DNA RNA and proteins


What are therapeutic uses of SMZ-TPM

Urinary tract infections
Otitis media
Shigella sis and pneumocystis jiroveci pmeumonia


What are adverse effects of sulfonamides and trimethoprim

Hypersensitivity including Stevens Johnson syndrome
Blood dyscrasias
Kernicturis ( jaundice, increased bilirubin levels which is neurotoxic to infants)
Sulfonamides can increase the effect of warfarin, phenytoin, sulfonylurea oral hypoglycemic and tolbutamide.


What are contraindications and precautions of sulfonamides and trimethoprim

SMZ-TMP is contraindicated in clients who have folate acid deficiency because it increase the risk of. Megoblastic anemia.
Clients who have renal disfunction
Clients older than 65 who take ACE inhibitors because it can cause hyperkalemia.


What are urinary tract symptoms

Decrease frequency burning and during urination negative culture urines.


What are urinary tract antiseptics

They treat acute urinary tract infections
Prohhylaxis for recurrent lower urinary tract infections


What is the prototype drug of urinary tract antiseptics

Nitrofurantoin( Furadantin, Novo- Furan,)
Macrocrystals ( Macrodantin, macrobid)
Methenamine( Hiprex, urex)


What is nitrofurantoin

It is a broad spectrum urinary antiseptic with bateriostatic and bacteriocidal action, bacterial injury occurs by damaging DNA


What are adverse effects of urinary tract antiseptics

GI discomfort, anorexia, nausea,vomiting, diarrhea.( take with milk or food, reduce dosage, use macrocrystalline tablets to reduce GI discomfort)
Hypersensitivity reactions with severe pulmonary manifestations such as dyspnea,cough,chest pain,fever, chills and alveolar infiltration
Blood dyscrasia, do baseline CBC and periodic LFT, monitor for easy bruising and epistaxis
Peripheral neuropathy, numbness,tingling of the hand and feet, muscle weakness, not recommended for ppl with kidney failure
Headache drowsiness dizziness


Nitrofurantoin is contraindicated in ppl who

Have renal dysfunction and creatinine clearance of less than 40 ml/ min


What are nursing considerations for a client taking urinary tract antiseptics

Urine will have a brownish color
Take with food if GI symptoms occur
Avoid crushing tab because of possibility of tooth staining
Teratogenic drug


What are fluoroquinolones

Broad spectrum antimicrobial used for a wide variety of micro organisms such as aerobic gram negative bacteria, gram positive bacteria.
Alternative to parenteral antibiotics who have severe infections
Urinary, respiratory, and GI TRACT infection, infections of the bones, joints, skin and soft tissues
Prevention of anthrax in ppl who have inhaled anthrax spores.


Adverse effects of fluoroquinolones

GI discomfort
Achilles rupture
Supra infection ( thrush,vaginal yeast infection)
Phototoxicity( severe sunburn) when exposed to direct or indirect sunlight and sunlamps even when sun screen is applied


Prototype drug of fluoroquinolones

Ciprofloxacin ( Cipro)
ofloxacin ( Floxin)
Moxifloxacin ( Avelox)
Levofloxacin ( Levaquin)


Contraindications of fluoroquinolones

Cipro shouldn't be given to ppl under 18 due to the risk of Achilles' tendons rupture unless the child is being treated for E. coli infections of urinary tract or inhalation anthrax
Increases risk for developing CDIFF
Use cautiously in older adults and those who have cardiovascular disorders.
Can affect the CNS


Sulfonamides are contraindicated in who

Clients taking diuretics, Tolbutamide, Lasix


What is nursing education for a client taking sulfamethoxazole- trimethoprim ( Septra)

Take med on a empty stomach with a full glass of water for maximum absorption


What is a discharge teaching for a client taking nitrofurantoin ( Furadantin)

Observe for bruising on the skin
Take with milk or meals
Expect brownish coloration of urine.


A nurse is teaching a client about cipro what should she instruct

Observe for pain and swellingat the Achilles' tendon
Monitor for vaginal yeast infection
Inspect mouth for cottage cheese like lesions


A nurse is planning to administer cipro via IV to a client who has cystitis what is a appropriate nursing action

Infuse over 60 minmot mimimize irritation of the vein