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pharm 46,41,42
abx
98
Nursing
Not Applicable
10/12/2010

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Term
bacteriostatic drugs
Definition
inhibit growth of bacteria
Term
bactericidal drugs
Definition
kill bacteria
Term
Nursing assesment
Definition
History current and past
allergies
med history
physical exam
lab test- culture and sensitivity
id who needs prophylactic abx treatment

Other considerations for use: toxicity potential to the patient, clinical judgment, previous infection treatments and reactions to antibiotics.
Term
aminoglycosides
Definition
Uses
Effective against gram-negative organisms that cause urinary infections, meningitis, wound infections, septicemia
Action
Inhibit bacterial protein synthesis
Gram -, E. coli, Proteus pseudomonas,
Bactericidal
Drugs
gentamicin (Garamycin)
tobramycin (Nebcin)
Route
IM, IV
Term
Gentamicin
Definition
1
Term
tobramycin (Nebcin)
Definition
has a vary narrow theraputic index. Monitor peak and trough!
Term
Aminoglycosides (cont’d
Definition
Side effects/adverse reactions
Photosensitivity
Superinfection
Secondary infection: normal flora are killed
Sites: mouth, skin, respiratory tract, vagina, intestines
Usually occurs when treated more than 1 week
Ototoxicity
Nephrotoxicity
Term
Aminoglycosides
Definition
known for their ototoxic effects
Term
Aminoglycosides
Definition
Drug interactions
Penicillins decrease aminoglycoside effectiveness
Penicillins increase warfarin’s effect
Term
aminoglycosides
Definition
Nursing interventions
Culture and sensitivity
Monitor renal function, hearing loss
Drink plenty of liquids
Warn to use sun block
Monitor for superinfection
Monitor peak and trough levels
Asses IV site!!!
Term
Carbapenems
Definition
Actions
Inhibit bacterial cell wall synthesis; potent broad-spectrum agents resistant to beta-lactamase enzymes secreted by bacteria
Broad-spectrum against gram + and gram – aerobes and anaerobes
Term
Carbapenems
Definition
Uses
Treat severe infections by multiresistant organisms (UTIs, resp, skin, bone)

Serious adverse effects
Severe diarrhea; dizziness, confusion, seizures
Term
Imepenem/ Cilastatin (primaxin
Definition
IV?IM combo drug cilastatin prevents abx from being deactivated by renal enzymes
Term
Meropenem (merrem)
Definition
Iv only
Term
Carbapenems
Definition
Drugs:
Imipenem/Cilastatin (Primaxin) IV/IM
Meropenem (Merrem) IV only
Nursing Considerations
Monitor for s/s yeast infection
Has very high renal concentrations so monitor renal functions
Must be diluted and given

Effective against intra-abdominal infections and pelvic sepsis.
Cilastatin is given with imipenem (Primaxin) to prevent the inactivation of imipenem by a renal enzyme. Cilastatin is not an antibiotic.
Term
Cephalosporins
Definition
Very closely related to pennicilin!
Term
Cephalosporins
Definition
Actions
Inhibit bacterial cell wall synthesis; potent broad-spectrum agents resistant to beta-lactamase enzymes secreted by bacteria
Broad-spectrum against gram + and gram – aerobes and anaerobes
Uses
Treat severe infections by multiresistant organisms (UTIs, resp, skin, bone)
Serious adverse effects
Severe diarrhea; dizziness, confusion, seizures
Term
Cephalosporins Generation
Definition
the higher the generatoion he more broad the spectrum of the abx.
Term
cephalosporins
Definition
First-generation
Cephalexin (Keflex), cefazolin (Kefzol)
Second-generation
cefoxitin (Mefoxin)
Third-generation
ceftriaxone (Rocephin)
Fourth-generation
Cefepime (Maxipime
Term
Beta-lactamases
Definition
enzymes produced by some bacteria and are responsible for their resistance to beta-lactam antibiotics like penicillins, cephalosporins (are relatively resistant to beta-lactamase), These antibiotics have a common element in their molecular structure: a four-atom ring known as a beta-lactam. The lactamase enzyme breaks that ring open, deactivating the molecule's antibacterial properties.

1st Generation: these are destroyed by beta-lactamases

Basically, 3rd & 4th generation are more effective against sepsis. The higher the number, the broader the spectrum.
Term
Cephalosporins (cont’d)
Definition
Drug interactions
Alcohol: may cause flushing, dizziness, HA, n, v, muscular cramps
Nursing Interventions
Assess for allergy (10% of people who are allergic to PCN are also allergic to cephalosporins. Monitor CLOSELY for rxn when giving to client with PCN allergy
C&S before therapy
Assess renal and liver function
Administer IV over 30 min b.I.d.-q.I.d.
Monitor for superinfection (Candida)
Term
MACROLIDES
Definition
Macrolides are usually the second choice when penicillins, cephalosporins, and tetracyclines are contraindicated
Term
Macrolides
Definition
Macrolides are usually the second choice when penicillins, cephalosporins, and tetracyclines are contraindicated
Term
Erythromycin (E-Mycin
Definition
1
Term
Azithromycin (Zithromax)
Definition
l
Term
Macrolides
Definition
Side effects/adverse reactions
GI distress, tinnitus
Superinfection
Ototoxicity, hepatotoxicity (especially if taken with other hepatotoxic drugs such as acetaminophen)

Nursing interventions
Culture and sensitivity before therapy
Monitor liver enzymes
Advise client to take full regimen
Administer antacids 2 hrs before or 2 hrs after macrolides
Give azithromycin 1 hr before or 2 hrs after meals with full glass of water
Term
Penicillins
Definition
Actions
Inhibit cell wall synthesis, penicillinase-resistant penicillins
Introduced to kill Staphyloccus
Inhibit bacterial cell wall synthesis
Uses
Treat middle ear infections, pneumonia, meningitis, urinary tract infections, syphilis, gonorrhea
Common adverse effects
Diarrhea, electrolyte imbalance
Serious adverse effects
Hepatotoxicity, nephrotoxicity
Term
Penicillinase
Definition
is the enzyme that bacteria produce to destroy the antibacterial activity of penicillin.
Term
pennicilin
Definition
Broad-spectrum penicillins
Against gram + and gram –
Escherichia coli, Salmonella, influenzae
Bactericidal
Also known as aminopenicillins
Examples: amoxicillin (Amoxil), ampicillin (Omnipen)
Term
pennicilin
Definition
Beta-lactamase inhibitors
Beta-lactamase is an enzyme that inactivates PCN
Are not given alone
Combined with penicillinase-sensitive penicillin
By combining a broad-spectrum such as amoxicillin with it inhibits the bacterial beta-lactamases which makes the ABX effective & extending the antimicrobial effect
Examples
Clavulanic acid
Sulbactam
Tazobactam
Term
pennicilin combo meds
Definition
Beta-lactamase inhibitors
Inhibits bacterial beta-lactamase enzyme
Amoxicillin-clavulanate (Augmentin)
Given orally
Combination intensifies effect of amoxicillin
Piperacillin-tazabactam (Zosyn), given IV
Ticarcillin-clavulanate (Timentin), given IV
Term
Piperacillin-tazabactam (Zosyn),
Definition
1
Term
Amoxicillin-clavulanate (Augmentin)
Definition
1
Term
Ticarcillin-clavulanate (Timentin),
Definition
1
Term
pennicilins
Definition
Nursing Interventions
C&S before drugs given
Women taking oral contraceptives should use a barrier method when taking
Monitor closely during first dose
Increase fluids
Take 1 hr before or 2 hr after meals
Check for superinfection
Consider safety issues
Term
Ciprofloxacin (Cipro),
Definition
1
Term
levofloxacin (Levaquin)
Definition
1
Term
Fluoroquinolones
Definition
Drug interactions
Antacids decrease absorption rate
Levofloxacin increase effect of oral hypoglycemics (monitor for hypoglycemic rxn), theophylline, caffeine
Nursing interventions
Culture and sensitivity
Infuse IV over 60-90 min
Increase fluid intake to >2000 ml/d to prevent crystalluria
Check for superinfection; avoid caffeine
Don’t take with antacids
Use sunscreen and wear protective clothing
Term
Streptogramins
Definition
Drug: quinupristin-dalfopristin (Synercid)
Actions
Inhibit protein synthesis in bacterial cells
Uses
Treat vancomycin-resistant E. faecium (VRE), MRSA
Common adverse effects
Pain, infusion site inflammation, nausea, vomiting, anorexia, abdominal cramps, diarrhea
Serious adverse effects
Hepatotoxicity, arthralgia, myalgia
Term
: quinupristin-dalfopristin (Synercid)
Definition
last resort for vancomyacin resistant bacteria, vre
Term
Sulfonamides
Definition
Actions
Inhibit bacterial biosynthesis of folic acid resulting in cell death
Uses
Treat UTIs and otitis media
Common adverse effects
Nausea, vomiting, anorexia, diarrhea
Serious adverse effects
Rash, pruritus, photosensitivity, hematologic reactions, neurologic CNS effects
Term
Sulfonamides
Definition
work fast, usually after one or two doses.
Used prophylactically in patients susceptible to streptococcal infection or rheumatic fever when penicillin is contraindicated.
Term
TMP/SMZ (Bactrim, Septra)
Definition
1
Term
sulfonamides
Definition
Drug interaction
Warfarin
Increases anticoagulation
Oral hypoglycemic
Increases hypoglycemia
Term
Sulfonamides
TMp/SMZ
Definition
Side effects: mild to moderate rash, photosensitivity, GI distress, stomatitis, crystalluria,fatigue, depression, H/A, dizziness
Adverse reactions: bloody dyscrasias, renal failure, steven-johnson syndrome
Term
Sulfonamides
TMp/SMZ
Definition
Nursing Interventions: Administer w/a full glass of water 1 hour before or 2 hours after a meal
Increase fluid intake
Monitor for sore throat, bruising or bleeding
Monitor CBC
Check for superinfection
Advise client not to take with antacids
Tell client to avoid direct sunlight
Term
Tetracyclines
Definition
Actions
Inhibit protein synthesis by bacterial cells
Uses
Treat venereal diseases, UTIs, upper respiratory tract infections, acne, pneumonia, and meningitis when penicillin is contraindicated
Common adverse effects
Nausea, vomiting, anorexia, abdominal cramps, diarrhea
Serious adverse effects
Photosensitivity
Term
Tetracyclines
Definition
Tetracycline (Sumycin)
Doxycycline (Vibramycin)\

Drug-food interactions
Milk products, antacids
Decreases effects of oral contraceptives
Digoxin absorption is increased, leading to
toxicity
Term
Tetracyclines
Definition
Symptoms
GI distress
Cough, sputum
Fever, night sweats, weight loss
Prophylaxis (6 months-1 yr)
Close contact with diagnosed TB client
HIV + with +TB test
Converted from negative to + TB test
Contraindicated in liver disease
Term
Tuberculosis
Definition
Etiology
Mycobacterium tuberculosis
Acid-fast bacillus
Transmission
Person to person via droplets
Coughing, sneezing
Clients at risk
Alcohol addicted, debilitated
Immunocompromised (HIV, elderly)
Term
Tuberculosis
Definition
Symptoms
GI distress
Cough, sputum
Fever, night sweats, weight loss
Prophylaxis (6 months-1 yr)
Close contact with diagnosed TB client
HIV + with +TB test
Converted from negative to + TB test
Contraindicated in liver disease
Term
Antitubercular Drugs
Definition
Drug combinations
Single-drug therapy
Ineffective because drug resistance develops in a relatively short time
Multidrug therapy
Decreases bacterial resistance to drug
Treatment duration decreased
Term
Antitubercular Agents
Definition
Drug: ethambutol (Myambutol)
Actions
Alter cellular RNA synthesis and phosphate metabolism
Uses
Treat tuberculosis
Common adverse effects
Nausea, vomiting, anorexia, abdominal cramps
Serious adverse effects
Confusion, hallucination, blurred vision, red-green vision changes
Term
Antitubercular Agents
Definition
Drug: isoniazid (INH, Nydrazid)
Actions
Disrupt the cell wall and inhibit replication of tuberculosis bacteria
Uses
Treat and prevent tuberculosis
choice antitubercular drug that is prescribed for the family when a member is diagnosed with tuberculosis
Common adverse effects
Nausea, vomiting
Serious adverse effects
Hepatotoxicity, tingling, numbness of hands and feet, dizziness, ataxia
Term
Antitubercular Agents
Definition
Isoniazid (INH)
Client teaching
Take INH 1 hr before meals or 2 hr after meals to increase absorption
Must follow complete regimen
Collect sputum specimen in early morning
Take pyridoxine (vitamin B6) to prevent peripheral neuropathy
Check liver enzymes, CBC
Need frequent eye exams
Report numbness, tingling, burning
Teach sun precautions, to avoid antacids
Term
Antitubercular Drugs
Definition
Drug: rifampin (Rifadin)
Actions
Prevent RNA synthesis by inhibiting DNA-dependent RNA polymerase
Uses
Eliminate meningococci and H. influenzae type b, (Hib) from asymptomatic carriers
Common adverse effects
Reddish orange secretions
Serious adverse effects
Nausea, vomiting, anorexia, abdominal cramps
Term
Miscellaneous Antibiotics
Definition
Metronidazole (Flagyl)
Bactericidal, trichomonacidal, and protozoacidal
Vancomycin (Vancocin)
Prevents synthesis of bacterial cell walls
Term
Vancomycin
Definition
Action
Inhibits cell wall synthesis
Fights gram +, staph aureus
Bactericidal
Uses
Serious infections of bone, skin, lower respiratory tract
Term
Vancomycin
Definition
Side effects/adverse reactions
Red neck or red man syndrome
Occurs when IV too rapid
Severe hypotension, red flushing of face, neck, chest, extremities
Nephrotoxicity, ototoxicity
Blood dyscrasias, Stevens-Johnson syndrome, pseudomembraneous colitis
Term
Vancomycin
Definition
Route
Oral, IV
Nursing interventions
Culture and sensitivity prior to therapy
Monitor vancomycin levels
Trough drawn prior to IV dose
Peak drawn 15-30 minutes after IV dose has infused
Administer over 1-2 hrs IV, rotate sites
Monitor BP, renal function, superinfection, hearing, IV site
Term
Metronidazole
Definition
Metronidazole (Flagyl)
Used primarily to tx organisms in the GI tract
Prophylactic tx prior to colon surgery
Side effects
Avoid alcohol
Disulfram-type reaction: facial flushing, sweating, severe headache, slurred speech, tachycardia, hypotension
Dark urine or reddish brown
High doses
Avoid during first trimester pregnancy
Term
Topical antifungal agents
Definition
Actions
Alter permeability of cell membranes causing amino acids and electrolytes to leak out
Uses
Treat tinea pedis, tinea cruris, tinea corporis, tinea versicolor, Candida infections
Common and serious adverse effects
Irritation, redness, swelling, blistering, oozing
Term
Topical antifungal agents
Definition
Nystatin (Mycostatin)
Methods of administration: oral, topical
Action
Increases permeability of fungal cell membrane
Fungistatic, fungicidal
Client teaching
Administration: Swish and swallow
Gargle if throat affected
Term
Systemic antifungal agents
Definition
Drug: amphotericin B dosage forms
Actions
Fungistatic agent; disrupt cell membrane of fungal cells
Uses
Treat systemic life-threatening fungal infection
Side Effects
Flushing, fever, chills, headache, dyspnea
Hypotension, hypertension, tachycardia
GI distress, pseudomembranous colitis
Seizures, paresthesia, thrombophlebitis
High doses: Nephrotoxicity, electrolyte imbalances, ototoxicity
Term
Systemic antifungal agents
Definition
Amphotericin B
Nursing interventions
Give IV slowly over 2-6 hours
Monitor vital signs q30 min
Prevent febrile reactions, anaphylaxis
Antipyretics, antihistamines, corticosteroids
Increase fluids
Monitor urine output, weight
Monitor electrolytes, renal and liver function
Term
Systemic antifungal agents
Definition
Drug: fluconazole (Diflucan)
Route: oral, IV, vaginal, topical
Actions
Chemically related to ketoconazole and itraconazole; inhibit certain metabolic pathways in fungi
Uses
Treat meningitis, candidiasis systemic candidiasis
Common adverse effects
Nausea, vomiting, diarrhea
Serious adverse effects
Rash, hepatotoxicity
Term
Systemic antifungal agents
Definition
Drug: terbinafine (Lamisil) topical also
Actions
Inhibit squalene epoxidase, a key enzyme required for biosynthesis in fungi
Uses
Treat onychomycosis of the toenail or fingernail
Serious adverse effects
Pruritus, rash, fever, chills; nephrotoxicity, hepatotoxicity; neutropenia, lymphopenia
Term
Viruses
Definition
Viruses
Method of transmission
Coughing, sneezing
Process of replication of itself (virus)
General signs and symptoms
Headache, fever, nausea, vomiting, diarrhea
Fatigue, muscular pain, cough
Term
Vaccines
Definition
Vaccines
Influenza virus vaccine
Changes yearly
Promotes antibody production
Composition: eggs
Success rate
65%-90%
Term
Antivirals for Influenza
Definition
Influenza A and B
Zanamivir (Relenza)
Actions: Inhibit neuraminidase, an enzyme on the viral cell coat necessary for replication
Uses: Uncomplicated acute illness from influenza
Serious adverse effects
Asthma, bronchospasm, diminishing pulmonary function, cough, sore throat, fever continuing symptoms
Oseltamivir (Tamiflu)
Inhibits viral replication if given within 48 hrs of symptoms
Term
Antiviral agents
Definition
Drug: acyclovir (Zovirax)
Actions
Inhibit viral cell replication
Uses
Topically used to treat herpes genitalis; orally used to treat recurrent genital herpes; IV to treat herpes simplex type 1 and 2 in immunosuppressed patients
Serious adverse effects
Pruritus, rash, burning, hives, diaphoresis, nephrotoxicity, hypotension, confusion
Term
Antiviral Agents
Definition
Acyclovir (Zovirax)
Nursing interventions
Administer IV over 60 minutes
Monitor CBC, renal and liver function tests, urine output
Monitor BP
Assess for superinfection
Increase fluid intake
Instruct client to practice abstinence or use condoms
Term
Antiviral Agents
Definition
Drug: famciclovir (Famvir)
Actions
Prodrug of penciclovir; inhibit viral cell replication
Uses
Treat recurrent infections of genital herpes, acute herpes zoster
Common adverse effects
Nausea, vomiting, headache
Serious adverse effects
Confusion
Term
Antiviral Agents
Definition
Drug:
lamivudine (Epivir)
Zidovudine (Retrovir): used alone during pregnancy
Actions
NRTI that inhibits replication of viruses
Uses
Epivir used in combination with zidovudine to treat HIV-1 infection; chronic hepatitis B associated with active liver inflammation
Serious adverse effects
Anemia, granulocytopenia, lactic acidosis, hepatotoxicity
Term
Antiviral Agents
Definition
Drug:
lamivudine (Epivir)
Zidovudine (Retrovir): used alone during pregnancy
Nursing considerations
Monitor liver functions
Take as directed
Meds do not cure HIV/AIDS, only control progression
Monitor viral load (amt of HIV in the blood) and CD4 (T-cells: help to organize your body's defenses against disease). count regularly
Term
Vaginitis
Definition
Leukorrhea is not a disease but symptom of an underlying disorder
Most common cause is infection of the lower reproductive tract
Common organisms: Candida albicans, Trichomonas vaginalis, Gardnerella vaginalis
Products to treat vaginitis
Miconazole (Monistat)
Metronidazole (Flagyl)
See Table 41-2 for further discussion
Term
Nursining Assessment
Definition
Be aware of increasing frequency of sexual activity among adolescents
History of current symptoms
Medication history
Psychosocial considerations
Laboratory and diagnostic studies
Physical examination
Proper approach and use of confidential information will encourage responses during interviews
Term
Sexually Transmitted Diseases
Definition
Instructions for adolescents
Rate of STDs is high among those who have unprotected sexual contact with multiple partners
Do thorough assessment of sexual activity and practices
For those sexually active, counsel regarding safe sex practices and voluntary testing
All adolescents should be taught about abstinence and safe sex practices
Term
Instruction for Women
Definition
Teaching self-care regarding STDs
Refrain from using irritating vaginal substances
Warm sitz baths may help relieve irritation
Discuss good personal hygiene practices
Hormonal and surgical contraceptive methods do not protect against STDs
Use chemical and physical barriers such as condoms
Properly apply vaginal medications
Term
Instruction for Men
Definition
Teaching self-care regarding STDs
Discuss good personal hygiene practices
Discuss appropriate interventions for men with altered sexual function
Latex condoms can be effective in reducing transmission of HIV and some STDs, but are not effective against STDs transmitted by skin-to-skin contact
Term
Oral Contraceptives
Definition
Actions
Estrogens block the pituitary release of FSH; progestins inhibit pituitary release of LH
Uses
Induce contraception by inhibiting ovulation
Common adverse effects
Nausea, weight gain, depression
Serious adverse effects
Breakthrough bleeding, yeast infection, blurred vision, severe headaches, dizziness, leg pain, chest pain, shortness of breath, acute abdominal pain
Term
Oral Contraceptives
Definition
Types
Combination pill – taken for 21 days of the menstrual cycle; contains estrogen and progestin
Subdivided into three classes: monophasic, biphasic, triphasic
Minipill – taken every day; contains only progestin
Extended and continuous–cycle – 24-day or 84-day cycles followed by a short placebo period
Term
Transdermal Contraceptives
Definition
Drug: norelgestromin–ethinyl estradiol transdermal system (Ortho Evra)
Actions
Inhibit ovulation
Uses
Estrogen and progestin hormones are in patch form
Common adverse effects
Nausea, weight gain, depression
Serious adverse effects
Blurred vision, severe headaches, dizziness, leg pain, chest pain, shortness of breath, acute abdominal pain
Term
Transdermal Contraceptives
Definition
Drug: norelgestromin–ethinyl estradiol transdermal system (Ortho Evra)
Actions
Inhibit ovulation
Uses
Estrogen and progestin hormones are in patch form
Common adverse effects
Nausea, weight gain, depression
Serious adverse effects
Blurred vision, severe headaches, dizziness, leg pain, chest pain, shortness of breath, acute abdominal pain
Term
Intra vaginal hormonal contraceptive
Definition
Drug: etonogestrel–ethinyl estradiol vaginal ring (NuvaRing)
Actions
Estrogen and progestin inhibit ovulation
Uses
Plastic ring dosage form is inserted into vagina
Common adverse effects
Nausea, weight gain, spotting, depression, mood changes, headaches, insomnia, fatigue, lack of energy
Serious adverse effects
Leg pain, chest pain, shortness of breath
Term
Alpha-1 Adrenergic Blocking Agents
Definition
Actions
Block alpha-1 receptors on the prostate gland, causing muscle relaxation, allowing greater urinary outflow
Uses
Reduce mild to moderate urinary obstruction in men with BPH
Common adverse effects
Drowsiness, headache, dizziness, weakness, lethargy; tachycardia, fainting
Term
Antiandrogen Agents
Definition
Drug: dutasteride (Avodart)
Actions
Inhibit enzyme 5-alpha reductase, reduce DHT levels
Uses
Treat symptoms of BPH, reduce risks of urinary retention, minimize need for surgery for BPH
Common adverse effects
Impotence, decreased libido, decreased volume of ejaculate
Term
Antiandrogen Agents
Definition
Drug: finasteride (Proscar)
Actions
Inhibit enzyme 5-alpha reductase, reduce DHT levels
Uses
Treat symptoms of BPH, reduce risks of urinary retention, minimize need for surgery for BPH, treat male pattern baldness
Common adverse effects
Impotence, decreased libido, decreased volume of ejaculate
Term
Phosphodiesterase Inhibitors
Definition
Drugs
Sildenafil (Viagra)
Tadalafil (Cialis)
Actions
Selective inhibitor of PDE-5 enzyme
Uses
Treat male erectile dysfunction; pulmonary arterial hypertension
Common adverse effects
Headache, flushing of the face and neck, color vision impairment
Serious adverse effects
Nitrates are contraindicated
Hypotension, dizziness, angina, loss of vision, sustained erection
Term
Urinary tract infection
Definition
11 million people treated every year
Second most common cause of death from infection
Urinalysis results
White and cloudy – infection
Dark yellow to amber – dehydration
Foul smell – infection
Foamy or frothy – proteins present
Casts – dehydration
Term
Causes of UTI's
Definition
Gram-negative aerobic bacilli from the GI tract
Escherichia coli
Other organisms
Staphylococcus saprophyticus
Klebsiella pneumoniae
Enterobacter
Proteus mirabilis
Pseudomonas aeruginosa
Term
Patient Education for repeated UTI's
Definition
Determine ways to reduce frequency of infection
Personal hygiene practices
Pattern of urination
Pattern of pain
Medication history
Maintaining adequate fluid intake
Term
Baseline data collection
Definition
Urine frequency, amount, odor, color
Urine acidity – check pH
Burning or pain on urination
Vital signs
Skin color
History of UTIs
History of GI complaints
Term
Quinolone Antibiotics
Definition
Cipro & Levaquin
Actions
Inhibit DNA gyrase enzymes needed for DNA replication in bacteria
Uses
Treat recurrent UTIs caused by E. coli, P. mirabilis, and others
Common adverse effects
Nausea, vomiting, anorexia, abdominal cramps, flatulence, drowsiness, visual disturbance, photosensitivity
Serious adverse effects
Hematuria, perineal burning, urticaria, hives, headache, dizziness, photophobia, tinnitus
Term
Anticholinergic Agents for overactive bladder syndrome
Definition
Drugs
Oxybutynin (Ditropan)
Tolterodine (Detrol)
Actions
Block the cholinergic receptors of the bladder, causing relaxation
Uses
Reduce urgency and frequency of bladder contractions in patients with overactive bladder (OAB)
Common adverse effects
Dry mouth, urinary hesitancy, retention, constipation, bloating, blurred vision
Serious adverse effects
Intensification of any of the above symptoms
Term
Miscellaneous Urinary Agents
Definition
Drug: bethanechol chloride (Urecholine)
Actions
Stimulation of the parasympathetic nerve that causes contraction in the bladder
Uses
Restore bladder tone and urination in nonobstructive urinary retention
Common adverse effects
Flushing of skin, headache
Serious adverse effects
Nausea, vomiting, sweating, colicky pain, abdominal cramps, diarrhea, belching, involuntary defecation
Term
Miscellaneous Urinary Agents
Definition
Drug: neostigmine (Prostigmin)
Actions
Increase tone of bladder muscles by blocking cholinesterase, preventing the breakdown of acetylcholine
Uses
Prevent and treat postoperative bladder distention and retention
Therapeutic outcome
Prevention or treatment of postoperative or postdelivery urinary retention
Term
Miscellaneous Urinary Agents
Definition
Drug: phenazopyridine hydrochloride (Pyridium)
Actions
Produce local anesthetic effect on ureters and bladder
Uses
Relieve burning, pain, urgency, frequency associated with UTIs
Common adverse effects
Reddish orange urine color
Serious adverse effects
Yellow sclera or skin
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