Pharmacology Exam

• Cystitis


  Lower UTI, frequently in females due to the short urethra
• Pyelonephritis


  Upper UTI, commonly seen in female patients
• Organisms causing Cystitis


  • E. Coli, Staphylococcus Saprophyticus, Klebsiella, Proteus, Pseudomonas
• Organisms causing Pyelonephritis


  • E. Coli
• In men, cystitis is usually due to prostatitis and has similar symptoms
• Severe cases of pyelonephritis might be hospitalized to receive IV antibiotics
• Urinary Analgesic


  Medication used to relieve pain, discomfort, and irritation in the urinary tract
• Urinary Stimulant


  Medication that enhances the function of the urinary system, typically by increasing urine production or promoting bladder emptying
• Urinary Antispasmodic


  Medication used to relieve spasms or involuntary contractions of the muscles in the urinary tract
• Phenazopyridine


  Urinary Analgesic, Relieves pain, burning sensation, frequency, urgency
• Side Effects of Phenazopyridine

  • Renal: Red-orange urine (dye), Toxicities: Nephrotoxicity, hepatotoxicity, GI: distress
• Phenazopyridine can alter the glucose urine test, therefore a blood test should be used to monitor glucose levels
• Patients should be advised to avoid antacids as they interfere with absorption of Phenazopyridine, and to increase fluids and take the drug with food to minimize GI upset
• Urinary Incontinence


  Involuntary leakage of urine, meaning a person urinates when they do not want to. Control over the urinary sphincter is either lost or weakened
• Bethanechol (Urechol)


  Urinary Stimulant, Increases bladder tone of detrusor urinary muscle, Produces a contraction strong enough to stimulate urination
• Side Effects of Bethanechol

  • GI distress, headache, dizziness, Nephrotoxicity, hepatotoxicity
• Bethanechol is contraindicated in patients with peptic ulcers
• Oxybutynin, Flavoxate


  Urinary Antispasmodics, Direct action on smooth muscles to relieve spasms
• Side Effects of Urinary Antispasmodics

  • Drowsiness, dizziness, Blurred vision, tachycardia, Dry mouth, GI distress, constipation
• Urinary Antispasmodics should be avoided in patients with glaucoma, GI, or urinary obstruction
• Tolterodine Tartrate (Detrol)


  Antimuscarinic/Anticholinergic drug used to control an overactive bladder and decrease urge and urinary incontinence
• Side Effects of Tolterodine Tartrate


  • Headache, dizziness, confusion, Blurred vision, dysphonia, Peripheral edema, elevated hepatic enzymes, Dry mouth, diarrhea, constipation, abdominal pain
• Tolterodine Tartrate is contraindicated in patients with narrow-angle glaucoma and hepatic impairment
• Trimethoprim Sulfamethoxazole (Bactrim DS)


  One of the most common antibiotics used for UTIs (around 90%), Can be used for a systemic infection; slow-acting bactericidal effects against most gram-negative and gram-positive organisms
• Side Effects of Trimethoprim Sulfamethoxazole

  • CNS: headache, dizziness, GI: C-diff, diarrhea, abdominal pain, anorexia, MS: malaysia, Dermatologic: photosensitivity, Renal: crystalluria
• Patients with a UTI should increase their fluid intake, including water and cranberry juice, but not caffeine, to help flush the kidney
• Methenamine


  Urinary antiseptic that interferes with cell wall synthesis by forming ammonia and formaldehyde in the urine, should be taken with cranberry juice to acidify the urine and make it work
• Side Effects of Methenamine

  • GI: nausea, upset stomach, mild diarrhea, CNS: headache, dizziness, weakness, Renal: crystalluria, super-infection: vaginal itching or discharge
• Methenamine should not be taken with sulfonamides
• Nitrofurantoin


  Used for cystitis and UTIs
• Side Effects of Nitrofurantoin

  • GI: n/v/d/, upset stomach, c-diff, CNS: headache, dizziness, weakness, myopathy, Renal: brown urine, Labs: blood levels, increase liver enzyme
• Nitrofurantoin needs to be taken with food to decrease GI distress, and absorption decreases with antacids
• Levothyroxine (Synthroid)


  Synthetic T4, Drug of choice for treatment of hypothyroidism
• Side Effects of Levothyroxine

  • CNS: insomnia, irritation, nervousness, GI: N/V/D, weight loss, Endocrine: no menstrual cycle
• Adverse Effects of Levothyroxine

  • CV: Hypotension, Palpitation, A-fib, Bone: Osteoporosis, CNS: Seizures
• Thyroid crisis/storm can occur with levothyroxine, characterized by extreme tachycardia, widened diastolic/systolic, and high temperature
• Levothyroxine should be taken on an empty stomach 30-60 minutes prior to breakfast, at the same time every day, and is safe for pregnancy
• Methimazole


  Drug of choice for treatment of hyperthyroidism, Inhibits thyroid hormone and blocks thyroid action but does not destroy
• Uses of Methimazole


  • Graves disease, Adjunct to radiation therapy, Suppressed thyroid synthesis in preparation for thyroidectomy
• Side Effects of Methimazole

  • CNS: HA, Dizziness, drowsiness, weakness, tiredness, GI: stomach pain, loss of taste, vomiting, heartburn, Hematologic: Agranulocytosis (decrease WBC)