Exam 3 Study Guide

• 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
• 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
• Urinary Incontinence


  Involuntary leakage of urine, meaning a person urinates when they do not want to
• Phenazopyridine


  Urinary Analgesic, relieves pain, burning sensation, frequency, urgency
• Phenazopyridine can alter the glucose urine test, therefore a blood test should be used to monitor glucose levels
• Phenazopyridine can cause renal and hepatic toxicity, GI distress
• Phenazopyridine should be taken with food and avoided with antacids as they interfere with absorption
• Bethanechol (Urechol)


  Urinary Stimulant, increases bladder tone of detrusor urinary muscle, produces a contraction strong enough to stimulate urination
• Bethanechol can cause GI distress, headache, dizziness, nephrotoxicity, hepatotoxicity
• Bethanechol is contraindicated in peptic ulcers
• Oxybutynin


  Urinary Antispasmodic, direct action on smooth muscles to relieve bladder spasms
• Oxybutynin is contraindicated in glaucoma, GI, or urinary obstruction
• Tolterodine Tartrate (Detrol)


  Antimuscarinic/Anticholinergic, used to control an overactive bladder and decrease urge and urinary incontinence

  
• Tolterodine is contraindicated in narrow-angle glaucoma and hepatic impairment
• Trimethoprim Sulfamethoxazole (Bactrim DS)


  One of the most common antibiotics used for UTIs, can be used for systemic infections, has slow-acting bactericidal effects against most gram-negative and gram-positive organisms
• Fluid intake is important for patients with a UTI to help flush the kidneys, including water and cranberry juice but not caffeine
• Methenamine


  Urinary antiseptic, interferes with cell wall synthesis by forming ammonia and formaldehyde in the urine, taken with cranberry juice to acidify the urine and make it work
• Methenamine should not be taken with sulfonamides
• Nitrofurantoin


  Used for cystitis and UTIs
• Nitrofurantoin needs to be taken with food to decrease GI distress, and absorption is decreased by antacids
• Levothyroxine (Synthroid)


  Synthetic T4, drug of choice for treating hypothyroidism
• Adverse effects of levothyroxine include hypotension, palpitation, A-fib, osteoporosis, seizures, and thyroid crisis/storm
• 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
• Frequent lab monitoring is required when taking levothyroxine
• Methimazole


  Drug of choice for treating hyperthyroidism, inhibits thyroid hormone and blocks thyroid action but does not destroy it
• Methimazole is safer than PTU except in the first trimester of pregnancy, and agranulocytosis is the most serious toxicity
• Propylthiouracil (PTU)


  Second line drug for hyperthyroidism, inhibits thyroid production and prevents conversion of T4 to T3 in the periphery
• PTU is safer in pregnancy and breastfeeding than methimazole, and is preferred during the first trimester and thyroid storm
• Radioactive Iodine 131I and 123I

  Used for thyroid cancer (high dose 131I) and hyperthyroidism (lower dose 131I), and diagnostic testing (123I)
• Radioactive iodine is contraindicated in pregnancy/lactation and pediatric patients
• Non-radioactive iodine


  Used short-term for hyperthyroidism, such as prior to thyroidectomy or thyrotoxic crisis
• Non-radioactive iodine is also contraindicated in pregnancy/lactation and pediatric patients
• Beta blockers


  Used to suppress tachycardia and other symptoms of Grave's disease, and may be used in thyrotoxic crisis
• Beta blockers are contraindicated in patients with asthma
• Liothyronine


  Used for rapid onset treatment of hypothyroidism, often used for initial treatment of myxedema