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Drugs Used to Treat Disorders of the Urinary System
Chapter 42Chapter 42
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 2
Chapter 42
Lesson 42.1
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 3
ObjectivesObjectives
• Develop a health teaching plan for an individual who has repeated urinary tract infections
• Analyze Table 42-1 and identify specific portions of a urinalysis report that would indicate proteinuria, dehydration, infection, or renal disease
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 4
Urinary Tract Infections (UTIs)Urinary Tract Infections (UTIs)
• 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
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 5
Causes of UTIsCauses of UTIs
• Gram-negative aerobic bacilli from the GI tract Escherichia coli
• Other organisms Staphylococcus saprophyticus Klebsiella pneumoniae Enterobacter Proteus mirabilis Pseudomonas aeruginosa
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Patient Education for Repeated UTIsPatient Education for Repeated UTIs
• Determine ways to reduce frequency of infection Personal hygiene practices Pattern of urination Pattern of pain Medication history Maintaining adequate fluid intake
Slide 6Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 7
Chapter 42
Lesson 42.2
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 8
ObjectivesObjectives
• Identify essential components involved in planning patient education that will enhance compliance with the treatment regimen
• Explain the major action and effects of drugs used to treat disorders of the urinary tract
• Identify the symptoms, treatment, and medication used for overactive bladder syndrome
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Objectives (cont’d)Objectives (cont’d)
• Identify important nursing assessments and interventions associated with the drug therapy and treatment of diseases of the urinary system
• Identify baseline data the nurse should collect on a continuous basis for comparison and evaluation of drug effectiveness
Slide 9Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 10
Objectives (cont’d)Objectives (cont’d)
• Prepare a chart of antimicrobial agents used to treat urinary tract infections. Give the drug names, the organisms treated, and special considerations (e.g., the need for acidic urine, changes in urine color, and effect on urine tests).
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 11
Baseline Data CollectionBaseline Data Collection
• 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
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Drug Class: Fosfomycin AntibioticsDrug Class: Fosfomycin Antibiotics
• Drug: fosfomycin (Monurol)• Actions
Inhibit bacterial cell wall synthesis, reduce bacteria’s adherence to the urinary tract
• Uses Single dose treatment for UTI
• Common adverse effects Nausea, diarrhea, abdominal cramps,
flatulence
• Serious adverse effects Perineal burning, dysuria
Slide 12Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Drug Class: Quinolone AntibioticsDrug Class: Quinolone Antibiotics
• 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, tinnitusSlide 13Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Other Urinary Antibacterial AgentsOther Urinary Antibacterial Agents
• Drug: methenamine mandelate (Mandelamine)• Actions
Form formaldehyde in presence of acidic urine, suppressing growth of bacteria
• Uses Treat chronic, recurrent UTIs
• Common adverse effects Nausea, vomiting, belching
• Serious adverse effects Hives, pruritus, rash; bladder irritation, dysuria,
frequency
Slide 14Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Other Urinary Antibacterial Agents Other Urinary Antibacterial Agents (cont’d)(cont’d)
• Drug: nitrofurantoin (Furadantin, Macrodantin)• Actions
Interfere with several bacterial enzyme systems
• Uses Treat UTIs
• Common adverse effects Nausea, vomiting, anorexia, urine discoloration
• Serious adverse effects Dyspnea, chills, fever, rash, pruritus,
neuropathies, secondary infection
Slide 15Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Drug Class: Anticholinergic Agents Drug Class: Anticholinergic Agents for Overactive Bladder Syndromefor Overactive Bladder Syndrome
• 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
Slide 16Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Miscellaneous Urinary AgentsMiscellaneous Urinary Agents
• 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
Slide 17Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Miscellaneous Urinary Agents Miscellaneous Urinary Agents (cont’d)(cont’d)
• 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
Slide 18Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Miscellaneous Urinary Agents Miscellaneous Urinary Agents (cont’d)(cont’d)
• 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
Slide 19Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.