Infection urinary tract

The sulfa dmgs are stiH important as antimicrobials, although they have been replaced in many systemic infections by the natural and semisynthetic antibiotics. They are of great value in third world countries where problems of storage and lack of medical personnel make appropriate use of antibiotics difficult. They are especially useful in urinary tract infections, particularly the combination of sulfamethoxazole with trimethoprim. Their effectiveness has been enhanced by co-adniinistration with dihydrofolate reductase inhibitors, and the combination of sulfamethoxazole with trimethoprim is of value in treatment of a number of specific microbial infections. The introduction of this combination (cotrimoxazole) in the late 1960s (1973 in the United States) resulted in increased use of sulfonamides. 

Sulfonamides in combination with dihydrofolate reductase inhibitors are of continuing value. Pyrimethamine [58-14-0] (5) in combination with sulfonamides is employed for toxoplasmosis (7), and a trimethoprim (6)-sulfamethoxa2ole preparation is used not only for urinary tract infections but also for bmceUosis, cholera, and malaria. 

Mixtures of sulfas (eg, the tri-sulfapyrimidines) have also been used for this purpose. Resistant organisms frequently result after a urinary tract infection has been treated with sulfonamides, however. 

L-Dopa and Trimethoprim are two other dmgs that can be made from vanillin. u-Dopa is used for the treatment of Parkinson s disease Trimethoprim is an antiinfective agent used mainly for urinary tract infections and certain venereal diseases. Also, Mebeverine, an antispasmodic agent, and Verazide, a generic antitubercular agent, are dmgs that can be made from vanillin or its derivatives. 

Cefuroxime (35) is effective against community-acquired pneumonia in which ampicillin-resistant Haemophilus influence is the probable etiologic agent. Cefoxitin (23) is used to treat mixed aerobic—anaerobic infections including pelvic infections, intra-abdorninal infections, and nosocomial aspiration pneumonia. Cefonicid (31), because of its long half-life has been used in a once-a-day regimen to treat a variety of mild to moderate infections including community-acquired pneumonias, urinary tract infections, and infections of the skin and soft tissue (132,215). 

Chlorhexidine has found other medical appHcations, eg, in urology in preventing urinary tract infections (217), in obstetrics and gynecology (218), in controlling infection in bums and wounds (219), and in the prevention of oral disease (220). Hypersensitivity to chlorhexidine has been reported in Japan (221) but 0.05% concentration is considered to be safe. 

The sulfonamides are often used to control urinary tract infections caused by certain bacteria such as Escherichia coli, Staphylococcus aureus, and Klebsiella-Enterobacter. Mafenide (Sulfamylon) and silver sulfadiazine (Silvadene) are topical sulfonamides used in the treatment of second- and third-degree bums. Additional uses of the sulfonamides are given in the Summary Drug Table The Sulfonamides. 

Ms. Bartlett, age 80, has been prescribed a sulfonamide for a urinary tract infection and is to take the drug for 10 days. You note that Ms. Bartlett seems forgetful and at times confused. Determine what problems might be associated with Ms. Bartlett s mental state and her possible noncompliance to her prescribed treatment regimen. 

The natural and semi ynthetic penicillins are used in tire treatment of bacterial infections due to susceptible microorganisms. Fbnicillins may be used to treat infections such as urinary tract infections, septicemia, meningitis, intra-abdominal infection, gonorrhea, syphilis, pneumonia, and other respiratory infections. Examples of infectious microorganisms (bacteria) that may respond to penicillin therapy include gonococci, staphylococci,... 

The fluoroquinolones are used in the treatment of infections caused by susceptible microorganisms. The fluoroquinolones are effective in the treatment of infections caused by gram-positive and gram-negative microorganisms. They are primarily used in the treatment of susceptible microorganisms in lower respiratory infections, infections of the skin, urinary tract infections, and sexually transmitted diseases. Ciprofloxacin, norfloxacin, and ofloxacin are available in ophthalmic forms for infections in the eyes. 

Discuss the uses, general drug actions, adverse reactions, contraindications, precautions, and interactions of the drugs used to treat infections and symptoms associated with urinary tract infections or an overactive bladder. 

Discuss important preadministration and ongoing assessment activities the nurse should perform on the patient taking a drug for a urinary tract infection or an overactive bladder. 

Discuss ways to promote an optimal response to therapy, how to manage adverse reactions, and important points to keep in mind when educating patients about the use of drugs used to treat a urinary tract infection or symptoms associated with an overactive bladder. 

This chapter discusses drug s used to treat urinary tract infections (UTIs) and certain miscellaneous drag > used to relieve the symptoms associated with an overactive bladder (involuntary contractions of the detrusor or bladder muscle). Structures of the urinary system that may be affected include the bladder (cystitis), prostate gland (prostatitis), the kidney, or the urethra (see Pig. 47-1). These drug s also help control the discomfort associated with irritation of the lower urinary tract mucosa caused by infection, trauma, surgery, and endoscopic procedures. 

Urinary tract infection (UTI) is an infection caused by pathogenic microorganisms of one or more structures of the urinary tract. The most common structure affected is the bladder, with the urethra, prostate, and kidney also affected (see Pig. 47-1). Display 47-1 identifies the disorder most frequently associated with each of these structures within the urinary system. Clinical manifestations of a UTI of the bladder (cystitis) include urgency, frequency, burning and pain on urination, and pain caused by spasm in the region of the bladder and the suprapubic area. 

The term generic indicates the drug is available in generic form. UTI, urinary tract infection. 

Cranberry juice has long been recommended for use in treating and preventing urinary tract infections (UTIs). Clinical studies have confirmed that cranberry juice is beneficial to individuals with frequent UTIs Cranberries inhibit bacteria from attaching to the walls of the urinary tract and prevent certain bacteria from forming dental plaque in the mouth. Cranberry juice is safe for use asa food and for urinary tract health. Cranberry juice and capsules have no contraindica-tions no known adverse reactions and no drug interactions The recommended dosage is9 to 15 capsules a day (400-500 mg/d) or 4 to 8 ounces of juice per day. (See Chap. 6 for more information.)... 

The energy substrates are contraindicated in patients with hypersensitivity to any component of the solution. Dextrose solutions are contraindicated in patients with diabetic coma with excessively high blood sugar. Concentrated dextrose solutions are contraindicated in patients with increased intracranial pressure, delirium tremens (if patient is dehydrated), hepatic coma, or glucose-galactose malabsorption syndrome Alcohol dextrose solutions are contraindicated in patients with epilepsy, urinary tract infections, alcoholism, and diabetic coma... 

Cranberry Vaccinium macrocarpon Urinary tract infection (UTI) Large doses can produce gastrointestinal symptoms (je, diarrhea) None significant. 

MaUk AA, Radhakiishnan N, Reddy K, Smith AD, Singhal PC (2002) Morphine-induced macrophage apoptosis modulates migration of macrophages use of in vitro model of urinary tract infection. J Endourol 16 605-610... 

From a clinical point of view, the sulphonamides are extremely useful for the treatment of uncomplicated urinary tract infection caused by E. coli in domiciliary practice. They have also been employed in treating meningococcal meningitis (a current... 

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