URINARY TRACT INFECTION Medical Presentation

Urinary Tract Infection PowerPoint Presentation

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Published on : Sep 27, 2019 | Views : 3729 | Downloads : 13

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URINARY TRACT INFECTION
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OBJECTIVES 1. Differentiate the types of urinary tract infection with their sign and symptoms 2. Describe the factors that affect treatment of the problems 3. Describe an appropriate plan for the treatment problem
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Norma 8y/o S/S: Increased urinary urgency for the last 5 days No fever, cough and colds PE: Unremarkable Lab exam: WBC: 13.5x1O9/L PF URINALYSIS: WBC: 20-25 cells/mm3 Urine Culture: Gram negative rods
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What is UTI and differentiate it’s types? What is your diagnosis and basis of diagnosis? What is the risk factors does the patient for UTI? List the different bacteria that may cause UTI? Discuss the nonpharmacological and pharmacological treatment of uncomplicated UTI Differentiate the different drug class that can be used for the treatment of UTI depending on efficacy, suitability, safety and cost (table) What is the drug of choice Write a prescription for this patient and be able to discuss this to the patient follow up and monitoring
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Pathogenesis of UTI
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TYPES OF UTI
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DIAGNOSIS ACUTE UNCOMPLICATED CYSTITIS BASIS OF DIAGNOSIS: -Urinary urgency -No fever -Acute dysuria- Increased WBC Urinalysis - Increased WBC in CBC -Presence of Gram Negative rods on Urine Culture
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RISK FACTORS FEMALE Sexual intercourse Catheter- Associated UTI Host- dependent factors: Structural or functional abnormalities of the urinary tract Pregnancy Diabetes Mellitus Immunocompromise Uncircumsized males Chronic constipation in toddlers
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Microorganism that causes UTI
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Nonpharmacological treatment Drink plenty of fluids (water) Drink cranberry juice Urinate when the need arise Proper hygiene with proper toilet training Drink probiotics Take Vit C
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Pharmacologic treatment 2nd Generation Cephalosporins 3rd Generation Cephalosporins Trimetroprim Sulfamethoxazole
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Drug class
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Trimetroprim sulfamethoxazole PHARMACODYNAMICS: A trimethoxybenzylpyrimidine, selectively inhibits bacterial dihydrofolic acid reductase, which converts dihydrofolic acid to tetrahydrofolic acid, a step leading to the synthesis of purines and ultimately to DNA.
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PHARMACOKINETICS: A- well absorbed from the gut D- Because trimethoprim is more lipid-soluble than sulfamethoxazole, it has a larger volume of distribution than the latter drug. Therefore, when 1 part of trimethoprim is given with 5 parts of sulfamethoxazole (the ratio in the formulation), the peak plasma concentrations are in the ratio of 1:20, which is optimal for the combined effects of these drugs in vitro. M- Liver E- About 30–50% of the sulfonamide and 50–60% of the trimethoprim are excreted in the urine within 24 hours.
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ADVERSE EFFECTS -antifolate drug- megaloblastic anemia, leukopenia, and granulocytopenia Nausea and vomiting, drug fever, vasculitis, renal damage, and central nervous system disturbances occasionally occur also. Patients with AIDS and pneumocystis pneumonia have a particularly high frequency of untoward reactions to trimethoprim-sulfamethoxazole, especially fever, rashes, leukopenia, diarrhea, elevations of hepatic aminotransferases, hyperkalemia, and hyponatremia.
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Presciption Trimetroprim Sulfametoxazole 8 mg/kg trimethoprim and 40 mg/kg sulfamethoxazole every 12 hours.