Drugs That Act on the Urinary Tract
TERMS
□ sulfamethoxazole-trimethoprim (Bactrim)
□ phenazopyridine (Pyridium)
□ Qxybutnin (Ditropan)
QUICK LOOK AT THE CHAPTER AHEAD
Urinary tract infection (UTI) and other urinary problems are treated with various medications. Four classes of drugs that are used for UTI will be discussed in this chapter: sulfonamides, urinary tract antiseptics, urinary tract analgesics, and a miscellaneous anti-infective that is used specifically for UTI. Urinary antispasmodics will also be discussed.
The sulfonamides are synthetic and are all derived from sulfanilamide, the first sulfonamide that was discovered. Because they achieve high concentrations in the kidneys, which are the organs that eliminate them from the body, they are a good choice for the treatment of UTI. The sulfonamides have a broad spectrum of activity and are given orally. They are considered to be bacteriostatic.
The urinary tract antiseptics are unable to reach therapeutic levels in the tissues or blood and are not used to treat systemic infections. They are used specifically for the treatment of UTI. They concentrate in the urine and are used successfully against common bacteria found in the urinary tract. They are considered to be second-line treatment for UTI.1 There is no prototype for this group, so each drug will be discussed individually. They are all given orally.
Phenazopyridine (Pyridium) is used as a urinary tract analgesic. It doesn’t have any anti-infective action but is used to relieve the symptoms of UTI. It is given orally.
Fosfomycin (Monurol) is a synthetic, broad-spectrum antibiotic. It is bactericidal and given orally as a one-time dose. Improvements in symptoms of UTI are seen in 2 to 3 days after administration.
Spasms of the urinary tract can be caused by various problems. The urinary antispasmodics are used to stop the spasms.
Table 10-1 Drugs That Act on the Urinary Tract | ||||||||||||||||||
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DRUGS THAT ACT ON THE URINARY TRACT CLIENT TEACHINGSulfonamides
Take with 8 ounces of water on an empty stomach.
Take all of medication.
Stop drug if skin rash appears.
Stay out of sun and wear sunscreen and protective clothing if you have to be exposed.
Drink 8 to 10 glasses of water per day.
Take with 8 ounces of water on an empty stomach.
Stay out of sun and wear sunscreen and protective clothing if you have to be exposed.Urinary Tract Antiseptics
Cinoxacin (Cinobac)
Take all of medication.
Take drug around the clock.
Notify physician if symptoms worsen or tinnitus occurs.
No driving or hazardous activities until reaction to drug is known
Do not breast-feed.
Notify physician if symptoms worsen or tinnitus occurs.
Do not breast-feed.Methenamine (Hiprex)
Take with food.
Do not breast-feed.
Do not take OTC antacids containing sodium bicarbonate or sodium carbonate.
Increase foods that will acidify urine (proteins, prunes, plums, cranberry juice).
Do not take OTC antacids containing sodium bicarbonate or sodium carbonate.Nalidixic Acid (NegGram)
Take all of drug exactly as prescribed.
Report headaches and behavior changes immediately.
Increase fluid intake to 2 to 3 L/day.
Stay out of sun for 3 months after drug is discontinued.
Report vision problems in initial days of therapy.
Do not breast-feed.
Report headaches and behavior changes immediately.
Stay out of sun for 3 months after drug is discontinued.Nitrofurantoin (Macrodantin)
IM injection is painful.
Urine may turn brown.
Do not force fluids.
Do not breast-feed.
Urinary Tract Analgesic
Phenazopyridine (Pyridium)
Urine will turn red-orange and will stain clothes.
Report yellow color of skin or sclera immediately.
Stop drug when discomfort is gone.
Breast-feed only after discussing with physician.
Urine will turn red-orange and will stain clothes.
Report yellow color of skin or sclera immediately.Urinary Antispasmodics
Do not breast-feed.
Do not get overheated as fever and heat stroke can develop.
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