Transcript Tunyapon Sasithorn Kay

Tunyapon Sasithorn
Kay
Case # 32
Pharmacology clinical case
Case # 32
• JV a 23 y/o female, single was seen at the
OPD because of dysuria , frequency,
urgency and suprapubic pain. Urinalysis
revealed UTI
UTI
A urinary tract infection (UTI) is a bacterial
infection that affects any part of the urinary
tract. Although urine contains a variety of fluids,
salts, and waste products, it usually does not
have bacteria in it. When bacteria get into the
bladder or kidney and multiply in the urine, they
cause a UTI. The most common type of UTI is a
bladder infection which is also often called
cystitis. Another kind of UTI is a kidney
infection, known as pyelonephritis, and is much
more serious.
Signs and symptoms
•For Bladder Infections
•For Kidney Infections
•Frequent urination along with the feeling
of having to micturate even though little or
no urine actually comes out.
•Nocturia: Need to urinate during the
night.
•Urethritis: Discomfort or pain at the
urethral meatus or a burning sensation
throughout the urethra with micturition
(dysuria).
•Cystitis: Pain in the midline suprapubic
region.
•Pyuria/Hematuria: Pus or blood in urine.
•Pyrexia: Mild fever
•Discharge from the urethra.
•Cloudy and foul-smelling urine
•Some urinary tract infections are
asymptomatic
•The above symptoms.
•Emesis: Vomiting is common.
•Back, side (flank) or groin pain.
•Abdominal pain or pressure.
•Shaking chills.
•Night Sweats.
•Extreme Fatigue.
Diagnosis
• A patient with dysuria (painful voiding) and
urinary frequency will generally have a midstream urine sample sent for urinalysis.
• The diagnosis of UTI is confirmed by a
urine culture.
• Specific finding will include the presence of
nitrates, bacterias, leukocytes or
leukocyte esterase.
Differential diagnosis
•Urethral syndrome
•Dysuria
•Urgency
•Nocturia
•Urinary frequency
•Urethral discomfort
•Painful urination
•Urinary symptoms worsened by sex
•No bacteria in urine
•Have no bacterial infection
•No pus in urine
•No lower abdominal pain
•No fever
•Pelvic pain
•Slowing of your urinary stream
•Bladder cancer
•Frequent urination
•Pain during urination,
•Blood in the urine (making the
urine slightly rusty to deep red)
Treatment
•Drugs most commonly recommended for simple UTIs
include
•amoxicillin (Amoxil, Trimox),
•nitrofurantoin (Furadantin, Macrodantin),
•trimethoprim (Proloprim)
•Antibiotic combination:
trimethoprim and sulfamethoxazole
(Bactrim, Septra)
Management and prevention
You can take steps to reduce your risk of urinary tract infections.
• Drink plenty of liquids, especially water. Cranberry juice may have
infection-fighting properties. However, don't drink cranberry juice if
you're taking the blood-thinning medication warfarin. Possible
interactions between cranberry juice and warfarin can lead to
bleeding.
• Urinate promptly when the urge arises. Avoid retaining your urine
for a long time after you feel the urge to void.
• Wipe from front to back. Doing so after urinating and after a bowel
movement helps prevent bacteria in the anal region from spreading
anal region from spreading to the vagina and urethra.
• Empty your bladder as soon as possible after intercourse. Also, drink
a full glass of water to help flush bacteria.
• Avoid potentially irritating feminine products. Using deodorant
sprays or other feminine products, such as douches and powders, in
the genital area can irritate the urethra
Thank you
