Quiz 3 Study Guide: Derm, UTIs, STIs
1. Know how to treat skin infections. Know primary and secondary treatments
(eg., in case of allergic reaction to initial drug choice)
● bacterial
● viral
● fungal
● parasitic
1. Know how to treat simple and complex urinary tract infections.
- Uncomplicated cystitis recommended therapy
- trimethoprim/sulfamethoxazole DS BID for three days
- Nitrofurantoin 100mg BID for 5 days
- Fosfomycin 3g
- Alternative: fluoroquinolones for 3 days, beta lactams for 3-7 days
- Uncomplicated pyelonephritis therapy
- trimethoprim/sulfamethoxazole DS BID for 14 days
- fluoroquinolones for 5-7 days
- beta lactams for 10-14 days
- Complicated UTI: Male sex, Hospital acquired, Pregnancy, Indwelling urinary catheter,
Immunosuppression, Recent antibiotic use
- Inpatient :
- Fluoroquinolone
- Aminoglycoside
- Extended spectrum beta lactam
- Duration is about 5-14 days (5 days with levofloxacin)
- Pregnancy: 7 day treatment regimen
- Amoxicillin
- Nitrofurantoin (avoid after 38 weeks gestation and during labor and delivery)
- Cephalexin
- Avoid: fluoroquinolones, tetracycline, aminoglycosides
-
1. Know how to manage UTIs in special populations (peds, pregnancy,
elderly)
Infants and children
- Diagnose with catheterized specimens.
- Febrile UTI is treated aggressively, with parenteral antibiotics (ceftriaxone) until afebrile.
- Treat for 10 days.
- Perform follow up culture to document successful treatment.
- Urine culture
- Re-culture at end of therapy
This study source was downloaded by 100000846529857 from CourseHero.com on 05-06-2022 12:57:34 GMT -05:00
https://www.coursehero.com/file/131569112/NURS-6234-Pharmacology-Quiz-3-Study-Guide-Spring-2021pdf/
, - May need radiological workup
- Consider anatomical problems, such as vesicoureteral reflux.
Older adults
- Risk for asymptomatic UTI
- Treatment based on culture and sensitivity
Males: increased risk with enlarged prostate
Pregnancy
- Asymptomatic bacteriuria
- Routine screening during pregnancy
- Need follow-up urine culture every 2 weeks until delivery
1. Know how to diagnose and treat different types of vaginitis.
- Diagnosing vaginal discharge and vulvar conditions requires examination of the area affected and
microscopic examination of vaginal secretions.
- Vaginitis may or may not be sexually transmitted.
Pathophysiology
Cytolytic vaginosis
- Overgrowth of Lactobacillus occurring late in the menstrual cycle
- Treatment with intravaginal sodium bicarbonate capsules twice weekly in last week of menstrual
cycle
Atrophic vaginitis with secondary infection
- Cultures performed to guide treatment
Goal: Treat the infection or inflammation, prevent reinfection, and prevent complications of the infection
or inflammation.
Accurate diagnosis is essential for treatment.
Phone diagnosis is not always accurate.
Rational Drug Selection
- Need to use correct drug for pathogen
- Drug resistance
- Cost
- Over-the-counter antifungals are inexpensive.
Patient variables
- Pregnancy may affect treatment choices.
Drug variables
- Intravaginal medications have the fewest drug interactions.
Monitoring
- No ongoing monitoring is required unless chronic infection.
Outcome evaluation
- If patient does not respond to therapy, consider referral.
Patient education
- Treatment plan
- Adherence issues
This study source was downloaded by 100000846529857 from CourseHero.com on 05-06-2022 12:57:34 GMT -05:00
https://www.coursehero.com/file/131569112/NURS-6234-Pharmacology-Quiz-3-Study-Guide-Spring-2021pdf/
1. Know how to treat skin infections. Know primary and secondary treatments
(eg., in case of allergic reaction to initial drug choice)
● bacterial
● viral
● fungal
● parasitic
1. Know how to treat simple and complex urinary tract infections.
- Uncomplicated cystitis recommended therapy
- trimethoprim/sulfamethoxazole DS BID for three days
- Nitrofurantoin 100mg BID for 5 days
- Fosfomycin 3g
- Alternative: fluoroquinolones for 3 days, beta lactams for 3-7 days
- Uncomplicated pyelonephritis therapy
- trimethoprim/sulfamethoxazole DS BID for 14 days
- fluoroquinolones for 5-7 days
- beta lactams for 10-14 days
- Complicated UTI: Male sex, Hospital acquired, Pregnancy, Indwelling urinary catheter,
Immunosuppression, Recent antibiotic use
- Inpatient :
- Fluoroquinolone
- Aminoglycoside
- Extended spectrum beta lactam
- Duration is about 5-14 days (5 days with levofloxacin)
- Pregnancy: 7 day treatment regimen
- Amoxicillin
- Nitrofurantoin (avoid after 38 weeks gestation and during labor and delivery)
- Cephalexin
- Avoid: fluoroquinolones, tetracycline, aminoglycosides
-
1. Know how to manage UTIs in special populations (peds, pregnancy,
elderly)
Infants and children
- Diagnose with catheterized specimens.
- Febrile UTI is treated aggressively, with parenteral antibiotics (ceftriaxone) until afebrile.
- Treat for 10 days.
- Perform follow up culture to document successful treatment.
- Urine culture
- Re-culture at end of therapy
This study source was downloaded by 100000846529857 from CourseHero.com on 05-06-2022 12:57:34 GMT -05:00
https://www.coursehero.com/file/131569112/NURS-6234-Pharmacology-Quiz-3-Study-Guide-Spring-2021pdf/
, - May need radiological workup
- Consider anatomical problems, such as vesicoureteral reflux.
Older adults
- Risk for asymptomatic UTI
- Treatment based on culture and sensitivity
Males: increased risk with enlarged prostate
Pregnancy
- Asymptomatic bacteriuria
- Routine screening during pregnancy
- Need follow-up urine culture every 2 weeks until delivery
1. Know how to diagnose and treat different types of vaginitis.
- Diagnosing vaginal discharge and vulvar conditions requires examination of the area affected and
microscopic examination of vaginal secretions.
- Vaginitis may or may not be sexually transmitted.
Pathophysiology
Cytolytic vaginosis
- Overgrowth of Lactobacillus occurring late in the menstrual cycle
- Treatment with intravaginal sodium bicarbonate capsules twice weekly in last week of menstrual
cycle
Atrophic vaginitis with secondary infection
- Cultures performed to guide treatment
Goal: Treat the infection or inflammation, prevent reinfection, and prevent complications of the infection
or inflammation.
Accurate diagnosis is essential for treatment.
Phone diagnosis is not always accurate.
Rational Drug Selection
- Need to use correct drug for pathogen
- Drug resistance
- Cost
- Over-the-counter antifungals are inexpensive.
Patient variables
- Pregnancy may affect treatment choices.
Drug variables
- Intravaginal medications have the fewest drug interactions.
Monitoring
- No ongoing monitoring is required unless chronic infection.
Outcome evaluation
- If patient does not respond to therapy, consider referral.
Patient education
- Treatment plan
- Adherence issues
This study source was downloaded by 100000846529857 from CourseHero.com on 05-06-2022 12:57:34 GMT -05:00
https://www.coursehero.com/file/131569112/NURS-6234-Pharmacology-Quiz-3-Study-Guide-Spring-2021pdf/
