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What populations are at risk for Toxic shock syndrome?
Tampon use for more than 8 hours, high absorbency tampon use, diabetes, alcoholism, minor trauma, recent surgery
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What is the most common bacterial infection?
UTI
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What bacteria is implicated in most UTIs?
E. coli
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How do UTIs develop?
Normal vaginal flora is introduced to the urethra through sexual activity, foreign instrumentation or compromised immunity
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What are the signs and symptoms of a UTI?
Urge to urinate, small frequent urination, burning, cloudy urine, strong urine smell, pelvic pain, blood in urine
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What are the risk factors for UTI?
Female, sexual activity, post-menopause, se of spermicides/diaphragms, kidney stones, catheter, immunosuppression, Urinary tract abnormalities
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What non-pharmacological treatments are there for UTI?
Drink lots of water, avoid coffee, alcohol and soft drinks, heating pad on abdomen
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What pharmacologic options are available for UTI treatment?
Sodium Salicylate, Phenazopyridine and Methenamine
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What patients are at risk of Sodium Salicylate use for the treatment of UTI?
Hypertensive, heart disease and GI issues
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What are the consequences of use for Sodium Salicylate?
GI distress, rash, HA and dizziness
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What is the MOA for sodium salicylate in the treatment of UTI?
Inhibits prostaglandin synthesis
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What is the MOA for Phenazopyridine?
Azo dye that acts as a local anesthetic in the urinary tract
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What is the recommended dose of Phenazopyridine for the treatment of UTIs?
100-200mg TID after meals for 2 days
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Is Phenazopyridine usually used alone or in combination?
Combination with an antibiotic
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What are the consequences of use for Phenazopyridine?
Headache/dizziness and stomach cramps (well tolerated)
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What populations are at risk for taking Phenazopyridine?
Renally impaired
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What should you counsel patients using Phenazopyridine on?
Urine will be dark orange
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What is the MOA of Methenamine for the treatment of UTIs?
Metabolized to ammonia and formaldehyde in the urine, formaldehyde has anti-bacterial properties
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What are the consequences of use for Methenamine?
Pruritis, N/V (large doses can also irritate the bladder)
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What patients are at risk when taking Methenamine?
Gout, hepatic impairment
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What is the safety and effectiveness rating for Cranberry in the treatment of UTI?
Likely safe and possibly effective AT PREVENTION
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Is Cranberry effective in the treatment of a UTI?
No, useful only for prevention
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What is the MOA of cranberry in the prevention of UTI?
Proanthocyanadins in cranberry wrap around bacteria and prevent them from adhering to the urinary wall
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Does Cranberry acidify the urine?
No
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What are the consequences of use for Cranberry in treatment of UTI?
Large intake may cause GI distress
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What populations are at risk when using cranberry in the treatment of UTI?
Prone to kidney stones, aspirin allergy, diabetics
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Define overactive bladder:
bladder has problems storing urine leading to urgency and incontinence
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What are the two main type of overactive bladder?
Stress and Urge
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What proportion of women have overactive bladder?
50% in nursing homes, 10-70% in the community
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What are the signs and symptoms of Overactive bladder?
Sudden urge to urinate, Nocturia, frequent urination, involuntary urination
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What is the definition of frequent urination?
>8/day
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What are the at risk groups for Overactive bladder?
Age, pregnancy, obesity, high impact exercise, diuretic use
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What are the non-pharmacological treatments for overactive bladder?
Weight loss, fluid restriction, scheduled bathroom breaks, proper diuretic use, avoiding caffeine/alcohol, kegels
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What drugs are available for the treatment of Overactive Bladder?
Oxybutynin
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What is the MOA of Oxybutynin?
Inhibits ACHE on smooth muscle, direct antispasmodic effect
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What dose of Oxybutynin would be recommended for the treatment of Overactive bladder?
3.9 mg/day (change patch every 4 days)
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What are the consequences of use for Oxybutynin in the treatment of Overactive bladder?
Pruritus near application site, xerostomia, constipation, dizziness and drowsiness
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What groups are at risk when using Oxybutynin?
Urinary retention, dementia, elderly, CV disease, GI issues, renal dysfunction
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What is the definition of menopause?
Permanent end of fertility and menstruation, occurs 12 monthas after your last period
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What is the average age of menopause?
51
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