Kee: Pharmacology, 7th Edition

Chapter 34: Drugs for Urinary Tract Disorders Key Points: Audio and Print The largest number of urinary tract disorders are caused by urinary tract infections. Urinary tract infections may result from an infection of the upper urinary tract, such as pyelonephritis, or the lower tract, such as cystitis, urethritis, or prostatitis. Urinary antiseptics or antiinfectives, urinary analgesics, urinary stimulants, and urinary antispasmodics may be used in the treatment of urinary tract disorders. Urinary antiseptics or antiinfectives are limited to the treatment of urinary tract infections. Drug action occurs in the renal tubule and bladder, where it is effective in reducing bacterial growth. The nurse must assist the client with the appropriate technique for a pretreatment clean-catch urine sample. A urinalysis, as well as a culture and sensitivity test, is usually performed before the initiation of drug therapy. The nurse must also educate the client regarding side effects of these drugsmost importantly, gastrointestinal upset. Clients should be educated to take these drugs with food and to drink cranberry juice, eat plums, or take vitamin C supplements to keep urine acidic. Urine pH should be less than 5.5 for some antiseptics to be effective. Urinary analgesics relieve the urinary pain and burning that are symptomatic of lower urinary tract infections. The nurse should educate the client that this drug may cause gastrointestinal disturbances. It also causes the urine to become a harmless reddishorange color, and it may alter the glucose urine test; therefore a blood test should be used to monitor glucose levels as needed. Urinary tract spasms resulting from infection or injury can be relieved with antispasmodics that have a direct action on the smooth muscles of the urinary tract. This group of drugs is contraindicated for use if urinary or gastrointestinal obstruction is present or if the client has glaucoma. The nurse should educate the client regarding side effects, which include dry mouth, increased heart rate, dizziness, intestinal distention, and constipation. The client taking antimuscarinic/anticholinergic drugs should be taught to report urinary retention, severe dizziness, blurred vision, palpitations, and confusion. The client should be warned to use caution in hot environments to avoid heat prostration.

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.