Pharmacological Effects of Trimethoprim in the Treatments of UTI and Nursing Implications
Description and action of Trimethoprim
- Used for the treatment of uncomplicated urinary tract infections
- Precaution for chronic recurrent urinary tract infections
- Blocking action for the bacterial folic acid synthesis
- Bactericidal action against susceptible organisms
- Effective against gram-positive and gram-negative pathogens
- Suitable for adults and children over 12
- Not applied in patients with hypersensitivity or megaloblastic anemia (“Trimethoprim,” 2015).
Pharmacokinetics of Trimethoprim
- Good absorption in case of oral administration
- Wide distribution, including breast milk and placenta
- 80% discharged through the urine, unchanged
- 20% metabolized by the liver
- 8-11 hours’ half-life period, or more in renal impairment
- Action can change in interaction with other drugs
- Adverse reactions and side effects possible (“Trimethoprim,” 2015).
A cohort study to assess the use of Trimethoprim for UTI
- Evaluation of adverse outcomes in older adults
- Risk of acute kidney injury can increase
- Increased risk of hyperkaliemia
- Increased risk of kidney injury compared to amoxicillin
- Renin-angiotensin system blockade does not influence
- No impact of Trimethoprim on the incidence of sudden death (Crellin et al., 2018)
Precautions for Trimethoprim use
- Pregnancy and breastfeeding
- Low level of folic acid
- Problems with kidneys function
- Some blood disorders, including porphyria
- Use of other medicine
- Allergic reactions to medicine
Nursing implications for the treatment of UTI
- Assessment of patients for UTI symptoms
- Organization of lab tests to check blood
- Development of potential nursing diagnoses
- Implementation of the treatment strategy
- Planning of patient and family teaching
- Evaluation and prognoses of the desired outcomes
- Provision of patient safety through timely administration of medicine.
Patient and family teaching plan for using Trimethoprim for UTI
- Patient instructions about taking medication
- Focus on the necessity of the complete course
- Warning about the unacceptability of sharing medication
- The necessity to report adverse reactions and side effects
- Monitor the symptoms of folic acid deficiency
- Inform a healthcare professional if symptoms do not improve
- Importance of the follow-up examinations to assess the effectiveness
Pharmacological Effects of Tetracycline in Managing and Treating P. Acnes and Nursing Implications
Tetracycline description and action
- Used for treatment of diverse infections
- Applied for P. acnes therapy
- Inhibitor for bacterial protein synthesis
- Proved bacteriologic action against susceptible bacteria
- Used for adults and children older than 8
- Probability of adverse reactions and side effects
- Contradicted for patients with hypersensitivity or intolerance (“Tetracycline,” 2015).
Pharmacokinetics of tetracycline
- Absorption of 60-80% with oral administration
- Wide distribution, penetrates bones, placenta, and breast milk
- Discharged by the kidneys
- 6-12 hours’ half-life period
- Attention to drug-drug and drug-food interactions
- Active against gram-positive and gram-negative pathogens (“Tetracycline,” 2015).
Pathogenesis of acne and its treatment
- Excessive serum production
- Hyper-proliferation of the epidermis resulting in comedones
- Acnes infiltration with propionibacterium
- The beginning of the inflammation process
- Topical treatment method
- Systemic treatment method
- Complementary and alternative medicines for acne (Fox, Csongradi, Aucamp, du Plessis, & Gerber, 2016).
Tetracycline for acne treatment
- Tetracycline is active against P. acnes
- Lower efficiency pf topical tetracycline
- Use of oral form of tetracycline
- Effectiveness and low cost of tetracycline
- Anti-inflammatory and antibacterial action
- The lower resistance of P. acnes to tetracycline compared to macrolide
- More efficiency in a combination of topical and oral antibiotics (Fox et al., 2016).
Nursing implications for tetracycline acne therapy
- Assessment of patient’s symptoms during therapy
- Laboratory tests in case of necessity
- Development of the most probable nursing diagnoses
- Administration of treatment around the clock
- Avoid administration simultaneously with calcium, antacids, etc.
- Patient and family teaching
- Evaluation of the effectiveness of treatment and the desired outcomes.
Patient and family education planning
- Instructions on regular and timely medicine intake
- Avoidance of dairy products including milk
- The necessity of sunscreen to avoid photosensitivity reactions
- The necessity to report adverse effects
- The necessity to inform healthcare professionals in case of surgery
- Nonhormonal contraception recommended for females
- Outdated tetracycline is toxic and should not be used (“Tetracycline,” 2015).
References
Crellin, E., Mansfield, K., Leyrat, C., Nitsch, D., Douglas, I., & Root, A. et al. (2018). Trimethoprim uses for urinary tract infection and risk of adverse outcomes in older patients: cohort study. BMJ, k341. Web.
Fox, L., Csongradi, C., Aucamp, M., du Plessis, J., & Gerber, M. (2016). Treatment modalities for acne. Molecules 2016, 21, 1063. Web.
Tetracycline. (2015). Web.
Trimethoprim. (2015). Web.