Urology Case No 2.UTI Part 2

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Urology Case No 2.UTI Part 2

Urinary Tract Infection (UTI)

মহিলাদের সবচেয়ে কমন একটি সমস্যা..

এমনিতেই Female দের এই সমস্যা ছেলেদের থেকে বেশি হয়। কারন Female দের urethra ছোট হয়& এর অবস্থান vagina ও Anal কাছে থাকে। যেখান থেকে সহজেই জীবানু মুএনালীতে প্রবেশ করতে পারে & Infection করে**

UTI এর কারণ *

প্রস্রাব আটকে রাখার জন্য

প্রয়োজনে চেয়ে পানি কম খাওয়ার জন্য

রোগপ্রতিরোধ ক্ষমতা কমে গেলে যেমনঃ ডায়াবেটিস।

নোংরা পানি ব্যবহার করা

Intercourse এর আগে ও পরে প্রস্রাব না করা

কিডনিতে পাথর

প্রস্রাবের পর ঐস্থান ভালোভাবে ও নিয়মমত পরিস্কার না করা।

কোনো কারনে ক্যাথেটার ব্যবহার করলে

পরিস্কার পরিচ্ছন্নতার অভাব

যৌনবাহিত কোনো রোগ থাকলে

আগে একবার হয়েছিল কিন্তুু ঔষধের কোর্স ঠিকমতো কম্পিলিট করা হয় নাই।

ইত্যাদি

Symtoms**

প্রসাব এর সময় ; প্রশ্বাবের রাস্তায় জ্বালাপোড়া (Dysuria**)

প্রসাবের বেগ আসলে; ধরে রাখতে না পারা(Urgency**)

ঘন ঘন প্রসাব এর চাপ আসা(Urine Frequency**)

কোমড় থেকে তলপেটে ও ২ পাশে ব্যথা(Lion to grion pain)

Urine আটকে থাকা

বাজে তিক্ত গন্ধ থাকে অনেক সময়

প্রসাবের colur Change হয়ে যায়

Nausea & Vomiting **

UTI এর লক্ষন গুলোর মধ্যে এগুলাই most Common **

এই লক্ষন গুলো দিয়েই মোটামুটি অনেক সময় UTI Diagnosis করা যায়;;

URINE R/M/E করে আমরা Confirm হতে পারি

Urine R/M/E তে Pus cell**

Epithelial cell* Present থাকে more than Normal**

ESR ও বেড়ে যায়

NB:-IF Patient condition is sever lower abdomain pain with vomiting patient is unstable or serious condition then emergency treatment protocal is

Jodi Patient er sever Pain in Low Abdomen with Vomiting hoi tokhon Nicher emergency treatment hisebe dite hobe:-

Emergency treatment hose:- Nicher 4Ti Injection aksate Stat Use korte hove

Injection1:Rolac 30mg/ml IM/IV ( Stat) AS A Ketorolac Tromethamine( AS A Drugs used for Rheumatoid Arthritis, Non-Opioid Analgesics)

Injection 2.Algin 5mg/2ml IM/IV 2ML Ampule.(Stat)

Injection 3:Paloxi 0.25mg/ 5ml IM/IV 5ML Ampule(Stat)

Injection 4:Sergel 40mg/Vial/IV AS A Esomoprazole(Stat)

________________________________

UTI confirm হয়ে RX..…

Tab (Nitrofurantoin*)Drug of choice

Tab Nintoin Sr**

OR Much better drug choice of capsule1:Tablet:Umactin BD 100 MG (75MG+25MG) AM

(AS A Nitrofurantoin + Nitrofurantoin Microcrystals AS A Systemic Urinary Anti- infective)

Indications Of Umactin Bd 100mg ((AS A Nitrofurantoin + Nitrofurantoin Microcrystals):-

For the treatment of and prophylaxis against acute or recurrent, uncomplicated lower urinary tract infections or pyelitis either spontaneous or following surgical procedures. Nitrofurantoin is specifically indicated for the treatment of infections when due to susceptible strains of Escherichia coli, enterococci, staphylococci, Citrobacter, Klebsiella and Enterobacter.

Side Effects Of Umactin Bd 100mg ((AS A Nitrofurantoin + Nitrofurantoin Microcrystals):-

In clinical trials of Macrobid, the most frequent clinical adverse events that were reported as possibly or probably drug related were nausea (8%), headache (6%), and flatulence (1.5%)

1+0+1 FOR 7DAYS .

(AS A Nitrofurantoin AS A Systemic Urinary Anti- infective).

Indications Of Nintoin Drug (Nitrofurantoin):–

Nintoin is specifically indicated for the treatment & prophylaxis of urinary tract infections caused by susceptible strains of Escherichia coli, Enterococci, Staphylococcus aureus, Staphylococcus saprophyticus and certain susceptible strains of Klebsiella and Enterobacter species.

Side Effects Of Nintoin Drug (Nitrofurantoin):-

The most frequent clinical adverse events are nausea, headache, and flatulence. Other less occurred adverse events are diarrhea, dyspepsia, abdominal pain, constipation, emesis, dizziness and drowsiness.

1+0+1——৭ -১০ দিন

Tab Furotil 500mg(Cefuroxim*)

(AS A Cefuroxime Axetil AS A Second generation Cephalosporins).

Indications Of Furotil 500mg Drug(Cefuroxime Axetil):-2^nd Generation

It is indicated for the treatment of infections caused by sensitive bacteria.

Pharyngitis/Tonsillitis caused by Streptococcus pyogenes.
Acute Bacterial Otitis Media caused by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis (beta-lactamase producing strains) or Streptococcus pyogenes.
Acute bacterial maxillary sinusitis caused by Streptococcus pneumoniae or Haemophilus influenzae (non beta-lactamase producing strains)
Lower respiratory tract infections including pneumoniae, caused by Streptococcus pneumoniae, Haemophilus influenzae (including beta lactamase-producing strains), Klebsiella spp., Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains), Streptococcus pyogenes, E. coli
Acute bacterial exacerbation of chronic bronchitis and Secondary bacterial infections of Acute bronchitis caused by Streptococcus pneumoniae, Haemophilus influenzae (beta-lactamase negative strains) or Haemophilus parainfluenzae (beta-lactamase negative strains).
Skin and skin-structure infections caused by Staphylococcus aureus (including beta-lactamase producing strains) or Streptococcus pyogenes.
Urinary tract infections caused by E.coli or Klebsiella pneumoniae.
Bone and Joint Infections caused by Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains).
Gonorrhoea caused by penicillinase-producing and non-penicillinase producing strains of Neisseria gonorrhoeae.
Early Lyme Disease (erythema migrans) caused by Borrelia burgdorferi.

Side Effects Of Furotil 500MG((Cefuroxime Axetil):-2^ND Generation

Adverse effects to Furotil have occurred infrequently and have been generally mild and transient in nature. Effects reported include rashes and gastrointestinal disturbances. As with other antibiotics, prolonged use may result in the overgrowth of non susceptible organisms e.g. Candida.

1+0+1——–৭ দিন

Tab Denvar 200mg(Cefixim *)

(AS A Cefixime Trihydrate Third generation Cephalosporins)

Indications Of Denver 200mg (Cefixime Trihydrate):-

Denvar is an orally active cephalosporin antibiotic which has marked in-vitro bactericidal activity against a wide variety of Gram-positive and Gram-negative organism. It is indicated for the treatment of the following acute infections when caused by susceptible microorganisms.

Upper Respiratory Tract Infections (URTI): e.g. otitis media; and other URTI where the causative organism is known or suspected to be resistant to other commonly used antibiotics, or where treatment failure may carry significant risk. Lower Respiratory Tract Infections-e.g. bronchitis.

Urinary Tract Infections: e.g. cystitis, cystourethritis, pyelonephritis. Clinical efficacy has been demonstrated in infections caused by commonly occurring pathogens including Streptococcus pneumonia, Streptococcus pyogenes, Escherichia coli, Proteus mirabilis, Klebsiella species, Haemophilus influenzae (beta-lactamase positive and negative), Moraxella catarrhalis (beta-lactamase positive and negative) and Enterobacter species. Denvar is highly stable in the presence of beta-lactamase enzymes.

Side Effects Of Denver 200mg drug(Cefixime Trihydrate):–

Denvar is generally well tolerated. The majority of adverse reactions observed in clinical trials were mild and self limiting in nature. Gastrointestinal disturbances: The most frequent side-effects seen with Denvar are diarrhoea and stool changes; diarrhoea has been more commonly associated with higher doses. Other gastrointestinal side-effects seen less frequently are nausea, abdominal pain, dyspepsia, vomiting and flatulence. Pseudomembraneous colitis has been reported. Central nervous system: headache and dizziness. Hypersensitivity reactions: allergies in the form of rash, pruritis, urticaria, drug fever and arthralgia have been observed. These reactions usually subsided upon discontinuation of therapy. Hematological and clinical chemistry: thrombocytopenia, leukopenia and eosinophilia have been reported. These reactions were infrequent and reversible. Mild transient change in liver and renal function tests have been observed. Miscellaneous: other possible reactions include genital pruritis and vaginitis.

1+0+1———৭ দিন

Tab Ciprocin 500mg(Ciprofloxacin)

(AS A Ciprofloxacin 4-Quinolone preparations, Anti-diarrhoeal Antimicrobial drugs)

Indications Of Ciprocin 500mg Drug(Ciprofloxacin):-

Ciprocin is indicated for the treatment of single infection or mixed infections caused by two or more susceptible organisms. It can also be used for infections caused by organisms resistant to other antibiotics including Aminoglycosides, Penicillins and Cephalosporins.

As antibacterial concentrations of Ciprocin are obtained in serum and body tissues as well as in the urine following administration by mouth, Ciprocin has been suggested for use in the treatment of a wide range of infections caused by susceptible organisms including infections of the urinary, respiratory and gastrointestinal tracts, gonorrhoea and septicaemia. The extensive tissue penetration of Ciprocin combined with its enhanced antibacterial activity (including antipseudomonal activity), enables Ciprocin to be used alone (pending sensitivity results) or in combination with an Aminoglycoside or with beta lactam antibiotics for instance when severe neutropenia is present or with an antibiotic active against anaerobes where the presence of bacteroides fragilis is suspected. Ciprocin is indicated for the treatment of the following infections caused by sensitive bacteria:

Severe systemic infections: e.g. septicaemia, bacteraemia, peritionitis, infections in immunosuppressed patients with haematological or solid tumors and in patients in intensive care unit with specific problems such as infected burns.
Respiratory tract infections: Lobar and bronchopneumonia, acute and chronic bronchitis, acute exacerbation of cystic fibrosis, bronchiectasis, empyema.
Urinary tract infections: Uncomplicated and complicated urethritis, cystitis, pyelonephritis, prostatitis, epididymitis.
Skin and soft tissue infections: e.g. infected ulcers, wound infections, abscesses, cellulitis, otitis externa, erysipelas, infected burns.
Gastro-intestinal infections: e.g. enteric fever, infective diarrhea.
Infection of the biliary tract: e.g. cholangitis, cholecystitis, empyema of the gall bladder.
Intra abdominal infections: e.g. peritonitis, intra abdominal abscesses.
Bone and joint infection: Osteomyelitis, septic arthritis.
Pelvic infections: e.g. salpingitis, endometritis, pelvic inflammatory diseases.
Eye, ear, nose and throat infections: e.g. otitis media, sinusitis, mastoiditis, tonsillitis.
Gonorrhoea: Including urethral, rectal and pharyngeal gonorrhoea caused by beta-lactamase producing organisms or organisms moderately sensitive to penicillin.

Side Effects Of Ciprocin 500mg Drug(Ciprofloxacin):-

Gastrointestinal disturbances e.g. nausea, diarrhoea, vomiting, dyspepsia, abdominal pain. Disturbances of the central nervous system e.g. headache, dizziness, tiredness, confusion, convulsion & risk of retinal detachment. Hypersensitivity reactions e.g. skin rash (very rarely Stevens-Johnson syndrome and toxic epidermal necrolysis), pruritus and possible systemic reactions. The other less reported reactions are joint pain, mild photosensitivity and transient increase in liver enzymes (particularly in patients with previous liver damage), serum bilirubin, urea or creatinine levels. Risk of hypoglycemia & mental health adverse effects.

1+0+1—-7 দিন

Cap Oflacin 500 mg (Ofloxacin 500 mg)

(AS A Ofloxacin AS A 4-Quinolone preparations, Aural Anti-bacterial preparations)

Indications Of Oflacin 400 mg Drug (Ofloxacin):-

Oflacin tablets are indicated for the treatment of adults with mild to moderate infections caused by susceptible strains.

Lower Respiratory Tract: Acute bacterial exacerbation of chronic bronchitis lung abscess, pneumonia.
Gastrointestinal Tract: Enteric fever, shigellosis.
Multi-drug-resistant Tuberculosis.
Skin and skin structures: Uncomplicated skin and skin structure infections. Sexually
Transmitted Diseases: Acute, Uncomplicated urethral and cervical gonorrhoea. Nongonococcal urethritis and cervicitis. Mixed infections of the urethra and cervix.
Urinary tract: Uncomplicated Urinary Tract Infections, Complicated urinary tract infections.

Oflacin Eye & Ear Drops is indicated in-

Eye: It is indicated for the treatment of external ocular infections such as acute & sub-acute conjunctivitis, keratitis, kerato-conjunctivitis, blepharo-conjunctivitis, blepharitis, corneal ulcer and pre-operative prophylaxis in ocular surgery.
Ear: It is indicated for the treatment of external ear infections (otitis externa) and certain middle ear infections (otitis media).
Side Effects Of Oflacin 400 mg Drug (Ofloxacin):-

Oflacin tablet is generally well tolerated and clinical side-effects of Oflacin has been quite low. Among the adverse effects gastrointestinal and central nervous systems’ reactions are common. Nausea, rash, vomiting, abdominal pain, diarrhoea and gastrointestinal distress are the gastrointestinal adverse effects. Common central nervous system reactions are headache, dizziness and insomnia.

Eye: Transient ocular irritation, burning, stinging, redness, itching or photophobia have been reported.

Ear: Mild irritation or mild discomfort in the ear may occur. Symptoms of an allergic reaction include rash, itching, swelling or trouble breathing.

1+0+1____7 দিন

Fosfomycin 3mg sachet

(AS A Fosfomycin Trometamol AS Intracellular antibiotic)

Indications Of Fosfomycin 3mg sachet powder drug(Fosfomycin Trometamol) :-

It is indicated only for the treatment of uncomplicated urinary tract infections (acute cystitis) in women caused by susceptible strains of Escherichia coli and Enterococcus faecalis.

Side Effects of Fosfomycin 3mg sachet powder drug(Fosfomycin Trometamol) :-

In clinical trials, the most frequently reported adverse events occurring in >1% of the study population regardless of drug relationship were: diarrhea 10.4%, headache 10.3%, vaginitis 7.6%, nausea 5.2%, rhinitis 4.5%, back pain 3.0%, dysmenorrhea 2.6%, pharyngitis 2.5%, dizziness 2.3%, abdominal pain 2.2%, pain 2.2%, dyspepsia 1.8%, asthenia 1.7%, and rash 1.4%.The following adverse events occurred in clinical trials at a rate of less than 1%, regardless of drug relationship: abnormal stools, anorexia, constipation, dry mouth, dysuria, ear disorder, fever, flatulence, flu syndrome, hematuria, infection, insomnia, lymphadenopathy, menstrual disorder, migraine, myalgia, nervousness, paresthesia, pruritus, SGPT increased, skin disorder, somnolence, and vomiting.

One sachet once only**with mixed of half glass of water**Pregnancy Safe…

উপরের ৫ টা থেকে যেকোনো একটা ****

______________________________

প্রস্রাবের এর রাস্তায় জ্বালাপোড়া হলে

Syrap Citra k or Urikal**(best one)

(AS A Potassium Citrate +Citric Acid AS A Prevention of repeated kidney stone formation, Urinary Alkalinizing Agent).

Indications Of SYRUP Citra K ((AS A Potassium Citrate +Citric Acid):-

Citra-K is indicated in the following cases:-

To relieve discomfort in urinary tract infections
To prevent kidney stone
With uricosuric agent to prevent gout
Acidosis caused by kidney diseases

Side Effects Of SYRUP Citra K ((AS A Potassium Citrate +Citric Acid):-

This solution is generally well tolerated without any unpleasant side effect when given in recommended doses to patients with normal renal function and urinary output. However, as with any alkalinizing agent, caution must be used in certain patients with abnormal renal mechanisms to avoid development of hyperkalemia or alkalosis. Potassium intoxication causes listlessness, weakness, mental confusion, tingling of extremities and other symptoms associated with a high concentration of Potassium in the serum.

2 চামচ সিরাপ ১ গ্লাস পানিতে mixed করে ২/৩ বার**

পেট বেথা থাকলে

Tab 1.Viset or Algin ANY ONE .

(AS A Tiemonium Methylsulfate AS A Anticholinergics)

Indications Of Viset drug (Tiemonium Methylsulfate AS A Anticholinergics):-

Viset is an antispasmodic drug that reduces muscles spasm of the intestine, biliary system, bladder and uterus. It is used in symptomatic treatment of pain related to functional disorders of the digestive tract and biliary system. It is also indicated for the treatment of spasm and pain in urological and gynaecological diseases.

1+1+1 /1+0+1 7 days

Side Effects Of Viset drug (Tiemonium Methylsulfate AS A Anticholinergics):-

Viset Methylsulphate may have the risk of hypotension & tachycardia in certain individuals.

1+1+1 /1+0+1

UTI incase of pregnancy তে আমরা

1st & 2nd Trimester এ

Nintoin Sr (drug of choice **)

3rd trimester এ Cefuroxim **/Amoxillin*

___________________________

অনেক পেশেন্ট দেখা যায় Recurnt UTi নিয়ে আসে;;কেঊ যদি ৬ মাসে ২ বারের বেশি ;১ বছরে ৪ বারের বেশি Affected হয়;; তাহলে Recurnt UTI বলা হয়***

In case of Recurnt UTI Rx___

• Acute treatment 7–14 দিন চলবে

++Prophylaxis হিসেবে আমরা

• Trimethoprim 100mg Tablet 1:Cosat Ds 800 mg (AS A Sulphamethoxazole Trimethoprim AS A Anti-diarrhoeal Antimicrobial drugs, Sulphonamides & Trimethoprim).

At night* drug of choice* OR

Tablet 1:Megatrim Ds (800mg +160 mg)

As A (Trimethoprim As A Sulphamethoxazole + Trimethoprim) As A (Anti-diarrhoeal Antimicrobial drugs, Sulphonamides & Trimethoprim).

Indications Of Megatrim Ds Drug (Sulphamethoxazole + Trimethoprim):-

Cotrimoxazole is bactericidal in vitro to a wide range of Gram-positive and Gram-negative organisms, including Streptococcus, Staphylococcus, Pneumococcus, Neisseria, B. catarrhalis, Escherichia coli, Klebsiella, Proteus spp., Haemophilus, Salmonella, Shigella, Vibrio cholerae, Brucella, Pneumocystis carinii, Nocardia and Bordetella. A particularly high degree of activity is exhibited against Haemophilus influenzae, E. coli and Proteus spp., making Cotrimoxazole particularly suitable for the treatment of chronic bronchitis and urinary tract infections. Cotrimoxazole exerts its bactericidal action by the sequential blockade of two bacterial enzyme systems in the biosynthesis of Folinic acid in the micro-organisms. The synergy thus produced accounts for the high degree of bactericidal activity.

Indications are :

Respiratory tract infections, including acute and chronic bronchitis (treatment and prophylaxis), bronchiectasis, lung abscess, lobar and broncho-pneumonia, Pneumocystis carinii pneumonitis, sinusitis and otitis media.
Genito-urinary tract infections, including urethritis, acute and chronic cystitis, pyelonephritis, prostatitis and gonorrhoea.
Gastro-intestinal tract infections, caused by Salmonella typhi and Salmonella paratyphi, including the chronic carrier state.
Other infections, caused by a wide range of organisms confirmed to be susceptible to Cotrimoxazole and where the therapeutic benefits are considered to outweigh the possible occurrence of adverse events.
Such infections include acute and chronic osteomyelitis, acute brucellosis, skin infections including pyoderma, abscesses and wound infections, septicaemia, bacillary dysentery and cholera (as an adjuvant to fluid and electrolyte replacement), nocardiosis and mycetoma.

Side Effects Of Megatrim Ds Drug((Sulphamethoxazole + Trimethoprim):-

The side effects like crystalluria, allergic reactions, haemolysis, thrombocytopenia, neutropenia, agranulocytosis etc. have been reported rarely with Sulphamethoxazole-Trimethoprim combination. Other side effects are less serious in nature such as malaise, headache, nausea and vomiting. These are normally transient and do not require withdrawal of treatment.

• Tab Nintoin 50 mg

(AS A Nitrofurantoin AS A Systemic Urinary Anti- infective).

0+0+1—- 6 মাস

Indications Of Nintoin Drug (Nitrofurantoin):-

Side Effects Of Nintoin Drug (Nitrofurantoin):-

0+0+1—- 6 মাস

• সাথে Cap Cran B 300mg

Capsule 1:Cran B 300 mg (As A Cranberry [Vaccinium macrocarpon] As A Herbal and Nutraceuticals.)

Indications Of Cran B 300mg Drug (Cranberry [Vaccinium macrocarpon]):-

Cran-B is indicated for:-

The treatment and prevention of urinary tract infection.
Kidney stones.

Side Effects Of Cran B 300mg Drug (Cranberry [Vaccinium macrocarpon]):-

Well tolerated in recommended dose. Occasionally diarrhea or mild gastrointestinal upset may occur at high dose.

1+0+1—-6মাস

Note**বার বার ইনফেকশন হলে urine c/s করে Antiobiotics Sensitive & pregnancy Safe Antiobiotics advice করা

Advice For All**

প্রতিদিন ২-৩ লিটার পানি খাবে

প্রস্বাব আটকে রাখবেন না;চাপ আসলেই প্রস্বাব করবেন

Intercourse এর আগে পরে Bladr খালি করবে

পরিষ্কার রাখবেন,প্রয়োজনে Toilet Tissue use করবেন((Foward to Backward)**

Personal hygiene মেনে চলবে

প্রস্বাব করার সময় Bladr সম্পুর্ন খালি করা

Raiyyan Tahsan Date:-02-11-24 Saturday time:07:47pm

Raiyyan Tahsan

Raiyyan Tahsan