Question

RN 102 Pharmacy Applications Case Study UTI - Trimethoprim-sulfamethoxazole RM a 46-year old woman, has a sever urinary tract infection. She is taking trimethoprim- sulfamethoxazole (Bactrim) 160 mg/800 mg every 6 hours. Is the dose within the recommended drug dose and dosing interval? What is the nurse's responsibility? 1. 2. What are the similarities and differences between trimethoprim-sulfamethoxazole and sulfadiazine? 3. What are the signs of thrombocytopenia, hemolytic anemia, and agranulocytosis for patients who take high doses of sulfonamides? 4. Explain the assessment and nursing interventions regarding these severe adverse reactions to sulfonamides. 5. Patient teaching is an important part of nursing interventions. Explain the nurse's role regarding patient teaching concerning the following: What is the required amount of daily fluid intake? A. B. What are the cross-sensitive effects if a patient is allergic to other sulfonamide preparations? What allergic reactions may occur? C. What time of the day should sulfonamides be taken?

Answer 1

1, Trimethoprim and sulfamethoxazole is a combinaiton of two antibiotics that treat UTI and other infections. Daily maximum recommended dose is 960mg trimethoprim per day every 6,8 and 12 hours for 14 days. 800mg per day dose is recommended drug dose with correct dosing interwals.
nursing responsibility includes assess the patient CNS depression and neurological status, metabolic acidosis, and respiratory level. monitor the patient fluid intake and urine output. monitor the patient electrolyte level and CBC level. do a culture test prior to medicine therapy. observe the patient for renal damage and steven johnson syndrome.
2, There will be a difference in pharmacokinetics. sulfadiazine is metabolized to very less extension than sulfamethoxazole.
but both medicines has equal antibacterial properties with same spectrum of activity. this both action against many gram positive and gram negative aerobic organism, but less action against anerobic bacteria.
3, adverse effects of sulfonamide include thrombocytopenia signs of serious skin rashes, redness, blistering, peeling of the skin, and low platlet count. hemolytic anemia signs include fatigue, darkunine, shortness of breath, rapid heart rate, yellow and pale skin cause jaundice and headache. agranulocytosis signs include fever, chronic infection, lethargy, weakness, diarrhea, pneumonia and skin infection.
4, Assess the patient potential drug interactions if patient taking warfarin, herbal medicine, and other prescribed medicines. advise the patient to discontinue and call the doctor immediately if any skin rashes observed due to hypersensitivity. advise the patient to avoid exposure to sunlight. observe the patient for signs of jaundice, fever, pallor skin and check the patient CBC count. Advice the patient to take 8 to 10 glasses of water per day. advise the patient not to drive or perform the activity that increases dizziness.