Trimethoprim and Tetracycline Pharmacological Effects

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.