A patient is receiving methenamine (Mandelamine) for the ...

[mikaylakyoung]

A patient is receiving methenamine (Mandelamine) for the treatment of a chronic UTI. Which agent, when given concurrently with methenamine, can create a risk for crystalluria?
 
  a. Ciprofloxacin (Cipro)
  b. Sulfisoxazole
  c. Nalidixic acid (NegGram)
  d. Erythromycin (ERYC)

Question 2

A patient returns to the clinic after taking antibiotics for a UTI. When a urinalysis is performed, it is determined that the patient still has a UTI. The nurse asks the patient if she took all her medication until it was gone.
 
  The patient replied that she hates taking pills two and three times a day and asks if there is something she can take just once and get it over with. The nurse anticipates that the prescriber will order
  a. ciprofloxacin (Cipro).
  b. cephalexin (Keflex).
  c. fosfomycin (Monurol).
  d. amoxicillin (Amoxil).

[whitcassie]

Answer to Question 1

ANS: B
Methenamine should not be combined with sulfisoxazole. Formaldehyde forms an insoluble complex with sulfonamides, posing a risk of urinary tract injury from crystalluria.
Ciprofloxacin would not increase the risk of crystalluria, but it may increase the risk of tendon rupture.
Nalidixic acid can be administered with methenamine without increasing the risk of crystalluria.
Erythromycin would not increase the risk of crystalluria.

Answer to Question 2

ANS: C
When adherence is a concern, fosfomycin, which requires only a single dose, is an attractive choice.
Cipro is ordered twice a day for 3 days.
Keflex is ordered three times a day for 7 to 14 days.
Amoxil is ordered three times a day for 14 days.

[mikaylakyoung]

Excellent

[amcvicar]

Gracias!