Full Answer Section

• • • Azithromycin: 1 gram orally, single dose.
      • Class: Macrolide antibiotic
      • Rationale: Effective against most strains of Chlamydia trachomatis.
  • Gonorrhea:
    • Ceftriaxone: 250 mg intramuscularly, single dose.
      • Class: Third-generation cephalosporin
      • Rationale: Effective against most strains of Neisseria gonorrhoeae.

• Non-prescription Medications:

  • Over-the-counter pain relievers like ibuprofen or acetaminophen can be used to manage discomfort associated with infection.

• Patient Education:

  • Importance of partner notification and treatment.
  • Abstinence from sexual activity until both partners have completed treatment.
  • Safe sex practices, including consistent condom use.
  • Potential for re-infection if partner is not treated.
  • Importance of follow-up testing.

2. 52-year-old male with BPH complaint

• Patient Specifics:

  • 52-year-old male with a history of hypertension and type 2 diabetes mellitus.
  • Complains of weak urinary stream, hesitancy, nocturia, and urgency.
  • Digital rectal exam (DRE) reveals an enlarged prostate.

• Treatment:

  • Tamsulosin: 0.4 mg orally, once daily.
    • Class: Alpha-1 adrenergic receptor blocker
    • Rationale: Relaxes smooth muscle in the prostate and bladder neck, improving urinary flow.

• Non-prescription Medications:

  • Over-the-counter medications like phenazopyridine can be used to temporarily relieve urinary tract discomfort, such as burning or urgency.

• Patient Education:

  • Importance of maintaining adequate fluid intake.
  • Avoiding bladder irritants such as caffeine and alcohol.
  • Importance of regular follow-up with urologist to monitor symptoms and adjust medication as needed.
  • Potential for side effects such as dizziness or orthostatic hypotension.

3. 68-year-old female with a urinary tract infection

• Patient Specifics:

  • 68-year-old female with a history of hypertension and osteoarthritis.
  • Complains of dysuria, urgency, frequency, and suprapubic pain.
  • Urinalysis reveals the presence of leukocyte esterase, nitrites, and bacteria.

• Treatment:

  • Nitrofurantoin: 100 mg orally, twice daily for 5 days.
    • Class: Nitrofurantoin
    • Rationale: Effective against most common uropathogens.
  • Alternative:
    • Trimethoprim/Sulfamethoxazole: Double-strength tablet (160/800 mg) orally, twice daily for 3 days.
      • Class: Sulfonamide
      • Rationale: Effective against most common uropathogens.

• Non-prescription Medications:

  • Over-the-counter pain relievers like ibuprofen or acetaminophen can be used to manage discomfort.

• Patient Education:

  • Importance of completing the full course of antibiotics.
  • Increase fluid intake to help flush out bacteria.
  • Avoid bladder irritants such as caffeine and alcohol.
  • Practice good hygiene, such as wiping from front to back after urination.