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UNIT 7 SEMINAR Nephrotoxic Agents solvents (methanol, carbon tetrachloride) heavy metals (lead, arsenic, mercury) pesticides antibiotics (kanamycin, gentamicin) nonsteroidal anti-inflammatory drugs (NSAIDs) iodinated radiographic contrast media antineoplastic agents miscellaneous compounds (acetaminophen) poisonous mushrooms Nephrotoxic Herbal Remedies Others…. The urinary system is responsible for: A. cleansing the blood of waste products. B. regulating the normal balance of water and electrolytes. C. storing and excreting urine. D. all of the above. Patient- Related Risk Factors Age, Sex Previous renal disease Diabetes, Multiple myeloma, Lupus, Proteinuric disease Salt retaining diseases (Chirrosis, Heart Faiure, Nephrosis) Acidosis, potassium or magnesium depletion Hyperuricemia, Hyperuricosuria Kidney transplant (Tofovic, n.d.) Drug - Related Risk Factors Inherent nephrotoxic effects Dose Duration, frequency and form of administration Repeated exposure Drug interaction (synergistic toxic effects) (Tofovic, n.d.) Neprotoxic Effects Papillary necrosis Renal vasoconstriction Tubular injury Nephritis Acute renal failure (Tofovic, n.d.) Any Questions? STD Don’ts Have sex without knowledge of partner’s history Share drug-related needles Have sex with multiple partners Have direct skin contact with an open wound of an infected person Leave syphillis or a chancroid untreated STD Do’s Communicate with your partner or potential partner Proper use of condoms Get tested Get treated (if needed) & complete treatment All STD’s exhibit symptoms, so you will know if you have one. True OR False More than 20 infectious diseases are spread by sexual contact True OR False Chlamydia: Symptoms Female Thick vaginal discharge with burning sensation Itching Abdominal pain Pain during intercourse (dyspareunia) Male Discharge from penis with burning sensation Itching Burning sensation when urinating Scrotum may be swollen Syphilis A chronic, sexually transmitted infection that can affect the entire body if left untreated Symptoms manifest in four stages: Presence of a painless but highly contagious local lesion called a chancre (pronounced “shang-ker”) found on the genitalia Syphilis Within one-two months, the primary lesion heals, but the infection spreads throughout the body and can cause similar lesions anywhere Symptom stages The infection begins spreading systemically throughout the body and may present with: Fever, headache, aching joints, mouth sores, rashes on palms or soles of feet Latent period Final stage (can be life-threatening) Syphilis-Late stage untreated Gonorrhea A common STD with symptoms similar to chlamydia Additional symptoms: A discharge of pus from the genital tract in both males and females Difficult or painful urination Symptoms vary in severity Failure to seek treatment for a gonorrhea infection can result in complications including A. B. C. D. pelvic inflammatory disease (PID). septicemia. septic arthritis. all of the above. Trichomoniasis Symptoms When symptoms are present they are evidenced in both females and males and include: Difficult or painful urination Itching Women: profuse greenish yellow discharge from the vagina Genital Herpes Infection of the skin in the genital area resulting in painful genital sores Spread by direct skin-to-skin contact Caused by herpes simplex virus type 2 (HSV-2) Large percentage of infections go unnoticed Genital Herpes Treatment There is no cure. Prescription drugs are routinely used to reduce the frequency and duration of outbreaks. Women with genital herpes are at increased risk for cervical cancer and are encouraged to obtain a Pap smear every six months for screening. Genital Warts (Condylomata Acuminata) A genital infection that causes raised cauliflowerlike growths in or near the vagina or rectum or along the penis Warts are caused by the human papillomavirus (HPV) and is usually transmitted through sexual contact. Chancroid A bacterial infection of the genitalia that causes a shallow and painless lesion on the skin or mucous membrane that appears seven to 10 days after sexual contact with an infected person Symptoms: Over time, ulcer usually deepens and oozes pus Hepatitis B An infection of the liver that is caused by a DNA virus The disease has a long incubation and symptoms may become severe or chronic, causing serious damage to the liver Hepatitis B (cont’d.) Prognosis Acute cases: prognosis is good Liver heals and regenerates May take several months Chronic cases: prognosis is poor Inflammation liver failure causes destruction of liver cells and possible HPV is commonly associated with A. B. C. D. genital warts and many different types of cancer genital herpes. infection of the genitourinary tract. trichomoniasis. Any Questions? Prostate Problems Prostatitis Benign Prostatic Hyperplasia (BPH) Prostate Cancer Prostatitis Acute or chronic inflammation of the prostate gland Infection (bacterial or nonbacterial) is the most likely cause Inflammation of the prostate gland is more common in men older than 50 years. Prostatitis can be caused by the same bacterium that is responsible for gonorrhea. The best preventive measure against prostatitis is early treatment of urinary tract infections with antibiotics. True OR False Benign Prostatic Hyperplasia (BPH) A nonmalignant, noninflammatory enlargement of the prostate gland Common in men older than 50 years of age. Symptoms May compress urethra and cause urinary blockage Difficulty starting urination Weak urinary stream Inability to empty bladder Prostate Cancer: Malignancy of the prostate gland Risk factors Age (most cases occur in men over age 45) Heredity (presence of certain genes) Lifestyle (diet high in animal fat, low in vegetables and selenium) Ethnicity (more common in African-Americans) Symptoms Weak or interrupted urine flow Frequent urination Difficulty starting or stopping urination Urinary retention Blood in urine Erectile dysfunction Prostate Cancer (cont’d.) Prostate cancer is often without symptom at diagnosis. Prostate cancer grows very slowly and therefore is often diagnosed and treated before condition becomes terminal. Approximately 3 percent of men with prostate cancer die of the condition. It is the second-leading cause of cancer deaths in men. Treatment for Prostate Cancer Type of treatment depends on several factors: PSA level Age Stage of disease Physical condition of patient Options Radical resection of the prostate (TURP) Radical prostatectomy (surgical removal of prostate) Hormone therapy (for metastatic prostate cancer) Radiation therapy No intervention (for men 70 years or older or who have other co-existing illnesses) Prostate Cancer (cont’d.) Prevention Annual screening for all men 50 years of age or older, which consists of: Digital rectal exams Serum PSA test. There is a risk of false-positive and falsenegative results with the PSA test. If either test is positive biopsy is performed Test Results: Explain the difference between false-positive and false-negative. What kind of test is it? What do each mean? Any Questions? References Frazier, M.S. & Drzymkowski, J.W. (2009). Essentials of human diseases and conditions, (4th ed.). St. Louis, MO: Saunders Elsevier. Tofovic, S.P. (n.d.). Nephrotoxic drugs. 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