Essay Sample on Understanding Comorbidities Of MS & UTI: Pathophysiology & Impacts

Introduction

It is essential to understand the importance of comorbidity as it plays a significant role in impacting the life expectancy, healthcare cost, and quality of life of patients. Comorbidity refers to a pre-existing condition that implicates the treatment of disease and may prolong the length of stay in a hospital or medical facility. This paper addresses the comorbidities of multiple sclerosis and urinary tract infections (UTI).

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Pathophysiology Of Multiple Sclerosis And Urinary Tract Infection

The pathophysiology of multiple sclerosis consists of the pathology and physiology of the disease. Pathology refers to the conditions seen during the disease state, while physiology relates to the mechanisms operational in an individual. The pathology of multiple sclerosis consists of distributed glial scars in the central nervous system (Zephir, 2018). There are also leakages in the blood-brain barrier, causing the immune cells to infiltrate (Zephir, 2018). The physiology of multiple sclerosis consists of demyelination, inflammation, and neurodegeneration occur (Zephir, 2018). The pathophysiology of urinary tract infection includes the use of diaphragm and spermicide, the use of antibiotics, sexual intercourse, or new sexual partner within a year. It also comprises of recurrent urinary tract infection and first UTI at an early age. The alteration of these comorbid disorders impacts each other in that they may lead to poor bladder emptying and obstruct the flow of urine in a condition known as the neurogenic bladder (Zephir, 2018).

Patient Factors

Several patient factors and sociodemographic indicators affect the pathophysiology of multiple sclerosis and urinary tract infections. Patient factors affecting multiple sclerosis include disease duration, disability status, depression, and fatigue. The sociodemographic indicators include sex and age. These factors influence the pathophysiology of the disease as they increase an individual's risk of getting the disease. The patient factors influencing urinary tract infection include sexual intercourse, use of antibiotics, spermicide use, and new sex partner. The sociodemographic indicators of urinary tract infection include age, educational status, gestational age, family monthly income, history of UTI, and parity (Shaikh et al., 2016). These factors influence the pathophysiology of the disease as they predispose one to the infection and increase the chances of one getting the infection.

Health Assessments And Diagnostic Reasoning

The health assessment of an individual having urinary tract infection and multiple sclerosis involves the use of a urine dipstick to evaluate for the existence of a concurrent UTI. During the assessment, if the dipstick is positive for protein, blood, leucocytes esterase and nitrites, and the suspicion for UTI is high, the sample is sent for flow cytometry analysis and culture (Huang, Chen & Zhang, 2017). It gets done to test for the presence of bacteria. If there is a high number of bacteria, a culture gets done to determine the species of the bacteria. After identifying the bacteria, treatment gets commenced. The decision to name the bacteria gets based on the judgment of the doctor at the time of assessment. The special considerations done in the evaluation and treatment of the disease include microbial resistance to antibiotics. Also, if a patient is symptomatic for UTI with multiple sclerosis, it is essential to withhold the treatment until the culture and sensitivity of the bacteria are identified (Huang, Chen & Zhang, 2017).

Compensatory Mechanism Displayed By Patient

Patients suffering from urinary tract infection with multiple sclerosis display various compensatory mechanisms. First, there is a delay in the neuroprotective mechanism of neurodegeneration and the recovery of functions (Shaikh et al., 2016). There are also changes in neuroplasticity, sodium channel expression neuroprotective autoimmunity, and functional changes (Huang, Chen & Zhang, 2017). The patient also responds with the immune system triggering the toll-like receptor cells to clear the infection in the case of the urinary tract infection. The adaptive immune response in humans is effective in evoking protective immunity against UTI.

Pharmacokinetics And Pharmacodynamics Of The Medication

There are particular pharmacokinetics and pharmacodynamics observed in the use of drugs to treat the disorders. Antibiotics used to treat the urinary tract infection should be well analyzed before use. For example, beta-lactam is time-dependent, and hence it should not be used once in a day (Zephir, 2018). Other drugs, such as co-trimoxazole, have increased chemoresistance and, therefore, should not be used (Zephir, 2018). Some drugs are more active against the pathogens causing the infections. These drugs are concentration-dependent and have a prolonged post-antibiotic effect. The pharmacokinetics of other drugs do not change over time or between dosing regimens, and no accumulation is seen. However, peak serum concentration is observed one to two days after dosing. It indicates that the drug is effective if dosed every two weeks for patients with multiple sclerosis (Zephir, 2018).

Interactions Of Medication To Treat The Comorbid Conditions And Justification Of The Selection Of The Medication

The medications used to treat the patient for multiple sclerosis interact with those used to treat the urinary tract infection, and hence it is essential to select the dugs carefully. The interaction should adequately reduce the progression of both disorders and reduce the severity and frequency of the infections. The medications should be started early during treatment to ensure that they are effective. The selection of the drugs is justified if the medicines do not harm the health of the patient, and their side effects are not adverse.

Ways The Drugs Impact Body Systems Of The Patient

The treatment for multiple sclerosis and urinary tract infection affects various body systems. Some of the impacts observed when treating multiple sclerosis include irritation at an injection place or flu-like symptoms. There is also progressive multifocal leukoencephalopathy, which is a viral disease affecting the brain. At such, it is essential to identify a balance between benefit and risk of drugs used for treatment. The medications used to treat UTI also have some effect on body systems. Excessive use of Tylenol, a drug used to treat UTI, may lead to liver damage (Shaikh et al., 2016). Other drugs such as phenazopyridine make the urine turn orange, and the medication should not get taken for more than two days (Shaikh et al., 2016).

Educating The Patient On The Disorder

It is necessary to inform the patient on some of the impacts of multiple sclerosis and urinary tract infections to ensure that they remain healthy after treatment. They must get enough rest and plan activities. Avoid excessive heat, and also exercise is needed for patients with multiple sclerosis. It is also essential that the patients take their medications as instructed by the physician. The patient should take a balanced diet with a high intake of fiber and a lot of water to avoid constipation.

References

Huang, W. J., Chen, W. W., & Zhang, X. (2017). Multiple sclerosis: Pathology, diagnosis, and treatments. Experimental and Therapeutic Medicine, 13(6), 3163-3166. Retrieved from https://doi-org.ezp.waldenulibrary.org/10.3892/etm.2017.4410

Shaikh, N., Mattoo, T. K., Keren, R., Ivanova, A., Cui, G., Moxey-Mims, M., ... & Hoberman, A. (2016). Early antibiotic treatment for pediatric febrile urinary tract infection and renal scarring. JAMA pediatrics, 170(9), 848-854.

Zephir, H. (2018). Progress in understanding the pathophysiology of multiple sclerosis. Revue Neurologique, 174(6), 358-363.