Learning Outcomes
By the end of this section, you should be able to:
- 35.3.1 Identify the characteristics of urinary analgesic drugs used for urinary and bladder disorders.
- 35.3.2 Explain the indications, actions, adverse reactions, contraindications, and interactions of urinary analgesic drugs used for urinary and bladder disorders.
- 35.3.3 Describe nursing implications of urinary analgesic drugs used for urinary and bladder disorders.
- 35.3.4 Explain the client education related to urinary analgesic drugs used for urinary and bladder disorders.
Urinary analgesics are medications used to relieve pain and discomfort associated with the urinary tract. They are primarily used to treat conditions such as UTIs and interstitial cystitis (also known as bladder pain syndrome). Urinary analgesics work by numbing or reducing the sensitivity of the urinary tract, thus alleviating pain during urination.
It is important to note that urinary analgesics do not treat the underlying cause of the pain (such as bacterial infection in the case of UTIs); rather, they provide symptomatic relief. Therefore, it is crucial for the client to consult with a health care provider to determine the cause of urinary pain and to receive appropriate treatment. Additionally, urinary analgesics should be used only as directed and for a limited time because prolonged use without addressing the underlying cause may mask important signs and symptoms and delay appropriate diagnosis and treatment.
Phenazopyridine Hydrochloride
Phenazopyridine hydrochloride, an azo dye, is indicated for the symptomatic relief of pain, burning, urgency, frequency, and other discomfort arising from irritation of the lower urinary tract mucosa caused by infection, trauma, surgery, endoscopic procedures, or the passage of catheters (Eastham & Patel, 2022). This drug should not be used for more than 2 consecutive days to avoid potentially masking a bacterial infection requiring antibiotics.
Clinical Tip
Phenazopyridine Hydrochloride and Urine Color
Phenazopyridine hydrochloride may turn the urine, saliva, or tears a reddish-orange color. This is an expected effect of the medication and does not harm the client.
Adverse Effects and Contraindications
Adverse effects include headache; rash; pruritus; gastrointestinal disturbance; reddish-orange color of saliva, tears, or urine; hemolytic anemia; and renal and hepatic toxicity. Phenazopyridine hydrochloride is contraindicated in clients with hypersensitivity and in those with renal insufficiency.
Table 35.5 is a drug prototype table for phenazopyridine hydrochloride. It lists drug class, mechanism of action, adult dosage, indications, therapeutic effects, drug and food interactions, adverse effects, and contraindications.
| Drug Class Urinary analgesic Mechanism of Action Exerts an analgesic action locally on the urinary tract mucosa |
Drug Dosage 200 mg orally 3 times a day after meals. Use should not exceed 2 days. |
| Indications Symptomatic relief of pain and burning arising from irritation of the lower urinary tract mucosa Therapeutic Effects Relief of urinary frequency and urgency and of pain and burning of the urinary tract mucosa |
Drug Interactions Ketoconazole Lidocaine Procaine Tetracaine Food Interactions No significant interactions |
| Adverse Effects Headache Rash Pruritus Nausea, vomiting Abdominal discomfort Reddish-orange color of saliva, tears, and urine Hemolytic anemia Renal toxicity Hepatic toxicity Yellowish tinge to skin or sclera, which may indicate accumulation due to impaired renal excretion |
Contraindications Hypersensitivity Renal insufficiency |
Nursing Implications
The nurse should do the following for clients who are taking urinary analgesics:
- Before administering the drug, check the client’s medical history, current drug list (including over-the-counter medications), and allergies.
- Before administering the drug, assess the client’s renal and liver function because these drugs may cause renal or hepatic toxicity in clients who have insufficiency in these areas.
- Notify the health care provider if the client continues to have urinary issues.
- Provide client teaching regarding the drug and when to call the health care provider. See below for additional client teaching guidelines.
Client Teaching Guidelines
The client taking a urinary analgesic should:
- Take the medication as directed by their health care provider.
- Report any use of over-the-counter medications that may contain phenazopyridine hydrochloride to the health care provider because concomitant use may cause renal toxicity.
- Report any urinary tract symptoms that do not resolve or worsen to the health care provider because treatment may need to be modified.
The client taking a urinary analgesic should not:
- Take extra doses of this medication because doing so may cause serious adverse effects such as hemolytic anemia or renal or hepatic toxicity.
- Wear contact lenses while taking phenazopyridine hydrochloride because it may stain them a reddish-orange.
- Drink alcohol while taking urinary analgesics because their interaction may cause serious effects such as confusion, disorientation, and cardiac arrhythmias.
- Take this medication longer than 2 days because doing so could mask symptoms of a bacterial infection that is not resolving.