My mother aged 85 who is bed bound had 2-3 episodes of hematuria. She was hospitalized and urine sample was collected with the help of a catheter. Her urine routine showed 75-80 pus cells but urine culture and sensitivity test showed no microbial growth. Her usg kub shows that she's having more than 500 cc urine retention. One kidney shows hydronephrosis with dilated ureter. Her abdominal scan shows that her bladder wall is trabeculated with diverticula. She was treated with antibiotics and her urologist prescribed niftas 100 mg 1 tab for 3 months, macpee 25 mg 3 tabs/day for 2 months and veltam 0.4 mg 1 tab for two months. Within 10 days she again had episodes of hematuria which lasted for 2-3 days. Her doc prescribed zifi 200 2 tabs per day for 7 days. After two days of zifi bleeding in urine stopped. Currently she's complaining of lower abdominal pain sometimes and strange discomfort. On checking her spo2 it shows fluctuation and there is increase in pulse rate. Today her pulse jumped to 128 and spo2 dropped to 76 and then normalised to 98. Her pulse rate has never come out to be high and spo2 has never fluctuated this much. Does macpee, veltam cause side effects? If so, whatever my mother is experiencing are the side effects of the meds she's on? She's completed approx 25 days of macpee and veltam and 30 days of niftas 100. Does she require a catheter for urinary retention? We are quite apprehensive in going for the catheter as she may try to pull it out leading to injury. My mother has history of hiatus hernia, oesophageal stricture, oesophageal ulcers, uti, osteoporosis and age-related dementia. She was having hypertension since past sev years but from past one month she is off the antihypertensive as her bp comes out to be normal. please advise. Thanks a lot.
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She is under hospital doctors they will take care. Â
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Beta as for as urine part is concerned, she is getting right treatment, high pulse rate and low o2 saturation are not the side effects. When ever you check o2. Keep it on for some time may be 2or 3 minutes. Let the reading stabilise, then check. It will be normal. High pulse can be due to many causes. For that all reports of blood and other wise are needed.. Â
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Hello lybrate-user according me your mother needed hospital treatment continue as some medications and needed urologist opinion and if needed surgical treatment according to you provided hydronephrosis thank you for posting your problems here I wish your mother become get well soon, keep updating here. Â
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Sorry to hear about how your mother has suffered so much I am here to help however I can. (1) puss cells in urine but no growth on culture could indicate "sterile pyuria" which is common in elderly women. Possible reason for this may also be recent or incomplete antibiotic course. There are also several organisms that could cause uti, they may be present in bladder/urine but do not grow on culture media and they are capable of causing hematuria. (2) there can be several obstructive (obstruction of urine passage) and non-obstructive causes for urinary retention. An obstruction at the vesicoureteral junction (vuj) on one side can cause backpressure leading to dilatation of ureter and hydronephrosis of that side. Neurogenic bladder (not obstructive) can cause the same problems. Both of these conditions can lead to formation of bladder diverticula. Doctors usually do a test called ivp to rule out any blockage to urinary pathway. (3) niftas (nitrofurantoin), macpee (bethanechol) can have side effects like pain abdomen, nausea/vomiting, diarrhea, etc. (4) macpee - severe side effects of macpee include tachycardia (fast heart beat), severe abdominal pain & fainting. (5) veltam (tamsulosin) can also cause tachycardia (increased heart rate), arrythmia (irregular heart rate), hypotension (decreased blood pressure), etc. *as far as her abdominal pain/discomfort is concerned - any of the above three medications could be the cause for that. *for decreased spo2 and increased pulse - since she has had niftas, macpee and veltam for over 25 days a sudden reaction to them is unlikely. Now the only remaining medication that could cause this is zifi. (6) zifi (cefixime) - serious reaction to zifi has been reported where it caused dyspnoea / hypoxemia (decreased spo2), taachycardia (increased pulse / heart rate) and hypotension (decreased blood pressure). Usually this starts within hours of the first dose but you need to contact your doctor at the earliest if your mother is facing these problems. (7) yes, she might need a urinary catheter specially if she is confined to her bed mostly - an intermittent catheterization for draining urine could work. (8) along with treatment your mother would need all the emotional/mental support she can get from you and your family. I hope I have answered most of your questions. If you need any more help from me, you can contact me on private chat here at Lybrate. I wish your mother good health and you the strength to get through this. Â
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