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Pharmacology · chapter 35 · Urinary and Bladder Disorder Drugs

Urinary Analgesics

The 14 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 6 practice questions with the reasoning.

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Key points

  1. What urinary analgesics treat

    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.

  2. Symptom relief, not a cure

    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.

  3. Limited use can prevent masking

    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.

  4. Two-day limit for phenazopyridine

    This drug should not be used for more than 2 consecutive days to avoid potentially masking a bacterial infection requiring antibiotics.

  5. Reddish-orange body fluids

    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.

  6. Adverse effects

    Adverse effects include headache; rash; pruritus; gastrointestinal disturbance; reddish-orange color of saliva, tears, or urine; hemolytic anemia; and renal and hepatic toxicity.

  7. Contraindications

    Phenazopyridine hydrochloride is contraindicated in clients with hypersensitivity and in those with renal insufficiency.

  8. Check kidney and liver function

    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.

  9. Ongoing urinary problems

    Notify the health care provider if the client continues to have urinary issues.

  10. Over-the-counter products

    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.

  11. Symptoms that do not resolve

    Report any urinary tract symptoms that do not resolve or worsen to the health care provider because treatment may need to be modified.

  12. No extra doses

    From the book’s list of what the client should not do:

    Take extra doses of this medication because doing so may cause serious adverse effects such as hemolytic anemia or renal or hepatic toxicity.

  13. Contact lenses can be stained

    From the book’s list of what the client should not do:

    Wear contact lenses while taking phenazopyridine hydrochloride because it may stain them a reddish-orange.

  14. No alcohol

    From the book’s list of what the client should not do:

    Drink alcohol while taking urinary analgesics because their interaction may cause serious effects such as confusion, disorientation, and cardiac arrhythmias.

Terms to know

Urinary analgesics
Urinary analgesics are medications used to relieve pain and discomfort associated with the urinary tract.
Phenazopyridine hydrochloride
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).

Practice questions

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  1. A client with a UTI says, "The phenazopyridine took my burning away, so I don't need the antibiotic." What is the nurse's best response?

    1. "Stop both drugs if you feel better."
    2. "Phenazopyridine relieves symptoms but does not treat the infection, so keep taking the antibiotic."
    3. "Take phenazopyridine for two weeks instead."
    4. "You are right; the pain was the infection."

    Answer: "Phenazopyridine relieves symptoms but does not treat the infection, so keep taking the antibiotic."

    Urinary analgesics give symptomatic relief and do not treat the underlying cause, such as a bacterial infection. Longer use can mask infection, and stopping treatment is not advised.

  2. A client taking phenazopyridine calls because her urine is reddish-orange. What should the nurse tell her?

    1. This is an expected, harmless effect of the drug.
    2. This is blood in the urine; go to the emergency department.
    3. This means the kidneys are failing.
    4. Stop the drug immediately.

    Answer: This is an expected, harmless effect of the drug.

    Phenazopyridine may turn urine, saliva or tears reddish-orange; this is an expected effect and does not harm the client. The other responses misread a known drug effect.

  3. A nurse is teaching a client who is starting phenazopyridine. Which instructions are correct? Select all that apply.

    1. Do not wear contact lenses while taking it.
    2. Do not take it for longer than 2 days.
    3. Take an extra dose if the burning comes back.
    4. Avoid alcohol.
    5. Tell your provider about any over-the-counter urinary pain products.

    Answer: Do not wear contact lenses while taking it., Do not take it for longer than 2 days., Avoid alcohol., Tell your provider about any over-the-counter urinary pain products.

    Use is limited to 2 days to avoid masking infection, contact lenses may be stained, alcohol can cause confusion and arrhythmias, and OTC products may contain the same drug. Extra doses can cause hemolytic anemia and renal or hepatic toxicity.

  4. Before giving phenazopyridine, the nurse reviews the chart. Which finding should the nurse report to the provider?

    1. Burning on urination
    2. Renal insufficiency
    3. Recent urinary catheter removal
    4. Urinary frequency

    Answer: Renal insufficiency

    Phenazopyridine is contraindicated in renal insufficiency, and the nurse assesses renal and liver function before giving it. Frequency, burning and irritation after catheters are what the drug treats.

  5. Which findings in a client taking phenazopyridine suggest a serious adverse effect that needs follow-up? Select all that apply.

    1. Signs of hemolytic anemia
    2. Signs of renal toxicity
    3. Reddish-orange tears
    4. Reddish-orange urine
    5. Signs of liver toxicity

    Answer: Signs of hemolytic anemia, Signs of renal toxicity, Signs of liver toxicity

    Hemolytic anemia and renal and hepatic toxicity are serious adverse effects. Reddish-orange tears or urine are expected and harmless.

  6. A client has taken phenazopyridine for 2 days and still has burning and urgency. What should the nurse do?

    1. Double the dose.
    2. Tell the client to continue for another week.
    3. Tell the client to drink alcohol to relax the bladder.
    4. Notify the health care provider.

    Answer: Notify the health care provider.

    The nurse notifies the provider if urinary issues continue, because treatment may need to change and longer use could mask an infection. Continuing, doubling or alcohol are all unsafe.

Where every quote comes from

Section 35.3 Urinary Analgesics of Pharmacology for Nurses by Tina Barbour-Taylor, Leah Mueller (Sabato), Donna Paris, Dorie Weaver, OpenStax, 2024. Read the whole section free at openstax.org.

The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.