Antibacterial Medications Flashcards
trimethoprim, trimethoprim/
sulfamethoxazole (Bactrim, Septra) therapeutic use
- Sulfonamides
- Trimethoprim and sulfamethoxazole work together to treat:
- Urinary tract infections
- Pneumocystis pneumonia
- Shigella enteritis (shigellosis, also called traveler’s diarrhea)
- Chronic bronchitis (acute phase)
- Acute otitis media in children
trimethoprim, trimethoprim/
sulfamethoxazole (Bactrim, Septra) adverse reactions
GI symptoms: nausea, vomiting, anorexia
* Allergic skin reactions
* Blood cell deficiencies (thrombocytopenia, leukopenia, anemia,
agranulocytosis, aplastic anemia )
* Superinfection – Clostridium difficile-associated diarrhea (CDAD): or
Candida infections
* Severe rash, including Stevens-Johnson syndrome
* Kernicterus
trimethoprim, trimethoprim/
sulfamethoxazole (Bactrim, Septra) nursing interventions
- Monitor for and report severe symptoms.
- Monitor for rash and hives.
- Monitor for and report severe diarrhea.
- Monitor and report rash and/or blisters on skin to provider.
- Encourage patient to drink plenty of fluids
- Monitor I & O
- Monitor CBCs and Urinalysis throughout treatment
trimethoprim, trimethoprim/
sulfamethoxazole (Bactrim, Septra) medication administration
- Available as a fixed-dose combination in tablets, liquid solution, and IV
form. - Give oral dose with 8 oz. of water.
- Administer intermittent IV infusion slowly (over 60 to 90 min) and with
recommended dilution. - Drink at least 1,200 to 1,500 mL water/day during treatment with this
drug.
trimethoprim, trimethoprim/
sulfamethoxazole (Bactrim, Septra) client education
- Report symptoms to provider.
- Take with food to minimize GI symptoms.
- Report rash and hives to provider.
- Report fatigue, pallor, easy bruising, or new infections to provider.
- Report watery or bloody diarrhea to provider.
- Report pain in mouth, difficulty eating, or vaginal burning/discharge.
- Report onset of rash and/or blisters on the skin to provider.
- Warn clients that sulfonamides decrease the effectiveness of oral
contraceptives; use alternate form of contraception.
trimethoprim, trimethoprim/
sulfamethoxazole (Bactrim, Septra) contraindications and precautions
CONTRAINDICATIONS
* Women who are pregnant or nursing
* Allergy to sulfonamides, trimethoprim, cyclooxygenase-2 inhibitors
(celecoxib [Celebrex])
* Clients with megaloblastic anemia caused by folic acid deficiency
* Children under 2 months
* Pharyngitis caused by group A beta-hemolytic streptococci
* Hyperkalemia
* Severely impaired urine creatinine clearance
PRECAUTIONS
* Decreased kidney or liver function
* Hypersensitivity to sulfites used as preservatives (wine, foods), other
drugs related to sulfonamides (acetazolamide, thiazide diuretics,
tolbutamide)
* Suppressed bone marrow
* Clients at risk for megaloblastic anemia (clients with alcoholism,
pregnant women, clients who are debilitated)
trimethoprim, trimethoprim/
sulfamethoxazole (Bactrim, Septra) interactions
- Alcohol with the drug may cause a disulfiram-type reaction.
- May increase effects of warfarin, phenytoin, tolbutamide (and other
sulfonylurea oral antidiabetic drugs). - Taken with methotrexate, clients may have increased
immunosuppression. - Reduced effectiveness of oral contraceptives (use alternative
contraception).
amoxicillin (Amoxil), amoxicillin/clavulanic acid (Augmentin) therapeutic use
- Penicillins
- Treats broad-spectrum infections caused by gram-positive cocci and
bacilli, such as ear and throat infections and urinary tract infections. - Amoxicillin treats gonorrhea caused by non-penicillinase-producing
bacteria. - Addition of clavulanic acid increases spectrum of disorders treated by
amoxicillin and its ability to kill bacteria.
amoxicillin (Amoxil), amoxicillin/clavulanic acid (Augmentin) adverse reactions
- GI symptoms: diarrhea, nausea, vomiting
- Rarely may cause Clostridium difficile (C. Diff) superinfection (more
frequent with other antibiotics than amoxicillin) - Superinfection with Candida albicans
- Allergy to penicillin (rash, hives, wheezing and difficulty breathing)
amoxicillin (Amoxil), amoxicillin/clavulanic acid (Augmentin) nursing interventions
- Monitor for GI symptoms.
- Monitor and report bloody stools or long-term watery diarrhea.
- Monitor for and report Candida infections of mouth or vagina.
- Expect to treat Candida infections with an antifungal agent.
- Ask clients if they are allergic prior to administering the first dose.
- Monitor for allergy manifestations and notify provider.
- For injectable penicillins (IM or IV), keep client in facility for 30 min after
administration and monitor for allergy. - Prepare to treat rash/hives with antihistamines; anaphylaxis with
epinephrine and respiratory support.
amoxicillin (Amoxil), amoxicillin/clavulanic acid (Augmentin) medication administration
- Client should not crush or chew extended-release form.
- Chew chewable forms before swallowing.
- For infants or young children, place drops directly on tongue or mix
with a small amount of juice or formula; ensure that child takes full
dose. - Give at the beginning of meals to decrease GI symptoms and increase
absorption. - Give amoxicillin with probenecid, if prescribed, to increase therapeutic
activity of amoxicillin.
amoxicillin (Amoxil), amoxicillin/clavulanic acid (Augmentin) client education
- Report watery or bloody diarrhea to provider.
- Take drug at the start of meals.
- Report mouth pain or inability to eat.
- Report vaginal burning, itching, and discharge.
- Stop drug and notify provider for possible allergic reactions.
- Call 911 for severe symptoms, such as difficulty breathing.
amoxicillin (Amoxil), amoxicillin/clavulanic acid (Augmentin) contraindications and precautions
CONTRAINDICATIONS
* Allergy to penicillins, hypersensitivity to procaine and benzathine
PRECAUTIONS
* Renal impairment may need reduced dose
amoxicillin (Amoxil), amoxicillin/clavulanic acid (Augmentin) interactions
- Probenecid increases penicillin blood levels.
- Bacteriostatic agents may decrease therapeutic effects.
- Reduced effectiveness of oral contraceptives.
erythromycin therapeutic use
- Macrolides
First-line of treatment for: - Legionnaires’ disease
- Whooping cough
- Acute diphtheria
- Treatment of clients who are carriers of diphtheria
- Some Chlamydia infections
- Certain pneumonias
- Treats common infections for clients who have a penicillin allergy
- Ophthalmic ointment prevents eye infections in neonates
erythromycin adverse reactions
- GI symptoms: nausea, vomiting, abdominal pain, and diarrhea
- Cardiac symptoms: serious ventricular dysrhythmias can result in death
- Ototoxicity: hearing loss, vertigo, and tinnitus (able to reverse when
treatment ends) - Superinfection (C. diff-associated diarrhea, candidiasis)
erythromycin nursing interventions
- Monitor for and report GI reactions (a decrease in the dose may stop
symptoms). - Monitor for concurrent use of other drugs that increase erythromycin
blood levels. - Question client about history of prolonged QT.
- Monitor for and report signs of ototoxicity.
- Monitor for and report superinfection.
- Monitor liver function in long-term use
erythromycin medication administration
- Available in four forms:
- Erythromycin base: tablets, capsules, topical, and ophthalmic ointment
- Erythromycin stearate: tablets
- Erythromycin ethylsuccinate (EES): tablets
- Erythromycin lactobionate: IV form
- Give erythromycin base and erythromycin stearate on an empty
stomach 1 hr before or 2 hr after a meal for best absorption; give with 8
oz. of water. - If GI symptoms occur, may give with food.
- Give EES enteric-coated forms of erythromycin with or without meals.
- For IV form, follow dilution and rate recommendations to prevent
thrombophlebitis.
erythromycin client educations
- Take with food if GI symptoms occur.
- Report continuing symptoms to provider.
- Report palpitations and fainting spells to the provider.
- Report hearing loss, vertigo, and tinnitus to provider.
- Report bloody or watery diarrhea.
- Report mouth pain with white patches on the oral mucosa, or vaginal
discomfort and discharge.
erythromycin contraindications and precautions
CONTRAINDICATIONS
* Allergy to erythromycin or other macrolide antibiotic
* History of prolonged QT syndrome
* Hypokalemia
* Hypomagnesemia
PRECAUTIONS
* GI disorders
* Liver disorders
erythromycin interactions
- Decreases blood levels of chloramphenicol and clindamycin antibiotics.
- Increases blood levels of multiple drugs, including digoxin, warfarin,
and theophylline. - Drugs that inhibit the enzyme CYP3A4 increase erythromycin levels
(verapamil, azole antifungals, protease inhibitors for HIV, diltiazem)
imipenem (Primaxin) therapeutic use
- Carbapenems
- Treats serious infections caused by multiple types of organisms
imipenem (Primaxin) adverse reactions
- GI symptoms: nausea, vomiting (may occur if IV infusion is too rapid)
- Thrombophlebitis at IV site
- Possible cross-sensitivity with other antibiotics with beta-lactam ring
(penicillins, cephalosporins) - Superinfection
imipenem (Primaxin) nursing interventions
- Follow recommendation rate when infusing IV form.
- Monitor for nausea during infusion; treat with antiemetic.
- Monitor IV site for redness and swelling during infusion.
- Assess for and report antibiotic allergy prior to infusing imipenem.
- Monitor for secondary infections, such as oral candidiasis.
- Lab testing should include AST, BUN, LDH, as well as testing for bilirubin
and increased creatinine
imipenem (Primaxin) medication administration
- Only available for IM or IV use.
- IM and IV forms are not interchangeable–assure and use the correct
form for prescription. - Follow recommendations for rate and dilution when infusing IV doses.
imipenem (Primaxin) client education
- Report nausea, especially when it occurs during IV infusion.
- Report pain, swelling, or redness at IV site.
- Report all drug allergies to provider.
- Report mouth pain and difficulty chewing and swallowing.
- Report vaginal irritation and discharge.
imipenem (Primaxin) contraindications and precautions
CONTRAINDICATIONS
* Allergy to carbapenems
* Allergy to penicillin
PRECAUTIONS
* Allergy to cephalosporins
* Seizures
* Renal impairment
imipenem (Primaxin) interactions
- Monobactam, penicillin, and cephalosporin antibiotics may decrease
the effects of imipenem. - Probenecid decreases renal excretion and cyclosporine increases the
risk for seizures.
tetracycline, doxycycline, minocycline therapeutic use
- Tetracyclines
- First-choice antibiotic for:
- Chlamydia infections
- Mycoplasmal infections
- Rickettsial infections (such as typhus)
- Syphilis and gram-negative infections in clients with penicillin allergy
- Gram-positive infections (tetanus)
- Cholera
- Anthrax
- Treats acne vulgaris (topical and oral forms)
tetracycline, doxycycline, minocycline adverse reactions
- GI symptoms: nausea, vomiting diarrhea, abdominal pain
- Permanently discolors deciduous teeth of fetus (after 4th month
gestation) and permanent teeth in young children (under 8ys old) - Hepatotoxicity (especially in large doses or to pregnant/postpartum
women) - Superinfections (C. diff, Candida infections)
- Photosensitivity (severe sunburn-type reaction with sun exposure)
- Suppression of long-bone growth in premature infants
tetracycline, doxycycline, minocycline nursing interventions
- Give with non-dairy foods if symptoms occur.
- Monitor and report GI symptoms (decreased dose can be required).
- Determine if client could be pregnant before giving drug to women of
childbearing age. - Monitor liver function tests.
- Monitor for symptoms of liver damage.
- Monitor for signs of superinfection.
- Monitor for skin reaction.
- Monitor for lymphadenopathy and facial swelling
tetracycline, doxycycline, minocycline medication administration
- Give orally on an empty stomach 1 hr before or 2 hr after meals; give
with non-dairy food if client is unable to tolerate. - Do not give right before bedtime.
- Topical form treats acne vulgaris.
- IM and IV tetracycline are given only if oral form cannot be tolerated by
client. - Shake solution well before measuring.
- Ensure that outdated drug is not administered (causes a type of kidney
dysfunction). - Another tetracycline (doxycycline [Vibramycin]) can be given more
effectively with food and safely in clients with renal failure.
tetracycline, doxycycline, minocycline client education
- Take with non-dairy foods if GI symptoms occur.
- Report symptoms to provider.
- Report to provider if pregnant.
- Giving the drug to children under the age of 8 should be avoided.
- Report jaundice, abdominal pain, or fatigue to provider.
- Report mouth pain and difficulty chewing or swallowing.
- Report vaginal irritation/discharge.
- Report watery or bloody stools.
- Wear protective clothing and wear sunscreen for sun exposure.
tetracycline, doxycycline, minocycline contraindications and precautions
CONTRAINDICATIONS
* Pregnancy risk – teratogenic
* Children younger than 8 years
* Allergy to tetracycline
* Exposure to ultraviolet light
* Serious renal or liver failure
PRECAUTIONS
* History of liver or kidney disorder
tetracycline, doxycycline, minocycline interactions
- Absorption decreased by antidiarrheals containing kaolin; supplements
and antacids containing calcium, magnesium, or aluminum. - Dairy products and supplements with iron or zinc decrease absorption.
- Tetracyclines decrease effectiveness of oral contraceptives.
cephalexin (Keflex) therapeutic use
- First generation cephalosporins
- Cephalexin is a first-generation cephalosporin that treats infections
caused by gram-positive cocci. - Subsequent generations of cephalosporins (drugs from the second to
fifth generation) become: - more active against gram-negative bacteria.
- more resistant to beta-lactamase (gram-positive) bacteria.
- more able to penetrate cerebrospinal fluid to treat infections, such as
meningitis.
cephalexin (Keflex) adverse reactions
- GI symptoms: diarrhea and nausea
- Clostridium difficile-associated diarrhea (CDAD), which is rare, may be
from a superinfection - Possible cross-allergy to penicillin allergy (especially for clients with a
history of severe penicillin allergy) - Risk for hemorrhage with cefotetan (Cefotan) only
- Thrombophlebitis (cephalosporins infused via IV only)
- Cefotetan (Cefotan): disulfiram-like reaction if client takes with alcohol
cephalexin (Keflex) nursing interventions
- Monitor and report bloody stools or watery diarrhea to provider.
- Assess for cephalosporin or penicillin allergy before giving drug; inform
provider. - Prepare to treat rash/hives with antihistamines; anaphylaxis with
epinephrine and antihistamines. - Monitor prothrombin and bleeding time.
- Expect to administer vitamin K if bleeding occurs.
- Monitor for thrombophlebitis during IV infusion; for occurrence, stop
infusion and change IV site. - Follow recommendations when diluting IV cephalosporins; infuse
slowly. - Inform client that a disulfiram-like reaction will occur with the
combination of the drug and alcohol.
cephalexin (Keflex) medication administration
- Cephalexin is only available as capsules, tablets, or oral suspension.
- Other cephalosporins may be available for oral, IM, or IV use.
- Be careful to differentiate between cephalosporin prescriptions; generic
names may be very similar.
cephalexin (Keflex) client education
- Take with food to decrease GI symptoms.
- Report watery or bloody diarrhea to provider.
- Stop drug and notify provider for possible allergic reactions.
- Call 911 for severe symptoms, such as difficulty breathing.
- Report unusual bruising or bleeding to provider.
- Report burning, pain, or swelling at IV site during infusion of
cephalosporin. - Inform client about the potential for nausea, vomiting, severe
headache, and hypotension with the combination of the drug and
alcohol.
cephalexin (Keflex) contraindications and precautions
CONTRAINDICATIONS
* Allergy to cephalosporin antibiotics
* Allergy to penicillin (possible cross-sensitivity)
* Carnitine deficiency or milk protein allergy: cefditoren (Spectracef) only
* Any alcohol use causes a disulfiram-like reaction: cefotetan (Cefotan) only
PRECAUTIONS
* Renal failure
* GI disease
cephalexin (Keflex) interactions
- Probenecid causes prolonged effect of most cephalosporins
- Alcohol or any drug that promotes bleeding: cefotetan (Cefotan) only
- IV calcium and ceftriaxone (Rocephin) only
vancomycin (Vancocin) therapeutic use
- Vancomycin
- Severe infections
- Methicillin-resistant Staphylococcus aureus infections (MRSA)
- Infections in clients with an allergy to penicillin
- Clostridium difficile-associated diarrhea (CDAD)
vancomycin (Vancocin) adverse reactions
- Renal failure secondary to nephrotoxicity
- Hypotension, tachycardia and flushing of the face and trunk (“red man”
syndrome) occur with rapid IV infusion - Rare – ototoxicity (usually reversible)
- Thrombophlebitis at IV site and tissue damage with IV infiltration
vancomycin (Vancocin) nursing interventions
- Administer over 1 hr by IV infusion. Follow recommendations for
dilution. - Monitor vital signs during infusion.
- Monitor vancomycin trough levels.
- Monitor BUN and creatinine levels.
- Assess IV infusion for redness and swelling.
- Assure that the IV is patent during infusion.
vancomycin (Vancocin) medication administration
- Give orally for C diff infections
- Give IV for all other infections.
- Administer slowly IV and follow recommendations for dilution.
- Infuse separately, if possible (incompatible in solution with many other
IV drugs).
vancomycin (Vancocin) client education
- Report flushing and feelings of faintness during IV infusion.
- Instruct clients to report tinnitus or perceived loss of hearing.
- Instruct clients to report an increase or decrease in urine output.
- Report pain, swelling, and redness at IV site immediately.
- Report vertigo
vancomycin (Vancocin) contraindications and precautions
CONTRAINDICATIONS
* Allergy to vancomycin
* Hypersensitivity
PRECAUTIONS
* Renal insufficiency (reduce dosage)
* Impaired hearing
* Colitis
vancomycin (Vancocin) interactions
- Drugs that are toxic to hearing or kidney increase the risk for ototoxicity
or nephrotoxicity. - Vancomycin is incompatible in a solution with multiple other IV drugs.
ciprofloxacin (Cipro) therapeutic use
- Fluoroquinolones
- Treats a wide range of bacterial infections, including severe urinary
tract disorders. - Prevents anthrax (following inhalation of anthrax spores) in both adults
and children.
ciprofloxacin (Cipro) adverse reactions
- Mild CNS symptoms (dizziness, headache; confusion in older clients)
- GI symptoms (nausea, vomiting, diarrhea)
- Achilles tendon rupture (rare), especially in older clients, and clients
taking glucocorticoids, and transplant recipients - Photosensitivity (sunburn-like reaction) even with indirect sun
exposure, sunlamp exposure; may occur despite use of sunscreen - Severe adverse reactions include seizures, intracranial pressure,
suicidal ideation, hepatotoxicity, anaphylaxis, and Clostridium difficile associated diarrhea (CDAD)
ciprofloxacin (Cipro) nursing interventions
- Monitor for and report GI symptoms (a decrease in the dose may need
to occur). - Monitor for and report tendon pain during treatment (discontinue if
pain occurs). - Don’t allow clients to go outdoors without covering their skin with
clothing. They also need to apply sunscreen to areas of exposure.
ciprofloxacin (Cipro) medication administration
- Available in oral and IV forms.
- IV:
- Infuse slowly over at least 60 min; follow recommendations for dilution.
- Incompatible with multiple other drugs in IV solution or IV tubing.
ciprofloxacin (Cipro) client education
- Report CNS symptoms to provider.
- Decrease caffeine use during treatment.
- Report GI symptoms to provider.
- Report tendon pain to provider.
- Avoid exposure to sunlight or sunlamp.
- Wear clothes that fully cover the body and apply sunscreen to
remaining areas of exposure. - Take antacids, iron, calcium, dairy products, and sucralfate 2 hr after or
6 hr before oral ciprofloxacin. - Encourage patients to drink at least 1,500 to 2,000 mL of fluids/day
ciprofloxacin (Cipro) contraindications and precautions
CONTRAINDICATIONS
* Allergy to any fluoroquinolone
* Tendon pain
* Myasthenia gravis
PRECAUTIONS
* Serious CNS disorders (seizure disorder)
* GI disorders
* Renal impairment
* Coumadin therapy
* Children under 18
* Pregnancy risk
ciprofloxacin (Cipro) interactions
- Antacids, iron preparations, calcium (including dairy products), and
sucralfate (Carafate) decrease oral absorption. - Increases theophylline levels and the risk for CNS symptoms.
- Increases warfarin (Coumadin) levels.
- Concurrent use of erythromycin, quinidine, some antipsychotics, and
tricyclic antidepressants can increase the risk for torsade de pointes in
those susceptible. - Increased hypoglycemia may occur when taken concurrently with
antidiabetic medication.
gentamicin therapeutic use
- Aminoglycosides
- Gram-negative aerobic bacilli severe infections (all aminoglycosides).
- Gentamicin (in combination with another antibiotic) treats severe
infections that some gram-positive cocci cause. - Topical form for skin and eye infections.
gentamicin adverse reactions
- Elevated trough levels of drug (early signs include tinnitus, headache,
and vertigo) can cause ototoxicity - Nephrotoxicity (polyuria, dilute urine, protein and casts in urine,
elevated BUN, creatinine) - Ataxia (poor muscle control that causes clumsy voluntary movements)
gentamicin nursing interventions
- Monitor for and report tinnitus and other symptoms of early
ototoxicity. - Monitor peak and trough blood levels.
- Monitor laboratory values (BUN, creatinine, urine for protein and casts)
and report elevations. - Evaluation of eighth cranial nerve with audiometry
- Monitor I&O
gentamicin medication administration
- Available in topical, ophthalmic, IM/IV, and intrathecal forms
- Ophthalmic drops
- Gently press the inner canthus for 1 to 2 min after instilling drops to prevent systemic absorption.
- Instruct the client to keep eyes shut for 1-2 min to maximize local absorption.
- Topical cream
- Don’t apply it to large skin areas.
- There is a risk for toxicity with systemic absorption.
- IM: Inject it deeply into a large muscle.
- IV: Give it as an intermittent infusion, using recommendations for rate and dilution.
- Intrathecal: Use a preservative-free form for intrathecal; discard portions you didn’t use.
gentamicin client education
- Report onset of tinnitus, headache, vertigo, or hearing loss to provider.
- Report an increase in the output of dilute urine to provider.
gentamicin contraindications and precautions
CONTRAINDICATIONS
* Allergy to any aminoglycoside
* Pregnancy risk – teratogenic
PRECAUTIONS
* Prior damage to acoustic nerve causes increased risk of hearing loss
* Presence of tinnitus or vertigo
* Renal disorders
* Chronic neuromuscular disorders
* Dehydration
gentamicin interactions
- Other ototoxic drugs increase the risk for ototoxicity.
- Amphotericin B (Fungizone), NSAIDS, or other nephrotoxic drugs
increase the risk for nephrotoxicity. - Cephalosporins, vancomycin, and penicillin enhance the bactericidal
effect of gentamicin. - Don’t mix multiple drugs in the same IV solution with gentamicin
(penicillin, cephalosporins, heparin). - Can prolong respiratory paralysis in combination with neuromuscular
blockers (pancuronium, succinylcholine [Anectine]).
nitrofurantoin (Macrodantin) therapeutic use
- Urinary tract antiseptic
- Treatment and prevention of UTIs.
nitrofurantoin (Macrodantin) adverse reactions
- GI symptoms: nausea/vomiting and diarrhea
- Respiratory symptoms:
* Acute: chills/fever, cough, lasts 2 to 4 days
* Subacute: cough, shortness of breath, lasts weeks to months and may be permanent - Permanent peripheral neuropathy (commonly in clients with impaired
renal function) - Blood cell dysfunction (anemia, including hemolytic anemia,
thrombocytopenia, neutropenia) - Tooth staining caused by contact with liquid suspension
- Urine may also appear brownish (harmless side effect)
- Dizziness, drowsiness, headache, and photosensitivity
- Pulmonary distress
nitrofurantoin (Macrodantin) nursing interventions
- Monitor and report GI symptoms (dose may be reduced or form of drug
may be changed to minimize symptoms). - Monitor and report respiratory symptoms (drug will be discontinued).
- Monitor for and report symptoms of neuropathy.
- Monitor laboratory values of blood components.
- Do not crush capsules; dilute suspension in milk or juice before
administration; have client rinse mouth if taking suspension. - Monitor I & O as well as bowel function
nitrofurantoin (Macrodantin) medication administration
- Available in oral capsules (Macrodantin and Macrobid) and liquid
suspension (Furadantin). - Have client swallow capsules whole.
- Dilute liquid suspension and have client rinse mouth after taking.
nitrofurantoin (Macrodantin) client education
- Take with food or milk.
- Report acute or subacute respiratory symptoms, such as dyspnea,
fever, or cough to the provider. - Report numbness, tingling, and weakness of the extremities.
- Report fatigue, easy bruising, or repeated infections to provider.
- Swallow capsules whole.
- Dilute liquid suspension.
- Rinse mouth after taking suspension.
nitrofurantoin (Macrodantin) contraindications and precautions
CONTRAINDICATIONS
* Allergy to nitrofurantoin
* Impaired kidney function (with low urine creatinine clearance levels)
* History of jaundice caused by gallbladder disease
* Pregnancy at more than 38 weeks’ gestation
* During labor or delivery, lactating
* Infants less than 1 month
PRECAUTIONS
* Asthma or other respiratory disorders
* Liver disorders
* Kidney disorder that does not affect creatinine clearance
* Electrolyte imbalance
* Vitamin B12 deficiency
nitrofurantoin (Macrodantin) interactions
- Concurrent use with antacids will decrease absorption.
- Probenecid increases the chance of toxicity.
- Avoid use with drugs with the potential for pulmonary toxicity.
