Nitrofurantoin Flashcards
What is the mechanism of action of nitrofurantoin?
Believed to inhibit enzymes involved in cell wall and bacterial carbohydrate metabolism
Is nitrofurantoin broad or narrow spectrum?
Narrow
Is nitrofurantoin effective against all pathogens that cause UTIs?
No
Give 2 examples of UTI pathogens that nitrofurantoin is not effective against?
- Proteus
- Pseudomonas
What are the routes of delivery of nitrofurantoin?
- PO
- IV
What are the indications for nitrofurantoin?
UTI
When is nitrofurantoin contraindicated?
- Acute porphyria
- G6PD deficiencies
- Infants <3 months old
When should nitrofurantoin be avoided?
- Term pregnancies
- Breast-feeding
Why should nitrofurantoin be avoided in term pregnancies and breastfeeding?
Teratogenic - may cause neonatal haemolysis
When should nitrofurantoin be used with caution?
- Anaemia
- B12 and folate deficiency
- Pulmonary disease
- Renal or hepatic impairment
- Conditions associated with peripheral neuropathy
What might nitrofurantoin interact with?
Oral magnesium salts
What might happen if nitrofurantoin is given with oral magnesium salts?
Reduced absorption of nitrofurantoin
What monitoring is required with nitrofurantoin?
- Monitor FBC during long-term treatment
- Monitor lung-function with long-term use
Why should FBC be monitored with long term use of nitrofurantoin?
Detect and treat any blood disorders that occur
Why should lung function be monitored in long-term use of nitrofurantoin?
To stop nitrofurantoin if deterioration in lung function occurs
What are the side effects of nitrofurantoin?
- Agranulocytosis
- Aplastic anaemia
- Arthralgia
- Blood disorders
- Cholestatic jaundice
- Hepatitis and pancreatitis
- Thrombocytopenia
- Alopecia
- Pulmonary fibrosis
- Peripheral neuropathy
- Haemolytic anaemia
- Hyperkalaemia
- Hypersensitivity reaction
(all rare or frequency not known)
What patient counselling is required with nitrofurantoin?
- Complete antibiotic course
- How to take
- Brown urine
How should nitrofurantoin be taken?
If taken as tablets, take with food and must be swallowed whole
What should the patient be told regarding brown urine with nitrofurantoin?
Warn patients that this antibiotic may cause their urine to turn brown in colour
