Nitrofurantoin Flashcards
What is the mechanism of action for Nitrofurantoin?
UNCLEAR
(possible inhibition of acetyl-CoA)
(possible production of reactive 5-nitro anion, free radicals)
How is Nitrofurantoin similar to Fosfomycin?
- Serum/tissue concentrations are theraputically insignificant; only high enough for adverse reactions
- Urine concentrations are very high; only used for UTIs
Why wouldn’t you use Nitrofurantoin to treat bacteremia?
What would you use Nitrofurantoin to treat?
serum concentrations so low
UTI
T/F
Rate of excreation for Nitrofurantoin is linear.
TRUE
Why wouldn’t you give Nitrofurantoin to a patient with impaired GFR (DO NOT USE if CrCl
Drug doesn’t reach urin for treatment; increase in systemic toxicity
What adverse reactions are related to Nitrofurantoin?
- Peripheral Neuropathy
- GI upset
- Pneumonia-like Reaction (with long term prophylactic use)
T/F
Like Trimethoprim and Sulfonamides, pts. may use Nitrofurantoin long term low dose for UTI prophylaxis.
TRUE
What adverse reaction to Nitrofurantoin is associated with prophylactic use of Nitrofurantoin?
Pulmonary Reaction that presents similarly to Pneumonia • Fever • cough • dyspnea • eosinophilia • infiltrate
What bugs are covered by Nitrofurantoin?
Staphylococcus aureus
Staphylococcus saprophyticus
Enterococcus faecalis
Enterococcus faecium
Escherichia coli
Klebsiella pneumonia
Citrobacter spp.
Enterobacter aerogenes
What G+ bugs are covered by Nitrofurantoin?
Staphylococcus aureus
Staphylococcus saprophyticus
Enterococcus faecalis
Enterococcus faecium
What G– bugs are covered by Nitrofurantoin?
Escherichia coli
Klebsiella pneumonia
Citrobacter spp.
Enterobacter aerogenes
Can Nitrofurantoin be used to treat Prostatitis or Pyelonephritis/Granulonephritis?
NO
concentration only high enough in the urine
What would you use Nitrofurantoin for?
- Acute Uncomplicated UTI
- UTI prophylaxis
