Nitrofurantoin Flashcards
When is nitrofurantoin indicated for use?
Uncomplicated Lower UTI - First line
Why is nitrofurantoin particularly suited to the treatment of UTI?
- Effective against common organisms
- Reaches therapeutic range in urine due to renal excretion
- Most bactericidal in acidic environments
How does nitrofurantoin work?
Metabolised in bacterial cells by nitrofurin reductase - active metabolite damages DNA
What organisms is nitrofurantoin active against?
- Gram negative
- Some gram positive
What are important adverse side effects of nitrofurantoin?
- GI upset
- Hypersensitivity
- Turns urine dark yellow/brown
- Pneumonitis/Fibrosis
- Hepatitis
- Peripheral neuropathy
When is the use of nitrofurantoin contraindicated for use?
- Pregnant women towards term
- Babies in first 3 months of life
- Renal impairment
How is nitrofurantoin normally administered?
Oral
When are maximal urinary concentrations of nitrofurantoin acheived?
2-4 hours after dosing
What dose of immediate-release nitrofurantoin would you prescribe in an adult with acute uncomplicated UTI?
50 mg 4 times a day (6hrly) - 3-7 days
How should nitrofurantoin be administered?
Orally - taken with food or milk
What advise should you give patients on nitrofurantoin in the short term?
Urine may change colour - become darker
What might you warn patients to look out for when using nitrofurantoin long term?
- Pins and needles
- Breathlessness
- Any other unexplained symptoms
How would you monitor efficacy of nitrofurantoin?
Symptoms/signs of UTI
