part 12

Question 1

How is trimethoprim like sulfonamides?

Answer 1

they both suppress bacterial synthesis of DNA, RNA, and proteins

Question 2

What are some adverse effects of trimethoprim?

Answer 2

• mostly well tolerated
• possible birth defects
• hyperkalemia

Question 3

Why must you be aware of serum potassium with trimethoprim?

Answer 3

• it suppresses renal excretion of K

- at risk are pt’s taking ACE inhibitors, ARB, K sparing diuretic, or potassium supplements

Question 4

What is special about trimethoprim/Sulfamethoxazole (TMP/SMZ).

Answer 4

much more powerful than one medication alone

Question 5

What is nitrofurantoin (macrodantin, macrobid)?

Answer 5

urinary tract antiseptics

Question 6

What can minimize the adverse effects (N,V,D) of nitrofurantoin?

Answer 6

milk or meals

Question 7

What are the pulmonary reactions of nitrofurantoin (macrodantin, macrobid)?

Answer 7

• dyspnea, CP, chills, fever, cough, and alveolar infiltrates
• symptoms resolve in 2 to 4 days after discontinuing the drug
• in some pt’s permanent lung damage may occur

Question 8

What are the hematologic effects of nitrofurantoin (macrodantin, macrobid)?

Answer 8

• agranulocytosis, leukopenia, thrombocytopenia, megaloblastic anemia
• hemolytic anemia in newborns
• contraindicated for pregnant women who are near term and for infants under the age of 1 month

Question 9

What labs need to be drawn for nitrofurantoin (macrodantin, macrobid)?

Answer 9

• H&H

- CBC

Question 10

What are the peripheral neuropathy issues with nitrofurantoin (macrodantin, macrobid)?

Answer 10

-damage to sensory and motor nerves is a serious concern

Question 11

Nitrofurantoin (macrodantin, macrobid) can cause hepatotoxicity so what needs to be checked?

Answer 11

-check LFT’s: liver injury that has resulted in death

Question 12

What are the CNS effects for nitrofurantoin (macrodantin, macrobid)?

Answer 12

-HA
-vertigo
-drowsiness
-nystagmus
(all reversible)