Urinary Antiseptics/Nitrofurantoin Macrocrystals

Question 1

therapeutic class

Answer 1

antibacterial

Question 2

pharmacologic class

Answer 2

urinary tract antiseptic

Question 3

pregnancy category

Answer 3

B

Question 4

mechanism of action

Answer 4

intermediates attack bacterial ribosomal proteins
inhibits protein synthesis, aerobic energy metabolism, DNA & RNA synthesis, and formation of cell wall
bactericidal in urine

Question 5

indications

Answer 5

uncomplicated acute cystitis, usually for prophylaxis of recurrent UTI; used when infections are resistant to TMP-SMZ or fluoroquinolones

Question 6

contraindications

Answer 6

renal impairment
pregnancy or neonate under one month
diffuse interstitial pneumonitis or pulmonary fibrosis

Question 7

precautions

Answer 7

pulmonary disease

hepatic disease

Question 8

drug interactions

Answer 8

antacids w/ magnesium may decrease absorption

fluoroquinolones and nalidixic acid may decrease drug effect

Question 9

adverse effects

Answer 9

hypersensitivity reactions, anorexia, headache, rash, nausea, vomiting

Question 10

serious adverse effects

Answer 10

acute and chronic pulmonary toxicity

hepatotoxicity

Question 11

responsibilities

Answer 11

give w/ food or milk
avoid crushing tablets
discontinue if oliguria or anuria occurs
assess for signs of urinary tract superinfections
assess for acute pulmonary sensitivity reaction

Question 12

teaching

Answer 12

urine may have brown color; report difficulty breathing, changes in urination, nausea, vomiting, diarrhea, rash, chest pain, cough, fever, vision changes, unusual bleeding, yellowing of skin, light-colored stools; consult provider on fluid intake; report severe diarrhea w/ fever; do not breast feed