UTI Flashcards
1
Q
Nitrofurantoin indications
A
- acute lower UTI
- Prophylaxis in recurrent UTI
2
Q
Spectrum of activity nitrofurantoin
A
- E coli and staph saprophyticus = gram -ve and positive
3
Q
MOA nitrofurantoin
A
- metabolised in bacterial cells by nitrofuran reductase.
- active metabolite damages bacterial DNA = bactericidal.
- bacteria with lower nitrfuran reductase are resistant to nitrofurantoin
- less common causes of UTI such as Klebsiella and proteus are resistant intrinsically
4
Q
SE nitrofurantoin
A
- GI upset
- immediate and delayed hypersensitivity
- turns urine dark yellow or brown
- chronic pulmoanry reactions e.g. pneumonitis and fibrosis
- hepatitis
- peripheral neuropathy
above 3 more likely with prolonged use - neonates; haemolytic anaemia as immature RBC are unable to mop up nitrofurantoin stimulated sueproxides which damage RBC
5
Q
CI nitrofurantoin
A
- pregnancy towards ter
- babies in first 3 months of life
- renal impairment = impaired excretion increases toxicity and reduces efficacy due to lower drug conc
- caution in long term prevention of UTI as chronic use increases risk of SE, particularly in elderly patients
6
Q
when are max urinary conc of nitro achieved
A
204hrs after dosing
7
Q
dosing regime for nitro
A
50-100mg 6hrly
8
Q
for prevention dose of nitro =
A
50-100mg single ON no longer than 6/12
9
Q
when should you take nitro
A
- taken with food or milk to minimise GI effects
