Nitrofurantoin Flashcards

1
Q

What is the mechanism of action of nitrofurantoin?

A

Believed to inhibit enzymes involved in cell wall and bacterial carbohydrate metabolism

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2
Q

Is nitrofurantoin broad or narrow spectrum?

A

Narrow

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3
Q

Is nitrofurantoin effective against all pathogens that cause UTIs?

A

No

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4
Q

Give 2 examples of UTI pathogens that nitrofurantoin is not effective against?

A
  • Proteus

- Pseudomonas

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5
Q

What are the routes of delivery of nitrofurantoin?

A
  • PO

- IV

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6
Q

What are the indications for nitrofurantoin?

A

UTI

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7
Q

When is nitrofurantoin contraindicated?

A
  • Acute porphyria
  • G6PD deficiencies
  • Infants <3 months old
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8
Q

When should nitrofurantoin be avoided?

A
  • Term pregnancies

- Breast-feeding

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9
Q

Why should nitrofurantoin be avoided in term pregnancies and breastfeeding?

A

Teratogenic - may cause neonatal haemolysis

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10
Q

When should nitrofurantoin be used with caution?

A
  • Anaemia
  • B12 and folate deficiency
  • Pulmonary disease
  • Renal or hepatic impairment
  • Conditions associated with peripheral neuropathy
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11
Q

What might nitrofurantoin interact with?

A

Oral magnesium salts

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12
Q

What might happen if nitrofurantoin is given with oral magnesium salts?

A

Reduced absorption of nitrofurantoin

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13
Q

What monitoring is required with nitrofurantoin?

A
  • Monitor FBC during long-term treatment

- Monitor lung-function with long-term use

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14
Q

Why should FBC be monitored with long term use of nitrofurantoin?

A

Detect and treat any blood disorders that occur

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15
Q

Why should lung function be monitored in long-term use of nitrofurantoin?

A

To stop nitrofurantoin if deterioration in lung function occurs

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16
Q

What are the side effects of nitrofurantoin?

A
  • Agranulocytosis
  • Aplastic anaemia
  • Arthralgia
  • Blood disorders
  • Cholestatic jaundice
  • Hepatitis and pancreatitis
  • Thrombocytopenia
  • Alopecia
  • Pulmonary fibrosis
  • Peripheral neuropathy
  • Haemolytic anaemia
  • Hyperkalaemia
  • Hypersensitivity reaction

(all rare or frequency not known)

17
Q

What patient counselling is required with nitrofurantoin?

A
  • Complete antibiotic course
  • How to take
  • Brown urine
18
Q

How should nitrofurantoin be taken?

A

If taken as tablets, take with food and must be swallowed whole

19
Q

What should the patient be told regarding brown urine with nitrofurantoin?

A

Warn patients that this antibiotic may cause their urine to turn brown in colour