NITROFURANTOIN

A Drug study presented to the

Faculty of the Nursing Department
San Pedro College, Davao City
Sarah Jane C. Pamaloan, RN

In Partial Fulfillment of the

Requirements in NCM 216 – RLE
OR/PC ROTATION

Submitted by:
NICOLE KEESHA J. MATA, ST. N
BSN 3G – Group 4 Subgroup 4

March 06, 2021

Generic Name: Nitrofurantoin

Brand Name: Macrobid, Macrodantin, Furadantin

Classification: Antibiotics

Pregnancy Category B

Mode of Action:
Nitrofurantoin is converted by bacterial nitroreductases to electrophilic
intermediates which inhibit the citric acid cycle as well as synthesis of
DNA, RNA, and protein.
Route and Dosage:
Oral
Adults and Pediatric Patients over 12 Years: One 100 mg
capsule every 12 hours for seven days.
Indication: Macrobid is indicated only for the treatment of acute
uncomplicated urinary tract infections (acute cystitis) caused
by susceptible strains of Escherichia coli or Staphylococcus
saprophyticus.

Contraindication:
Macrobid is contraindicated in patients with a previous history of
cholestatic jaundice/hepatic dysfunction associated with nitrofurantoin.
Macrobid is also contraindicated in those patients with known
hypersensitivity to nitrofurantoin.

Side Effects:

Eye pain, vision changes, nausea, loss of appetite, rash, itching,

mental/mood changes, persistent/severe headaches, new signs of
infection (e.g., fever, persistent sore throat), easy bruising/bleeding.

Adverse Effects:

Gastrointestinal: Diarrhea, dyspepsia, abdominal pain,

constipation, emesis
Neurologic: Dizziness, drowsiness, amblyopia

Respiratory: Acute pulmonary hypersensitivity reaction

Allergic: Pruritus, urticaria

Dermatologic: Alopecia

Others: Fever, chills, malaise

Drug Interaction:

 Benemid- High doses of probenecid (Benemid) or sulfinpyrazone

(Anturane) can partially block the kidneys' elimination of
nitrofurantoin. This can increase the blood concentrations of
nitrofurantoin and the risk of toxicity from nitrofurantoin.
 Magnesium trisilicate- Concomitant administration of a
magnesium trisilicate antacid may decrease the absorption of
nitrofurantoin, reducing the effectiveness of nitrofurantoin.
 BCG vaccine and live typhoid vaccine- Nitrofurantoin may
reduce the activity of live tuberculosis vaccine (BCG vaccine) and
live typhoid vaccine. In laboratory tests, nitrofurantoin reduced the
 effect of quinolone antibiotics, for example, norfloxacin (Noroxin).
Therefore, nitrofurantoin should not be combined with quinolone
antibiotics.

Nursing Responsibilities:

1. Monitor I&O. Report oliguria and any change in I&O ratio. Drug should
be discontinued if oliguria or anuria develops or creatinine clearance falls
below 40 mL/min.
2. Instruct patient to take medication as directed around the clock in order
for it to be effective in treating UTI. Take missed doses as soon as

remembered; check with health care professional if more than 1 dose is

missed. Consult health care professional prior to discontinuing medication.

3. Instruct patient to take this medication by mouth with food as directed

by your doctor, twice a day.

4. Assess for nausea which occurs fairly frequently. May be relieved by

reducing dosage.
5. Instruct patient not to take this drug again if he/she had an allergic
reaction to it. Taking it again could be fatal.

6. With prolonged therapy, monitor for subacute or chronic pulmonary

sensitivity reaction, commonly manifested by insidious onset of malaise,
cough, dyspnea on exertion, altered ABGs.

7. Instruct breastfeeding mother to consult a doctor about breastfeeding

their child. Patient may need to decide whether to stop breastfeeding or
stop taking this medication.
8. Be alert for and advise the patient to report onset of muscle weakness,
tingling, numbness, or other sensations. Peripheral neuropathy can be
severe and irreversible. Drug should be withdrawn immediately.

9. Instruct patient to consult physician regarding fluid intake. Generally,

fluids are not forced; however, intake should be adequate.

10. Instruct patient that Nitrofurantoin may impart a harmless brown color
to urine.
References:

Canadian Drug Name. (2020). Availability. Retrieved March 4, 2021, from

http://www.robholland.com/Nursing/Drug_Guide/data/monographfra
mes/N036.html

MedicalNewsToday. (2018, May 18). Nitrofurantoin: Side effects, dosage,

uses, and more. Retrieved March 4, 2021, from
https://www.medicalnewstoday.com/articles/nitrofurantoin-oral-
capsule#dosage

RxList. (2020, October 26). Macrobid (Nitrofurantoin): Uses, Dosage, Side

Effects, Interactions, Warning. Retrieved March 4, 2021, from
https://www.rxlist.com/macrobid-drug.htm#indications