Nitrofurantoin Pharmacology

Real Life Pharmacology - Pharmacology Education for Health Care Professionals

Eric Christianson, PharmD; Pharmacology Expert and Clinical Pharmacist

Education, Health & Fitness, Medicine

5 • 716 Ratings

🗓️ 14 March 2019

⏱️ 11 minutes

🔗️ Recording | iTunes | RSS

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Summary

On this episode I breakdown nitrofurantoin pharmacology. Nitrofurantoin is an antibiotic that is used in the treatment of UTI's.

Nitrofurantoin has activity by creating reactive metabolites that can disrupt protein synthesis and ultimately kills the bacteria causing the infection.

It is important to remember with nitrofurantoin, that in the setting of systemic infection and/or kidney involvement, the drug may not be very effective.

Nitrofurantoin can potentially reduce the effectiveness of certain vaccines. Be sure to look this up prior to administration.

Nitrofurantoin can cause pulmonary symptoms as well as neuropathy. This is very important to monitor for.

Transcript

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0:00.0	Hey all, thanks for listening to the Real Life Pharmacology podcast. I'm your host, Eric Christensen pharmacist.
0:07.2	Today I'm going to cover nitroferantoin, which is a drug that is most commonly used as an antibiotic to treat urinary tract infections.
0:18.9	Now, it's brand names that it goes by is macrobid or macrodentan.
0:24.2	And a lot of times people get these brand names mixed up. Really the primary difference is
0:32.6	in dosing. And if you remember macro bid,, that is twice a day drug.
0:39.8	So remember BID at the end, and that'll help you remember that that is twice a day versus
0:45.6	macrodentan, which is generally dosed four times a day.
0:49.5	MacroBid is that combination of basically the form of the drug, monydrate plus macrocrystals and macrodentin
0:58.2	is macrocristols only. But a big difference from a patient clinical perspective is macrobid
1:05.7	is dosed twice a day and that is generally the one that we use most often there. Now how this drug works,
1:13.1	how this drug helps us, you know, basically kill off bacteria, get rid of that infection,
1:19.3	is this drug is actually altered by bacterial flavile proteins. And this forms these reactive metabolites, which can ultimately, you know,
1:31.3	block processes, interfere with processes surrounding bacterial protein synthesis. So kind of a little bit of
1:40.1	a unique mechanism of action in that respect.
1:47.2	Now, I mentioned that this drug is certainly used for UTIs,
1:52.9	and that's really its primary and only major use. Now, one really, really important thing is nitrofrantone is not that active
1:58.2	against infections that may have systemic involvement. So if you get a situation
2:04.8	where you've got, you know, maybe more of an upper UTI syndrome or an infection where maybe
2:10.9	the kidney is involved and you're at risk of systemic infection, this drug may not cover that infection as well. So generally, nitroferentone is going to be
2:22.9	reserved for lower UTI-type urinary tract infections. So very, very important to remember that if we do have
2:32.3	some potential to have kind of a systemic infection or a larger
2:36.9	infection maybe involving the kidneys to likely avoid this drug and use other alternatives.
	...

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