Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Nitrofurantoin is an antibiotic that is used for
treating urinary tract infections caused by several types of bacteria. It is
effective against E. Coli, Enterobacter cystitis, Enterococcus, Klebsiella,
andStaphylococcus aureus. Nitrofurantoin interferes with the production of
bacterial proteins, DNA, and cell walls. Bacteria cannot survive without a cell
wall or multiply without DNA. Three forms are available: 1) a microcrystalline form
(Furadantin), 2) a macrocrystalline form (Macrodantin), and 3) a sustained release
macrocrystalline form used twice daily (Macrobid). The macrocrystalline form is
more slowly absorbed than the microcrystalline form and is useful for patients
who cannot tolerate the microcrystalline form. The FDA approved nitrofurantoin
in 1953.
STORAGE: All formulations should be kept at room temperature, 15-30 C (59-86
F).
PRESCRIBED FOR: Nitrofurantoin is used to treat or prevent urinary tract
infections.
DOSING: The recommended adult dose for treating urinary tract infections is
50-100 mg 4 times daily (Macrodantin, Furadantin) or 100 mg every 12 hours
(Macrobid). Nitrofurantoin can be taken with or without meals. Taking it with
meals increases its absorption into the body. The suspension can be mixed with
water, milk, juice, or infant formula. It also is used once a day (or in some
children, twice daily) to prevent urinary tract infections. It should not be
used in persons with poor kidney function.
DRUG INTERACTIONS: 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.
Concomitant administration of a magnesium trisilicate antacid may decrease
the absorption of nitrofurantoin, reducing the effectiveness of nitrofurantoin.
In laboratory tests, nitrofurantoin reduced the effect of quinolone
antibiotics, for example, norfloxacin (Noroxin). Therefore, nitrofurantoin
should not be combined with quinolone antibiotics.
PREGNANCY: Although there are no adequate studies of nitrofurantoin in
pregnant women, many women have safely used it
during pregnancy; however,
nitrofurantoin should not be used near the time of delivery (38-42 weeks
gestation) since it interferes with the immature enzyme systems in the red blood
cells of newborns, damaging the cells and resulting in anemia.
NURSING MOTHERS: Nitrofurantoin is distributed into
breast milk and should be
used with caution in women who are breast- feeding.
SIDE EFFECTS: Common side effects include headache, rash, itching, nausea,
vomiting, loss of appetite, diarrhea, and abdominal pain. The macrocrystalline
form (Macrodantin) appears to cause less stomach upset. Stomach upset also can
be minimized by using a lower dose or by taking nitrofurantoin with food or
milk.
Urinary tract infection (UTI) is an infection of the kidney, ureter, bladder, and/or urethra. Not
everyone with a UTI has symptoms. Common symptoms include a frequent urge to
urinate and a painful, burning when urinating.
Liver disease can be cause by a variety of things including infection (hepatitis), diseases such as gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause; however, common symptoms may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.
The liver, located in the right upper portion of the abdominal cavity just
beneath the right side of the rib cage, has many vital functions. Briefly, some
of these functions are:
Detoxification of blood
Production of important clotting factor and other important proteins
Metabolizing (processing) medications and nutrients
Processing of waste products of hemoglobin
Storing of vitamins, fat, cholesterol, and bile
Production of glucose
What are common liver blood tests?
Liver blood tests are some of the most commonly performed blood tests. These tests can assess liver functions or liver injury. An initial step in detecting liver damage is a simple blood test to determine the presence of certain liver enzymes (proteins) in the blood. Under normal circumstances, these enzymes reside within the cells of the liv...
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