NITROFURANTOIN
Ingredient: Nitrofurantoin
Equivalent Products: Furadantin; Furalan; Furan; Furanite; Macrobid; Macrodantin; Nitrofan.
Dosage Forms: Capsule: 25 mg (Macrodantin only); 50 mg; 100 mg (Macrodantin only).
Liquid (content per 5 ml teaspoon): 25 mg.
Tablet: 50 mg; 100 mg.
Use: Treatment of bacterial urinary tract infections such as pyelonephritis, pyelitis, or cystitis.
Minor Side Effects: Abdominal cramps; change in urine color; diarrhea; dizziness; drowsiness; headache; loss of appetite; nausea; vomiting. Most of these side effects, if they occur, should subside as your body adjusts to the medication. Tell your doctor about any that are persistent or bothersome.
Major Side Effects: Anemia; breathing difficulties; chest pain; chills; cough; dark urine; fever; hepatitis; irritation of the mouth; low blood pressure; muscle aches; numbness and tingling in face; rash; rectal and vaginal itching; super-infection; swelling of the hands and feet; symptoms of lung infection; transient hair loss; weakness; yellowing of eyes and skin. Notify your doctor if you notice any major side effects.
Contraindications: This drug should not be used by persons with severe kidney disease or little or no urine production. Be sure your doctor knows if either condition applies to you.
• This drug should not be used by pregnant women at term or in infants under one month of age. • This drug should not be used by people who are allergic to it. Consult your doctor immediately if this drug has been prescribed for you and you have such an allergy.
Warnings: This drug should be used cautiously by people with kidney disease, anemia, diabetes, vitamin-B imbalance, electrolyte imbalance, and certain other debilitating diseases. Be sure your doctor knows if any of these conditions applies to you.
• This drug should be used with caution by pregnant women, by women who may become pregnant, and by nursing mothers.
• This drug should be used with caution by blacks and by ethnic groups of Mediterranean and Near Eastern origin, since cases of hemolytic anemia have been known to be brought about in a percentage of such persons while using this drug.
• This drug may interact with nalidixic acid, norfloxacin, probenecid, magnesium trisilicate, and sulfinpyrazone. If you are currently taking any drugs of these types, consult your doctor. If you are unsure about the type or contents of your medications, ask your doctor or pharmacist.
• This drug may interfere with certain blood and urine laboratory tests. Remind your doctor that you are taking this drug if you are scheduled for any tests.
• This drug may cause false results with urine sugar tests.
• This drug should be taken cautiously; it has been associated with lung problems. If such problems occur, your doctor will discontinue this drug and appropriate measures will be taken.
• If you experience fever, chills, cough, chest pain, shortness of breath, rash, pallor, weakness, breathing difficulties, tingling of the fingers or toes, or signs of jaundice (yellowing of the eyes or skin), consult your doctor.
• This drug may cause nerve damage and liver disease. If this drug is taken for prolonged periods, tests to monitor for these effects are recommended. Report any tingling sensations or loss of feeling in your extremities.
Comments: To reduce nausea and vomiting, take this drug with a meal or glass of milk.
• This drug should be taken for as long as prescribed; stopping treatment early may result in re-infection.
• It is best to take this medication at evenly spaced intervals around the clock. Ask your doctor or pharmacist to help you establish a practical dosing schedule.
• If you have a urinary tract infection, you should drink at least nine or ten glasses of water each day, unless your doctor directs you otherwise.
• This drug may cause your urine to become dark in color. Do not be alarmed.
• Not all nitrofurantoin preparations are generic equivalents; consult your pharmacist about the use of generics. Macrodantin and Macrobid (which are not identical) contain macrocrystals of nitrofurantoin, which are better tolerated. They cause less nausea and less stomach distress than other nitrofurantoin products.
ANTIBIOTICS
PRESERVING THE USEFULNESS OF ANTIBIOTICS
In the 1300s, the scourge known as bubonic plague killed up to one third of Europe’s population. In modern times, we’ve been told that such a plague isn't possible. It would be controlled handily with the help of antibiotic drugs such as streptomycin, gentamicin, and chloramphenicol, drugs once thought to be invincible - that is, until 1995, when a 16-year-old boy from Madagascar, infected with bubonic plague, failed to respond to the usual antibiotic treatments. This was the first documented case of an antibiotic-resistant plague, which did eventually succumb to another antibiotic.
To some, this response was not all at surprising. Throughout the world, many other infectious germs, including those that cause pneumonia, ear infections, acne, gonorrhea, urinary tract infections, meningitis, and tuberculosis, can now outwit some of the most commonly used antibiotics and their synthetic counterparts, antimicrobials. According to specialists at the Mayo Clinic in Rochester, Minnesota, drug resistance may have contributed to the 58 percent rise in infectious disease deaths among Americans between 1980 and 1992.
Every time a patient takes penicillin or another antibiotic for a bacterial infection, the drug may kill most of the bacteria. But a few tenacious germs may survive by mutating or acquiring resistance genes from other bacteria. These surviving genes can multiply quickly, creating drug-resistant strains. The presence of these strains may mean the patients next infection may not respond to the first-choice antibiotic therapy. Also, the resistant bacteria may be transmitted to other people in the community.
What's behind these drug-resistant strains? Two things. One has to do with individual patterns. The other is related to practices of the medical community. On an individual note, people who are prescribed antibiotics correctly don't always follow instructions properly. To be completely effective, antibiotics are to be taken for a specific number of days. Many people, however, often slop taking the drug after symptoms have cleared or they start feeling better. Unfortunately, some of the bacteria may still be present in the system, free to attack again and able to mutate. In addition, experts say that doctors are sometimes too quick to prescribe antibiotics for all sorts of symptoms, despite the fact that antibiotics work only against bacterial infections, not viruses or the common cold. It is estimated that more than 50 to 150 million antibiotic prescriptions written for patients each year outside of hospitals are unnecessary. Organisms that have already developed defenses against antibiotic attack include these:
- Staphylococcus aureus. One of the primary causes of infections in patients in U.S. hospitals; can infect burns, skin, and surgical wounds.
- Enterococcus. Can cause everything from urinary tract infections to heart valve infections.
- Streptococcus pneumoniae. Up to 30 percent of the strains of this bacterium, which can cause pneumonia, meningitis, and ear infections, are at least partially resistant to antibiotics in the penicillin family.
Other bacteria that have grown resistant to antibiotics once considered reliable are Neisseria gonorrhoeae, which causes the sexually transmitted infection gonorrhea' Salmonella, Escherichia coli (E. coli), the culprits behind food poisoning; and Mycobacterium tuberculosis, which cause tuberculosis.
What can you do to help curb the problem of antibiotic-resistant bacteria?
- Don't demand an antibiotic when the health care provider determines that one is not appropriate.
- Finish each prescription. Even when the symptoms of an illness have disappeared, some bacteria may still survive and reproduce if the patient doesn't complete the course of treatment.
- Don't take leftover antibiotics or antibiotics prescribed for someone else.
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ANTIBIOTICS
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