Urinary antiseptics

Urinary antiseptics

1. URINARY ANTISEPTICS PREPARED BY: USHA RANI KANDULA, ASSISTANT PROFESSOR, DEPARTMENT OF ADULT HEALTH NURSING ARSI UNIVERSITY,ASELLA,ETHIOPIA, SOUTH EAST AFRICA.

2. DEFINITION Urinary antiseptic are substances, which prevent bacterial infection in urinary tract.

3. The common used drugs - Methenamine - nitrofurantoin

4. METHENAMINE Methenamine is a urinary antibacterial agent. The action depends on its hydrolysis to ammonia and formaldehyde in an acidic urine.

5. MOA In an acidic urine (PH 5.5 or lower) Drug hydrolyzed to form ammonia & formaldehyde Later being bactericidal Acid liberated from salt Exert weak antibacterial action

6. Doses for Methenamine Methenamine -tablet 0.5 g (adults-1g four times a day. Children-500 mg four times a day)

7. Indications Treatment of chronic bacteriuria with cystitis, pyelonephritis Prophylaxis before urinary instrumentation Adjunctive treatment of patient with anatomic abnormalities of urinary tract

8. ADVERSE EFFECTS Cramping Vomiting Diarrhoea Stomatitis Anorexia Urinary urgency Bladder irritation

9. Dysuria Protenuria Hematuria Hypersensitivity reaction Abdominal pain

10. Contraindications Renal insufficiency Severe hepatic diseases Severe dehydration

11. NITROFURANTOIN It is a synthetic nitrofuran derivative, nitrofurantoin is a specific urinary antibacterial agent.

12. MOA Bacteriostatic in lower concentration and bactericidal in higher concentrations. Its mechanism to interfere with caarbohydrate metabolism by inhibition of acetyl coenzyme-A, Also impair bacterial cell wall formation.

13. DOSES Oral : Adults: 50-100mg four times a day, Chronic therapy 25-50mg four times a day Children : 5-7 mg/kg/day in four devided doses.

14. Prophylaxis of recurrent infections : -50 mg daily at bedtime least for 6 months.

15. IV infusion : over 180 mg twice a day Infusion solution should is prepared by adding 20 ml 5% dextrose injection to the vial containing 180 mg nitrofurantoin sodium, each ml of this solution is added to at least 25 ml of parentral fluid, final solution is administered at rate of 2-3ml/min.

16. ADVERSE EFFECTS GI- Diarrhea, abdominal pain, pancreatitis Pulmonary - pneumonitis , cough Dermatologic- pruritis , alopecia Hematologic – hemolytic anemia, leukopenia thrombocytopenia Allergic – asthmatic attack, anaphylaxis Neurologic- drowsiness, headache, peripheral neuropathy.

17. CONTRAINDICATIONS Anuria Oliguria Renal impairment Pregnancy at term Infant under 3 months

18. Other drugs Sulfonamides Cotrimoxazole Nalidixic acid Fluoroquinolones Ampicillin Cloxacillin Carbenicillin

19. Aminoglycosides Tetracyclines Cephalosporins

20. Urinary analgesic – phenazopyridine ( pyridium ) has analgesic actions on the urinary tract. It relieves burning symptoms of dysuria and urgency.

21. Nursing responsibilities

22. Nursing responsibilities Use cautiously in pregnant and nursing mothers. Monitor intake and output. Provide adequate fluids. Monitor urinary PH. To minimise GI distress, administer drug with food.

23. Thanking you