urinaryantiseptics.pptx antiseptic medicine

antiseptics

1. URINARY ANTISEPTICS

2. DEFINITION Urinary antiseptic are substances, which prevent bacterial infection in urinary tract (UTI). The common drugs used- Methenamine , Nitrofurantoin

3. Other Drugs used in UTI Sulfonamides Cotrimoxazole Nalixic acid Fluoroquinolones Ampicilin Aminoglycosides Tetracycline

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

5. Mechanism of Action Methenamine is a urinary antiseptic. In the acidic environment of the urine, methenamine is hydrolyzed to formaldehyde and ammonia to produce an antibacterial/antifungal effect. A low urine pH of 5.5 or less is needed for optimal effect.

6. Doses for Methenamine S.No Drugs Dose & Route 1. Methenamine 1 g QID (Adults) 500 mg QID (Children)

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 Dysuria Protenuria Hematuria Hypersensitivity reaction Abdominal pain

9. Contraindications Renal disease Severe hepatic diseases Severe dehydration

10. NURSING CONSIDERATIONS Do not use alone for acute infections. Monitor intake output striktly . Instruct patient to take adequate fluid intake (>2 litres /day). Monitor urinary pH and provide supplementary acidification if required. Administer the drug with food to avoid GI disturbances. Instruct patient to avoid excessive intake of alkalinizing foods such as milk or citrus fruits.

11. 2. NITROFURANTOIN Nitrofurantoin is an antibiotic medication that is used for the treatment of uncomplicated lower urinary tract infections. It is effective against most gram-positive and gram-negative organisms. 

12. Mechanism of Action Nitrofurantoin inhibits the formation of peptide bond and protein synthesis in bacteria, which results in diffusion of bacterial cell membrane. It is bacteriostatic in lower concentration and bactericidal in higher concentrations.

13. DOSES Oral : Adults: 50-100mg BD Children : 5-7 mg/kg/day in four divided doses. Prophylaxis of recurrent infections: 50 mg daily at HS least for 6 months.

14. 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.

15. CONTRAINDICATIONS Anuria Oliguria Renal impairment Pregnancy Lactation

16. Nursing Responsibilities Administer the drug with meals or milk for better absorption. Monitor intake and output. Provide adequate fluids (more than 2litres /day). To minimize GI distress, administer drug with food. Instruct patient not to skip the dose. Don’t drive or use machinery after taking medicine. If side effects appear, inform physician immediatly .