urinary antiseptic

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URINARY ANTISEPTIC KIRAN RANDHAWA CLINICAL INSTRUCTOR

INTRODUCTION:

INTRODUCTION Urinary antiseptics are the antimicrobial drugs that are excreted mainly in the urine and perform its antiseptic action in bladder. These drugs have no action on body system. These drugs may be given before examination or surgery on the urinary tract or to treat UTI.

ACTION OF URINARY ANTISEPTIC:

ACTION OF URINARY ANTISEPTIC Urinary Antiseptic are concentrated in the kidney tubules which are mainly useful in lower urinary tract only. These drugs are used to treat lower urinary tract infection.

Urinary antiseptic drugs:

Urinary antiseptic drugs Nitrofurantoin Methenamine Nalidixic acid Phenazopyridine

a) nitrofurantoin:

a) nitrofurantoin It is an odorless yellow crystalline powder with a bitter taste. It is used as an urinary antiseptic in the treatment of urinary tract infection. It is primarily bacteriostatic. In higher doses it may act as bacteriocidal in acidic urine. It is slightly soluble in water. It is readily absorbed when administered orally. It is a broad spectrum antibacterial drug.

Cont…………d:

Cont…………d It is available as 50 mg ,100mg in tablet form TRADE NAME: FURADANTIN DOSAGE: (ADULT)- 100 mg ,orally 6 hourly , for 7 to 14 days. (CHILD)- 5 to 8 mg per kg body weight per day for 7 to 14 days.

Cont…………..d:

Cont…………..d INDICATION: Urinary tract infection ,cystitis ,pyelitis ,pyelonephritis , post operative infection of urinary tract. CONTRAINDICATION: Hypersensitivity ,Pregnancy ,lactation ,anuria ,renal disease. -use cautionaly in patient with impaired renal function ,anaemia ,diabetes mellitus. DRUG INTERACTION: a) Anticholinergics. b) Magnesium trisilicate antacids.

Cont………….d:

Cont………….d ADVERSE REACTION: CNS: headache ,dizziness ,drowsiness G.I: anorexia ,nausea ,vomiting ,abdominal pain ,diarrhea. RESPIRATORY REACTION: cough ,chest pain ,dyspnea , asthmatic attack in pt with history of asthma. OTHERS: hypersensitivity reaction.

2) methenamine:

2) methenamine Methenamine is an urinary anti infective drug. This drug do not exert any antimicrobial action in blood and body tissue and kidneys. Methenamine is administered as enteric coated tablets to prevent it from disintegrating in gastric juices. It is available as 500 mg ,1 gm tablet ,suspension containing 250 mg ,500 mg per 5ml.

Cont……..d:

Cont……..d DOSAGE:(ADULT AND CHILDREN ABOVE 12 YEARS AGE)- Orally 1 gm 12 hourly -Children 6 to 12 years- 500 mg to 1 gm 12 hourly , And orally maximum 2 gm per day. INDICATION: UTI caused by E.Coli ,Enterobacter. CONTRAINDICATION: Hypersensitivity reaction ,dehydration, pregnancy ,lactation and renal disease.

Cont………….d:

Cont………….d SIDE EFFECT: Headache ,rash ,urticaria ,nausea ,anorexia ,abdomen pain ,hematuria ,dysuria ,bladder irrigation ,stomatitis and fever

3) Nalidixic acid:

3) Nalidixic acid It is a urinary tract anti infective drug. It is odorless pale yellow crystalline powder. It is insoluble in water. Nalidixic acid is antibacterial drug against gram negative organism. It is used in the treatment of urinary tract infection and gastro-intestinal infections.

Cont………..d:

Cont………..d DOSAGE: Adult dose orally 1 gm 6 hourly orally for 7 days. -- FOR CHILD: 55 mg per kg body weight for 7 days. -- it is not recommended below 3 months age child. INDICATION: Acute and chronic urinary tract infection ,cystitis ,prostitis ,urethritis ,pyelonephritis ,intestinal infections ,diarrhea ,dysentery produced by salmonella ,shigella ,E.coli.

Cont…………d:

Cont…………d CONTR-INDICATION: hypersensitivity ,pregnancy ,convulsion disorder ,liver disorder ,child below 3 months age. And elderly patients. SIDE-EFFECT: Nausea , vomiting ,abdominal pain ,dizziness ,headache ,drowsiness ,insomnia , convulsion ,rash ,urticaria ,blurred vision and central nervous system disturbances. DRUG-INTERACTION: it reduces the effect of antacids.

4) phenazopyridine:

4) phenazopyridine Phenazopyridine act as an analgesic It has local anesthetic effect on urinary tract mucosa. It relief of burning sensation ,dysuria , urgency due to cystitis. TRADE NAME: TABLET PYRIDIUM DOSAGE:ADULT DOSE- 100 mg to 400 mg ,8 hourly orally after meals ,orally. INDICATIONS: pain with urinary tract irritation ,infection ,burning maturation ,dysuria ,cystitis.

Cont………..d:

Cont………..d CONTRAINDICATION: liver dysfunction , pregnancy ,uremia ,renal impairment ,contraindicated for children below 12 years ,hypersensitivity ,lactation. SIDE-EFFECT: nausea ,vomiting ,headache .leukopenia ,hemolytic anemia ,heart burn ,anorexia ,rash ,purities.

Nurses role:

Nurses role Assess the insomnia ,vertigo ,headache and drowsiness in pt. In case of long term therapy complete blood cell count should be done to check the anemia in pt. Assess fever ,rash and urticaria in pt To take medicine with food or milk. The drug may cause drowsiness to advice patient not to drive vehicle. Advice pt of possible adverse reaction that drug color urine red or orange and may stain clothing.

Cont…………..d:

Cont…………..d Use with caution in elderly pt because of possible decreased renal function. Administration with food or fluids to reduce G.I upset Nitrofurantoin suspension be protected from freezing ,shake the bottle before use. Assess intake and output ratio to determine hematuria To take plenty of fluids 2 to 3 liters to avoid crystallization in kidney To advice the pt not to discontinue treatment without the permission of prescriber.

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