Macrodantin, Alprim

Macrodantin. Nirtofurantoin. 'Other Antibacterials'

Indication:
UTI and prophylactic treatment too

MOA: 
Antibiotic that inhibits protein, DNA, RNA and cell wall synthesis in bacteria

Dosing:
Treatment of UTI: 50-100 mg qid for 3 days in women and 14 days in men (longer urethra)
Prophylaxis: 50-100mg n

Take it with food or milk to help improve nausea and decrease side effects of nausea.
It is normal for your urine to turn a dark brown colour during the course. Your contact lenses may also stain.

Adverse effects: 
Nausea and vomitting
Dizziness

Peripheral polyneuropathy (tell your doctor if you get numb or tingling sensations. Monitor renal function during long term treatment b/c poor renal function increases chances of peripheral polyneuropathy)

Acute and chronic pneumonia (monitor in long term treatment). Acute pneumonitis may occur 1-2 weeks after initial course and chronic occurs usually after 6 months.

Monitor:
Pulmonary function
Renal Function
Liver function for hepatitis


Alprim. Trimethoprim. 'Other Antibacterials'

Indication:
Empirical treatment of UTI
Epididymo-orchitis (from UTI)
Prostatitis

MOA: 
inhibits bacterial folate production

Dosage:
UTI: 300mg n for 3 days in women, 14 in men
Recurrent UTI: 300mg n for 10-14 days
Prophylactic (UTI): 150mg n

Give at night to achieve high concentration in drug in urine

Single dose for UTI in women is possible, but usually over 3 days is better in preventing recurring infections.

Be careful if taking drugs that result in potassium retention. Increased risk of hyperkalaemia b/c trimethoprim causes K retention too. Usually in higher doses and renal impairment after 4-5 days.

Be careful in folate deficiencies because this drug can worsen it. (MOA)

Monitor: 
Blood and folate (in long term/high dose use)
Potassium if renally impaired or taking potassium retaining drugs