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