FURAZOLIDONE

FURAZOLIDONE
(fur-a-zoe'li-done)
Furoxone
Classifications: nitrofuran antibiotic;
Therapeutic: antibiotic

Pregnancy Category: C

Availability

100 mg tablets; 50 mg/15 mL liquid

Action

Synthetic nitrofuran with antibacterial and antiprotozoal properties. Acts by interfering with several bacterial enzyme systems including cell wall synthesis of bacteria.

Therapeutic Effect

Bactericidal against majority of GI pathogens, gram-positive and gram-negative bacteria, as well as protozoa.

Uses

Bacterial or protozoal diarrhea and enteritis caused by susceptible organisms.

Contraindications

Hypersensitivity to furazolidone, concurrent use with alcohol, MAO INHIBITOR, tyramine-containing foods, indirect-acting sympathomimetic amines; infants <1 mo; neonates; pregnancy (category C), lactation.

Cautious Use

If at all, patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency due to possible development of reversible hemolysis.

Route & Dosage

Diarrhea and Enteritis
Adult: PO 100 mg q.i.d.
Child: PO 1 mo–1 y, 8–17 mg q.i.d.; 1–4 y, 17–25 mg q.i.d.; ?5 y, 25–50 mg q.i.d. (max: 8.8 mg/kg/d)

Administration

Oral
  • Store in tight, light-resistant containers (drug darkens on exposure to light). Protect from excessive heat.

Adverse Effects (≥1%)

GI: Nausea, vomiting, abdominal pain, diarrhea. Hypersensitivity: Fever, arthralgia, hypotension, urticaria, angioedema, vesicular or morbilliform rash. Body as a Whole: Headache, malaise, dizziness, hypoglycemia. Hematologic: Intravascular hemolysis in patients with G6PD deficiency, agranulocytosis (rare). Special Senses: Partial deafness.

Diagnostic Test Interference

Furazolidone metabolite reportedly may cause false-positive reactions for urine glucose with copper sulfate reduction methods, (e.g., Benedict's reagent, Clinitest, and Fehling's solution).

Interactions

Drug: Alcohol may elicit disulfiram-type reaction up to 4 d after the drug is stopped; mao inhibitors, narcotics, sympathomimetic amines, ephedrine, phenylpropanolamine may cause a hypertensive reaction; tricyclic antidepressants may cause toxic psychosis. Food: may interact with tyramine-containing foods, resulting in flushing, tachycardia, and hypertensive crisis. See phenelzine (mao inhibitor prototype). Herbal: Ginseng may cause hypertension, manic symptoms, headaches, nervousness; ma-huang, ephedra, St. John's wort may lead to hypertensive crisis.

Pharmacokinetics

Absorption: Poorly absorbed from GI tract. Metabolism: In intestines. Elimination: In urine.

Nursing Implications

Assessment & Drug Effects

  • Monitor for nausea and vomiting. Dosage reduction may be needed.
  • Note: Bed rest, fluid and electrolyte replacement (as indicated) are important adjuncts to therapy. Consult physician regarding dietary allowances.
  • Keep physician informed of S&S of dehydration (see Appendix F) and electrolyte imbalance.
  • Monitor patients for lost glycemic control because drug may cause hypoglycemia (see Appendix F). Use glucose oxidase methods for urine testing (e.g., Clinistix, Diastix, TesTape).

Patient & Family Education

  • Report the following to physician: Faintness, weakness, and light-headedness. These may be symptoms of hypersensitivity reaction or hypoglycemia.
  • Be aware of and avoid foods high in tyramine (e.g., aged and fermented food and drinks) that may produce hypertensive reaction. Hypertensive crisis is most likely to occur when drug is continued beyond 5 d or when large doses are given.
  • Do not drink alcohol during furazolidone therapy and for at least 4 d after drug is stopped. Ingestion of alcohol may cause disulfiram-type reaction (see Appendix F); symptoms may last up to 24 h.
  • Note: Drug may impart a harmless brown color to urine.
  • Monitor blood glucose for loss of glucemic control if diabetic.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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