Home Drug Guide Nalidixic Acid

Drug Guide

Generic Name

Nalidixic Acid

Brand Names Neggram

Classification

Therapeutic: Antibacterial, urinary tract infection agent

Pharmacological: Quinolone antibiotic

FDA Approved Indications

Treatment of urinary tract infections caused by susceptible bacteria

Mechanism of Action

Nalidixic acid inhibits bacterial DNA synthesis by targeting DNA gyrase, a type II topoisomerase, preventing bacterial replication and transcription.

Dosage and Administration

Adult: Dose varies; typically 1 gram every 12 hours for uncomplicated UTIs.

Pediatric: Not commonly used in pediatric patients due to safety concerns.

Geriatric: Adjust dose based on renal function; monitor for adverse effects.

Renal Impairment: Adjust dose based on degree of impairment; careful monitoring recommended.

Hepatic Impairment: Use with caution; no specific adjustment specified.

Pharmacokinetics

Absorption: Rapidly absorbed from gastrointestinal tract.

Distribution: Widely distributed in body tissues and fluids.

Metabolism: Minimal hepatic metabolism.

Excretion: Primarily excreted unchanged in urine.

Half Life: Approximately 3-4 hours.

Contraindications

Hypersensitivity to nalidixic acid or other quinolones.
Children under 3 months. (due to risk of joints damage in young children)

Precautions

Use caution in patients with renal impairment.
Monitor for hypersensitivity reactions.
Long-term use may lead to superinfection.

Adverse Reactions - Common

Nausea (Common)
Rash (Common)
Headache (Common)

Adverse Reactions - Serious

Anaphylaxis (Rare)
Clostridium difficile-associated diarrhea (Rare)
Crystalluria and renal stones (Uncommon)

Drug-Drug Interactions

Other nephrotoxic drugs, drugs prolonging QT interval.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor renal function, liver function, and for allergic reactions.

Diagnoses:

Risk for superinfection
Impaired urinary elimination

Implementation: Administer with food if gastrointestinal upset occurs.

Evaluation: Monitor for resolution of infection and adverse reactions.

Patient/Family Teaching

Take medication exactly as prescribed.
Report any signs of allergic reactions or severe diarrhea.
Maintain adequate hydration.

Special Considerations

Black Box Warnings: N/A

Genetic Factors: Not specifically mentioned.

Lab Test Interference: May affect urine tests for glucose or ketones.

Overdose Management

Signs/Symptoms: Nausea, vomiting, dizziness, urinary changes.

Treatment: Supportive care, activated charcoal if ingestion was recent, maintain hydration, and symptomatic treatment.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable under recommended storage conditions.