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Luai Al Bakour
El Temamy Pharmacy
Akoni Hijyen Teknolojileri Sanayi ve Dış Ticaret LTD. ŞTİ
Britton Chance Center for Biomedical Photonics
Arabian Trade Center - ATC
Medical Facility (32206):
Legality International. (Pvt.) Ltd.
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It is indicated for the treatment of urinary tract infections and concomitant symptoms caused by gram-negative organisms including nalidixic acid-sensitive E. Klebsiella Enterobacter coli and most strains of Proteus.
Not be given to patients with known hypersensitivity to nalidixic acid or in patients with a history of seizures. By its content of Phenazopyridine is contraindicated in hepatic and renal failure. Do not take during pregnancy or breastfeeding in children under 18.
The reactions reported after administration of nalidixic acid include CNS effects: headache, weakness, drowsiness and dizziness paresthesias. On rare occasions there have been subjective and reversible visual disturbances without objective findings (usually with each dose at the beginning of treatment). These reactions include: photosensitivity change in color perception difficulty focusing on visual acuity and diplopia. Generally, these changes disappeared as soon as discontinued therapy. Have occasionally been released toxic psychosis or minor seizures mainly in geriatric patients who have received too much or that are predisposed to these effects as in the case of epilepsy or cerebral arteriosclerosis. In neonatal and pediatric patients in general who are receiving therapeutic doses of nalidixic acid has been presented occasionally elevated intracranial pressure with bulging of anterior fontanel papilledema and headache. Rarely observed the sixth cranial nerve palsy. Although there are no known mechanisms of these reactions the signs and symptoms usually disappear rapidly after discontinuation of treatment. Gastrointestinal: Dyspepsia, abdominal pain, nausea, vomiting and diarrhea. Allergic: Rash itching urticaria angioedema stiffness eosinophilia and rarely anaphylactoid reactions. Photosensitivity reactions mainly on exposed skin surfaces disappear once treatment is stopped. Other: In rare cases have been filed metabolic acidosis paresthesia cholestasis or hemolytic anemia, thrombocytopenia, leukopenia in some patients may be associated with a deficiency in the activity of glucose 6-phosphate dehydrogenase. Use in adolescent patients: toxicological studies have shown that nalidixic acid and other quinolones cause erosion into cartilage and joints and other signs of arthropathy in immature animals of most species tested.
It has been observed cross-resistance between nalidixic acid hydrochloride fenazopiridona and other quinolones (eg oxilínico acid) but it has not been seen with other antibiotics. Nalidixic acid may increase the effects of oral anticoagulants such as warfarin or bishydroxycoumarin by a considerable shift of binding sites of plasma albumin.
It should warn patients not to expose to sunlight during treatment for avoiding photosensitivity reactions, if they may not arise therapy should be discontinued. If clinical response is not satisfactory or in case of relapse urine cultures and susceptibility testing should be performed as they may arise nalidixic acid-resistant strains relatively quickly. Not given to children under one year.
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Yaser Habrawi , F.R.C.S.Ed
Dr. Samer Al-Jneidy
Dr. Hani Najjar
Dr. Talal Sabouni
Dr. Faisal Dibsi
Samir Moussa M.D.
Dr. Tahsin Martini
Dr . Dirar Abboud