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VOL: 101, ISSUE: 05, PAGE NO: 31

Generic/proprietary names


Generic/proprietary names
- Trimethoprim: Monotrim, Trimopan.



- Trimethoprim prevents bacterial production by blocking the enzyme reduction of dihydrofolic acid.



- Is used in combination with sulfamethoxazole in co-trimoxazole because of synergistic activity but in this form it is associated with rare yet serious side-effects.



- Antibacterial.



- Folic acid inhibitor.



- Nurse prescriber: urinary tract infections in women.



- Other: acute and chronic respiratory tract infections, prostatitis, shigellosis and invasive salmonella infections.



- Allergy.



- Blood disease or disorders.



- Severe renal insufficiency.



- Renal impairment.



- Folate deficiency.



- Older people.



- Neonates.



- Pregnancy and breastfeeding.



- Porphyria.



Common side-effects
- Nausea and vomiting/diarrhoea.



- Pruritus.



- Rash.



- Hyperkalaemia.



- Depression of haematopoiesis.



Rare side-effects
- Erythema multiforme.



- Toxic epidermal necrolysis.



- Aseptic meningitis.



- Allergic reactions.



- Angioedema.



- Anaphylaxis.



- May increase action of antiepileptics, digoxin, antivirals, other antibacterials, anticoagulants and antiarrhythmic medications.



- An increased risk of haematological toxicity with some cytotoxic medication.



- An increased risk of nephrotoxicity with ciclosporin medication.



- Available in tablets or suspension.



- Usually given once or twice a day.



Nursing considerations
- Assess symptoms.



- Evaluate therapeutic response.



- Patients who are having long-term therapy need regular blood count assessment.



- In women of childbearing age enquire about last menstrual period.



Patient teaching
- Take trimethoprim on an empty stomach, one hour before or two hours after meals. Some patients may experience nausea. They can be advised to take trimethoprim with food.



- Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture.



- Discard any medication that is outdated or no longer needed.



- Be sure to complete the entire course of medication.



- Report any suspected side-effects to the health care professional who prescribed the medication.



- During breastfeeding traces of trimethoprim may be found in milk, but in short-term use this is not thought to be harmful.



- Women of childbearing age must be cautioned against becoming pregnant while taking trimethoprim, as there are teratogenic risks due to the folate-antagonist effects.



- Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines.

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