What should be monitored in patients on long-term nitrofurantoin therapy?

Monitoring pulmonary function and liver function tests in patients on long-term nitrofurantoin therapy is important due to the potential for significant side effects associated with prolonged use of the medication. Nitrofurantoin is primarily used for urinary tract infections, but long-term use can lead to pulmonary toxicity, characterized by symptoms such as cough, dyspnea, and pulmonary infiltration. This is particularly a concern for patients with preexisting lung conditions or those who are elderly.

Additionally, nitrofurantoin can affect liver function, leading to hepatoxicity in some cases. By monitoring liver enzymes, healthcare providers can catch signs of liver damage early and make necessary adjustments to treatment.

While renal function is indeed crucial to monitor in patients on nitrofurantoin, as the drug is contraindicated in patients with significant renal impairment due to reduced clearance and a higher risk of toxicity, it is not the only parameter that requires attention. Monitoring pulmonary and liver function adds a comprehensive approach to managing potential adverse effects of long-term therapy.