A patient is complaining of voiding of orange coloured urine. The patient is likely to be on which of the fol… - RML Lucknow - 2021

RML Lucknow - 2021

Pharmacology

Easy

Appeared in: RML Lucknow - 2021

Explanation

Rifampicin is an antibiotic primarily used in the treatment of tuberculosis.
A very common and harmless side effect of this medication is the secretion of reddish-orange colored body fluids, including urine, tears, sweat, and saliva.
This occurs because the drug itself and its metabolites are reddish-brown and are excreted from the body through these fluids.
This side effect, while visually alarming, does not indicate a problem and is expected.

Option B: Iron supplements are well-known for causing stools to turn dark green or black. While they can occasionally cause urine to become brown or black, they do not cause orange urine.
Option C: Nitrofurantoin, an antibiotic for urinary tract infections, can discolor urine. However, the color is typically dark yellow or brown, not the bright orange associated with Rifampicin.
Option D: Primaquine, an antimalarial drug, does not typically alter urine color. It can cause dark brown, 'cola-colored' urine if it induces hemolysis (destruction of red blood cells), which is a serious adverse effect primarily seen in patients with G6PD deficiency. This is different from a benign orange discoloration.

Clinical Relevance

Nursing practice connection: Use the key finding related to Pharmacology: Drug-induced changes in urine color to guide bedside assessment, documentation, and the next nursing action.
Patient education is a critical nursing intervention. Nurses must inform patients starting Rifampicin about the expected red-orange discoloration of body fluids to prevent anxiety and promote medication adherence.
A key safety point is to advise patients that soft contact lenses can be permanently stained by the discolored tears, so they should consider wearing glasses during treatment.
What if? If the patient reported orange urine along with yellowing of the skin and eyes (jaundice), the nurse should not dismiss it as a benign side effect. This combination could indicate drug-induced hepatitis, a serious adverse effect of Rifampicin, requiring immediate medical evaluation.

How to Approach the Question

First, identify the key clinical sign presented in the question: 'orange coloured urine'.
Recognize that this is a pharmacology-based question testing your knowledge of common and distinctive drug side effects.
Systematically review each medication option and recall its known effects on body fluid color.
Recall that Rifampicin is famously associated with causing a red-orange discoloration of urine, tears, and sweat.
Consider the other options: Iron causes black stools, Nitrofurantoin causes brown/yellow urine, and Primaquine's effect is rare and results in a different color (dark brown).
Based on this comparison, conclude that Rifampicin is the most probable cause for the specific color mentioned in the question.

Concept Tested & Keywords

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