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    Metronidazole

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    Metronidazole is an antibiotic and antiprotozoal medication used to treat bacterial and parasitic infections such as rosacea, amebiasis, trichomoniasis, and giardiasis. It works by inhibiting DNA synthesis in anaerobic bacteria and protozoa. Common side effects include nausea, vomiting, diarrhea, and a metallic taste. Alcohol should be avoided due to risk of severe reactions. Nursing considerations include administering with food, teaching about side effects and drug interactions, and monitoring for signs of liver or neurological toxicity.

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    Metronidazole

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    api-3797941
    5K views4 pages
    Metronidazole is an antibiotic and antiprotozoal medication used to treat bacterial and parasitic infections such as rosacea, amebiasis, trichomoniasis, and giardiasis. It works by inhibiting DNA synthesis in anaerobic bacteria and protozoa. Common side effects include nausea, vomiting, diarrhea, and a metallic taste. Alcohol should be avoided due to risk of severe reactions. Nursing considerations include administering with food, teaching about side effects and drug interactions, and monitoring for signs of liver or neurological toxicity.

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    Metronidazole is an antibiotic and antiprotozoal medication used to treat bacterial and parasitic infections such as rosacea, amebiasis, trichomoniasis, and giardiasis. It works by inhibiting DNA synthesis in anaerobic bacteria and protozoa. Common side effects include nausea, vomiting, diarrhea, and a metallic taste. Alcohol should be avoided due to risk of severe reactions. Nursing considerations include administering with food, teaching about side effects and drug interactions, and monitoring for signs of liver or neurological toxicity.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    5K views4 pages

    Metronidazole

    Uploaded by

    api-3797941
    Metronidazole is an antibiotic and antiprotozoal medication used to treat bacterial and parasitic infections such as rosacea, amebiasis, trichomoniasis, and giardiasis. It works by inhibiting DNA synthesis in anaerobic bacteria and protozoa. Common side effects include nausea, vomiting, diarrhea, and a metallic taste. Alcohol should be avoided due to risk of severe reactions. Nursing considerations include administering with food, teaching about side effects and drug interactions, and monitoring for signs of liver or neurological toxicity.

    Copyright:

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    Download as DOC, PDF, TXT or read online from Scribd
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    of 4

    metronidazole

    (me troe ni' da zole)


    Apo-Metronidazole (CAN), Flagyl, Flagyl 375, Flagyl ER, Flagyl IV, Flagyl IV
    RTU, MetroCream (CAN), MetroGel, Metro I.V., Neo-Tric (CAN), NidaGel
    (CAN), Noritate, Novonidazol (CAN), PMS-Metronidazole (CAN), Protostat,
    Trikacide (CAN)

    Pregnancy Category B

    Drug classes
    Antibiotic
    Antibacterial
    Amebicide
    Antiprotozoal

    Therapeutic actions
    Bactericidal: Inhibits DNA synthesis in specific (obligate) anaerobes, causing cell death;
    antiprotozoal-trichomonacidal, amebicidal: Biochemical mechanism of action is not
    known.

    Indications
    • Acute infection with susceptible anaerobic bacteria
    • Acute intestinal amebiasis
    • Amebic liver abscess
    • Trichomoniasis (acute and partners of patients with acute infection)
    • Preoperative, intraoperative, postoperative prophylaxis for patients undergoing
    colorectal surgery
    • Topical application: Treatment of inflammatory papules, pustules, and erythema
    of rosacea
    • Unlabeled uses: Prophylaxis for patients undergoing gynecologic, abdominal
    surgery; hepatic encephalopathy; Crohn's disease; antibiotic-associated
    pseudomembranous colitis; treatment of Gardnerella vaginalis, giardiasis (use
    recommended by the CDC)

    Contraindications and cautions


    • Contraindicated with hypersensitivity to metronidazole; pregnancy (do not use for
    trichomoniasis in first trimester).
    • Use cautiously with CNS diseases, hepatic disease, candidiasis (moniliasis), blood
    dyscrasias, lactation.

    Available forms
    Tablets—250, 500 mg; ER tablets—750 mg; capsules—375 mg; powder for injection—
    500 mg; injection—500 mg/100 mL

    Dosages
    ADULTS
    Oral
    • Amebiasis: 750 mg/tid PO for 5–10 days. (In amebic dysentery, combine with
    iodoquinol 650 mg PO tid for 20 days.)
    • Antibiotic-associated pseudomembranous colitis: 1–2 g/day PO for 7–10 days.
    • Gardnerella vaginalis: 500 mg bid PO for 7 days.
    • Giardiasis: 250 mg tid PO for 7 days.
    • Trichomoniasis: 2 g PO in 1 day (1-day treatment) or 250 mg tid PO for 7 days.
    IV
    • Anaerobic bacterial infection: 15 mg/kg IV infused over 1 hr; then 7.5 mg/kg
    infused over 1 hr q 6 hr for 7–10 days, not to exceed 4 g/day.
    • Prophylaxis: 15 mg/kg infused IV over 30–60 min and completed about 1 hr
    before surgery. Then 7.5 mg/kg infused over 30–60 min at 6- to 12-hr intervals
    after initial dose during the day of surgery only.
    Topical (MetroGel)
    • Treatment of inflammatory papules, pustules, and erythema of rosacea: Apply and
    rub in a thin film twice daily, morning and evening, to entire affected areas after
    washing; results should be seen within 3 wk; treatment through 9 wk has been
    effective.
    PEDIATRIC PATIENTS
    • Anaerobic bacterial infection: Not recommended.
    • Amebiasis: 35–50 mg/kg/day PO in 3 doses for 10 days.

    Pharmacokinetics
    Route Onset Peak
    Oral Varies 1–2 hr
    IV Rapid 1–2 hr
    Topical Generally no systemic absorption

    Metabolism: Hepatic; T1/2: 6–8 hr


    Distribution: Crosses placenta; enters breast milk
    Excretion: Urine and feces

    IV facts
    Preparation: Reconstitute by adding 4.4 mL of sterile water for injection, bacteriostatic
    water for injection, 0.9% sodium chloride injection, bacteriostatic 0.9% sodium chloride
    injection to the vial and mix thoroughly. Resultant volume is 5 mL with a concentration
    of 100 mg/mL. Solution should be clear to pale yellow to yellow-green; do not use if
    cloudy or if containing precipitates; use within 24 hr; protect from light. Add
    reconstituted solution to glass or plastic container containing 0.9% sodium chloride
    injection, 5% dextrose injection or lactated Ringer's; discontinue other solutions while
    running metronidazole.
    Infusion: Prior to administration, add 5 mEq sodium bicarbonate injection for each
    500 mg used (if not using premixed bags); mix thoroughly. Do not refrigerate neutralized
    solution. Do not administer solution that has not been neutralized. Infuse over 1 hr.

    Adverse effects
    • CNS: Headache, dizziness, ataxia, vertigo, incoordination, insomnia, seizures,
    peripheral neuropathy, fatigue
    • GI: Unpleasant metallic taste, anorexia, nausea, vomiting, diarrhea, GI upset,
    cramps
    • GU: Dysuria, incontinence, darkening of the urine
    • Local: Thrombophlebitis (IV); redness, burning, dryness, and skin irritation
    (topical)
    • Other: Severe, disulfiram-like interaction with alcohol, candidiasis
    (superinfection)

    Interactions
    Drug-drug
    • Decreased effectiveness with barbiturates
    • Disulfiram-like reaction (flushing, tachycardia, nausea, vomiting) with alcohol
    • Psychosis if taken with disulfiram
    • Increased bleeding tendencies with oral anticoagulants
    Drug-lab test
    • Falsely low (or zero) values in AST, ALT, LDH, triglycerides, hexokinase glucose
    tests

    Nursing considerations
    Assessment
    • History: CNS or hepatic disease; candidiasis (moniliasis); blood dyscrasias;
    pregnancy; lactation
    • Physical: Reflexes, affect; skin lesions, color (with topical application);
    abdominal exam, liver palpation; urinalysis, CBC, liver function tests

    Interventions
    • Avoid use unless necessary. Metronidazole is carcinogenic in some rodents.
    • Administer oral doses with food.
    • Apply topically (MetroGel, MetroCream) after cleansing the area. Advise patient
    that cosmetics may be used over the area after application.
    • Reduce dosage in hepatic disease.

    Teaching points
    • Take full course of drug therapy; take the drug with food if GI upset occurs.
    • Do not drink alcohol (beverages or preparations containing alcohol, cough
    syrups); severe reactions may occur.
    • Your urine may appear dark; this is expected.
    • Refrain from sexual intercourse unless partner wears a condom during treatment
    for trichomoniasis.
    • Apply the topical preparation by cleansing the area and then rubbing a thin film
    into the affected area. Avoid contact with the eyes. Cosmetics may be applied to
    the area after application.
    • These side effects may occur: Dry mouth with strange metallic taste (use frequent
    mouth care, suck sugarless candy); nausea, vomiting, diarrhea (eat frequent small
    meals).
    • Report severe GI upset, dizziness, unusual fatigue or weakness, fever, chills.

    Adverse effects in Italic are most common; those in Bold are life-threatening.

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