Metronidazole

dr.joan

Metronidazole :

Trade names: Flagyl

Class: systemic trichomonocide, amebicide

Pregnancy: (Category

Action:

· Effective against anaerobic bacteria & protozoa.

· Inhibit growth of trichomona & amebae by binding to DNA & inhibit nucleic acid synthesis cell death .

· Well absorbed from GIT & widely distributed in tissues.

· Eliminated in urine ( primarily) , 20% unchanged red, brown discoloration in urine following P.O. or I.V. use .

Uses:

A - Systemic:

1. amebiasis, trichomoniasis.

2. amebic dysentery.

3. amebic liver abscess.

4. septicemia

5. Endocarditis

6. Giardiosis

7. to anaerobic infections of the abdomen following colorectal surgery, hysterectomy, emergency appendectomy.

B. Topical :

1. Inflammatory papules & pustules.

Dose:

§ anaerobic infections (usually treated for 7 days and for 10 days in antibiotic-associated colitis), by mouth, either 800 mg initially then 400 mg every 8 hours or 500 mg every 8 hours, CHILD 7.5 mg/kg every 8 hours;

§ by rectum, 1 g every 8 hours for 3 days, then 1 g every 12 hours, CHILD every 8 hours for 3 days, then every 12 hours, age up to 1 year 125 mg, 1–5 years 250 mg, 5–10 years 500 mg, over 10 years, adult dose;

§ by intravenous infusion over 20 minutes, 500 mg every 8 hours;

CHILD 7.5 mg/kg every 8 hours

§ high-risk procedures; child 7.5 mg/kg at induction; up to 3 further doses of 7.5 mg/kg may be given every 8 hours for high-risk procedures

Contraindications:

· Active organic disease of CNS.

· Blood disorders

· Lactation.

· 1st trimester of pregnancy.

· Topical Hypersensitivity.

Side effects:

· Dry mouth , metallic taste, diarrhea, dizziness abdominal discomfort, furry tongue, ataxia, vertigo & leucopenia.

Nursing considerations:

· If used IV, drug should not be given by IV bolus.

· If a primary IV fluid setup is used, discontinue the primary solution during infusion of metronidazole.

· Report any symptoms of CNS toxicity immediately e.g. ataxia or tremor, which necessitate withdrawal of drug.

· The drug may turn urine brown.

· Explain for the male partner , the necessity to have therapy.