metronidazole (apo-metronidazole, flagyl, flagyl 375, flagyl ER, metric 21, metrogyl, novonidazol, protostat, trikacide)

AVAILABLE FORMS:

Capsules: 375 mg

Injections: 500 mg/100 ml ready to use

Oral suspension (benzoyl metronidazole): 200 mg/5 ml

Powder for injections: 500-mg single-dose vials

Tablets:200 mg, 250 mg, 400 mg, 500 mg

Tablets (extended-release): 750 mg


INDICATIONS & DOSAGES:

• Amebic liver abscess


• Intestinal amebiasis


• Trichomoniasis


• Refractory trichomoniasis


• Bacterial infections caused by anaerobic microorganisms


• Prevention of postoperative infection in contaminated or potentially contaminated colorectal surgery


• Bacterial vaginosis

MECHANISM OF ACTION:

A direct-acting trichomonacide and amebicide that works at both intestinal and extraintestinal sites.It's thought to enter the cells of microorganisms that contain nitroreductase.Unstable compounds are then formed that bind to DNA and inhibit synthesis, causing cell death.

ADVERSE REACTIONS

CNS:vertigo, headache, ataxia, dizziness, syncope, incoordination,confusion, irritability, depression, weakness, insomia, seizures, peripheral neuropathy.

CV: Flattenned T wave, edema, blushing, thrombophebitis, after IV infusion

EENT: Rhinitis, Sinusitis, Pharyngitis

GI: Abdominal cramping or pain, Stomatitis, Epigastric distress, Nausea, Vomiting, Anorexia, Diarrhea, Constipation, Proctitis, dry mouth, metalic taste.

GU: darkened urine, polyuria, dysuria, cystitis, dyspareunia, dry ness of vagina and vulva, vaginal candidiasis, vaginitis, genital pruritus.

Hematologic: transient leukopenia, neutropenia

Musculoskeletal: fleeting joint pain

Respiratory: Upper Respiratory Tract Infection

Skin: Rash

EFFECTS ON LAB TEST RESULTS:

May decrease WBC and neutrophil count.

CONTRAINDICATIONS:

First Trimester of Pregnancy.

NURSING CONSIDERATIONS:

1. It may interfere with the chemical analyses of aminotransferases and triglycerides, leading to falsely decreased values.
2. Use cautiously in patients with history of blood dyscrasia or CNS disorders.
3. Monitor liver function test carefully in elderly patients.
4. Give oral form with meals.
5. Record the amount and characteristics of the stools.
6. Tell patient that metallic taste and dark or red-brown urine may occur.