Metronidazole Flashcards
What is the mode of action of metronidazole?
Binds to DNA of specific pathogens, e.g. anaerobes and protozoa, resulting in cell death
Is metronidazole broad or narrow spectrum?
Narrow
What is the route of delivery of metronidazole?
- PO
- IV
- PR
Is metronidazole well-absorbed orally?
No
What is the result of metronidazole not being well absorbed orally?
It should only be prescribed orally for mild infections
What are the indications for metronidazole?
- Intra-abdominal sepsis
- As part of H. Pylori eradication therapy
- Infection with C. diff and other anaerobes
- Protozoal infections
- Dental infections
Who should metronidazole be used with caution in?
Pregnant or breastfeeding women
What should be done if metronidazole is given in hepatic impairment?
Reduce dose, and monitor LFTs during treatment
What should be done during topical use of metronidazole?
Avoid exposure to strong sunlight or UV light
What monitoring is required with metronidazole?
- Monitor WCC and CRP
- Review patients clinical state
- If treatment exceeds 10 days, check LFTs for hepatotoxicity and FBC for blood dycrasias
Why are long treatments with metronidazole not advisable?
Due to risk of hepatotoxicity, blood dycrasias, and of developing peripheral neuropathy
What might metronidazole interact with?
- Alcohol
- Warfarin
- Clozapine
- Acitretin
What might happen if metronidazole is given with alcohol?
Can induce profuse vomiting when alcohol is consumed
What might happen if metronidazole is given with warfarin?
Increased anticoagulant effect
What might happen if metronidazole is given with clozapine?
Increased risk of agranulocytosis
What might happen if metronidazole is given with acitretin?
Increased risk of hepatotoxicity
What are the side effects of metronidazole?
- Arthralgia
- Ataxia
- Dizziness
- Headache
- Blood dyscrasias
- Hepatitis and pancreatitis
- Metallic taste in mouth
- Peripheral neuropathy
- Dark urine
(all very rare or frequency not known)
What patient counselling is required with metronidazole?
- Complete antibiotic course
- Reacts with alcohol
What should the patient be told regarding metronidazole and alcohol?
May cause vomiting, headache, and dizziness when alcohol is consumed whilst taking drug, hence advisable to avoid alcohol whilst taking metronidazole and for 48 hours after stopping drug
