Metronidazole

Question 1

MoA

Answer 1

Pro-drug
The active form binds to DNA and disrupts helical structure, inhibiting bacterial nucleic acid synthesis.

Question 2

Active against

Answer 2

Anaerobic bacteria
Protozoa

Question 3

When is it used?

Answer 3

Alternative to penicillin for many oral infections when:
- anaerobes are resistant to penicillin
- patients are allergic to penicillin

Question 4

Indications

Answer 4

H.pylori eradication
Acute oral infections
Leg ulcers
Pressure sores

Question 5

Side effects

Answer 5

GI disturbances
Taste disturbances
Furred tongue
Oral mucositis
Anorexia

Question 6

Contraindications + cautiosn

Answer 6

Monitoring advised if treatment exceeds 10 days

Question 7

Counselling points

Answer 7

Take with or just after food
Disulfiram-like reaction with alcohol (i.e. N + V)
Wait 48 hours after stopping reaction before drinking alcohol

Question 8

Anaerobic infections

Answer 8

Dental infections
Antibiotic associated colitis
H.pylori
Rosacea
BV

Question 9

Protozoal infections

Answer 9

Vaginal trichomoniasis
Giardiasis

Question 10

Topical use

Answer 10

Rosacea
Avoid sunlight/direct UV exposure

Question 11

Pregnancy

Answer 11

AVOID
- use only if risk outweighs benefit
- esp avoid high doses