Metronidazole Flashcards

1
Q

What is the mode of action of metronidazole?

A

Binds to DNA of specific pathogens, e.g. anaerobes and protozoa, resulting in cell death

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2
Q

Is metronidazole broad or narrow spectrum?

A

Narrow

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3
Q

What is the route of delivery of metronidazole?

A
  • PO
  • IV
  • PR
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4
Q

Is metronidazole well-absorbed orally?

A

No

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5
Q

What is the result of metronidazole not being well absorbed orally?

A

It should only be prescribed orally for mild infections

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6
Q

What are the indications for metronidazole?

A
  • Intra-abdominal sepsis
  • As part of H. Pylori eradication therapy
  • Infection with C. diff and other anaerobes
  • Protozoal infections
  • Dental infections
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7
Q

Who should metronidazole be used with caution in?

A

Pregnant or breastfeeding women

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8
Q

What should be done if metronidazole is given in hepatic impairment?

A

Reduce dose, and monitor LFTs during treatment

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9
Q

What should be done during topical use of metronidazole?

A

Avoid exposure to strong sunlight or UV light

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10
Q

What monitoring is required with metronidazole?

A
  • Monitor WCC and CRP
  • Review patients clinical state
  • If treatment exceeds 10 days, check LFTs for hepatotoxicity and FBC for blood dycrasias
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11
Q

Why are long treatments with metronidazole not advisable?

A

Due to risk of hepatotoxicity, blood dycrasias, and of developing peripheral neuropathy

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12
Q

What might metronidazole interact with?

A
  • Alcohol
  • Warfarin
  • Clozapine
  • Acitretin
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13
Q

What might happen if metronidazole is given with alcohol?

A

Can induce profuse vomiting when alcohol is consumed

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14
Q

What might happen if metronidazole is given with warfarin?

A

Increased anticoagulant effect

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15
Q

What might happen if metronidazole is given with clozapine?

A

Increased risk of agranulocytosis

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16
Q

What might happen if metronidazole is given with acitretin?

A

Increased risk of hepatotoxicity

17
Q

What are the side effects of metronidazole?

A
  • Arthralgia
  • Ataxia
  • Dizziness
  • Headache
  • Blood dyscrasias
  • Hepatitis and pancreatitis
  • Metallic taste in mouth
  • Peripheral neuropathy
  • Dark urine

(all very rare or frequency not known)

18
Q

What patient counselling is required with metronidazole?

A
  • Complete antibiotic course

- Reacts with alcohol

19
Q

What should the patient be told regarding metronidazole and alcohol?

A

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