Metronidazole and nitrofurantoin

Question 1

How does metronidazole work ?

Answer 1

Inhibits DNA synthesis
High activity against anaerobic bacteria and protozoa
Narrow spectrum+ bactericidal

Question 2

Name anaerobic infections that metronidazole works against ?

Answer 2

dental infections
antibiotic-associated colitis
H.Pylori
Rosacea
Bacterial vaginosis

Question 3

Name protozoal infections that metronidazole works against ?

Answer 3

vaginal trichomoniasis

giardiasis

Question 4

What are the common side effects of metronidazole ?

Answer 4

GI disturbances, taste disturbance, oral mucositis, furred tongue

Question 5

Nitrofurantoin is only active against what pathogens ?

Answer 5

urinary pathogens

Question 6

How does nitrofurantoin work ?

Answer 6

damages bacterial DNA

narrow spectrum + bactericidal

Question 7

what are the s/e of nitrofurantoin ?

Answer 7

nausea
risk of peripheral neuropathy in renal impairment: antibacterial efficacy depends on renal secretion of the drug into urinary tract.

Question 8

What are the contraindications of nitrofurantoin ?

Answer 8

Acute porphyrias ; G6PD deficiency; infants less than 3 months old

Question 9

Why should nitrofurantoin be avoided at term ?

Answer 9

may produce neonatal haemolysis: blood problem in newborn babies, red blood cells break down at a fast rate

Question 10

What are the monitoring requirements especially if nitrofurantoin is used long-term ?

Answer 10

On long-term therapy, monitor liver function and monitor for pulmonary symptoms, especially in the elderly (discontinue if deterioration in lung function).

Question 11

Patient counselling for nitrofurantoin ?

Answer 11

take with or after food

colours urine yellow or brown