MicroB Antimicrobials Anti-protozoal agent

Question 1

Adverse effect of Metronidazole:
1. GI symptoms: nausea, vomiting, epigastric distress, and abdominal cramps.
2. unpleasant […] taste (well…affects compliance)
3. Oral moniliasis (yeast infection)
4. Central and Peripheral Nervous System Effects: Convulsive seizures, optic and peripheral neuropathy. Rare but it necessitates discontinuation of the drug if it happens. Avoid alcohol.

Answer 1

Adverse effect of Metronidazole:
1. GI symptoms: nausea, vomiting, epigastric distress, and abdominal cramps.
2. unpleasant metallic taste (well…affects compliance)
3. Oral moniliasis (yeast infection)
4. Central and Peripheral Nervous System Effects: Convulsive seizures, optic and peripheral neuropathy. Rare but it necessitates discontinuation of the drug if it happens. Avoid alcohol.

Cuz if u go and lick a train…..it will taste…metallic mah….hahahaha…

desperate times need desperate measures to memorize….

Question 2

Anti-protozoal agent that’s most important currently: […]

Answer 2

Anti-protozoal agent that’s most important currently: Metronidazole

Question 3

Mechanism of action of metronidazole:
[…]

Answer 3

Mechanism of action of metronidazole:
serve as electron acceptor, forming reduced cytotoxic free radicals that results in protein and DNA damage

Detailed mechanism
1. Ameobas possess Electron transport proteins that participate in metabolic electron removal reactions
2. Metronidazole is a nitroimidazole
3. the nitro serves as electron acceptor, forming reduced cytotoxic free radicals that damages protein and DNA

Question 4

Metronidazole is administered […]

CSF penetration: […]

Answer 4

Metronidazole is administered orally (very rapid and complete absorbtion)

CSF penetration: effective~

Question 5

Metronidazole is used to treat
- Amebic infections caused by Protozoa including […] , Trichomonas vaginalis ( vaginitis), […]

Although we say is an antiprotozoal agent, it is also useful in antibacterial treatment against

1. Anaerobes such as Bacterioides species and Clostridium difficile (IMPT: First line treatment)
2. […]
3. surgical prophylaxis (30 to 60 min before incision)

Answer 5

Metronidazole is used to treat
- Amebic infections caused by Protozoa including i , Trichomonas vaginalis ( vaginitis), Giardia lamblia (Giardiasis)

Although we say is an antiprotozoal agent, it is also useful in antibacterial treatment against

1. Anaerobes such as Bacterioides species and Clostridium difficile (IMPT: First line treatment)
2. H.pylori (part of the triple treatment, choose clarithromycin or metronidazole)
3. surgical prophylaxis (30 to 60 min before incision)

Means triple therapy for H.Pylori is usually CAO or MAO

Question 6

Most antiprotozoal agents have NOT been proven to be safe for […] patients because […]

Answer 6

Most antiprotozoal agents have NOT been proven to be safe for pregnant patients because they are unicellular eukaryotes (protozoal cells have metabolic processes closer to that of human host compared to prokaryotic bacterial pathogens)

General concept! High yield to know.