Metronidazole

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METRONIDAZOLE

Metronidazole 4

1.       TYPE OF DRUG – METRONIDAZOLE
Metronidazole is of the nitroimidazole class.

 

2.       INDICATIONS (USE) – METRONIDAZOLE
Metronidazole is given for treatment of protozoal infections like amoebiasis, giardiasis and trichomonas vaginitis. It is also used in the treatment of anaerobic infection, ulcerative gingivitis, trench mouth, guinea worm infestation.

 

3.       MECHANISM OF ACTION (MOA) – METRONIDAZOLE
Inhibits nucleic acid synthesis by disrupting DNA and causing strand breakage; amebicidal, bactericidal, trichomonacidal

 

4.       ROUTES OF ADMINISTRATION- METRONIDAZOLE
Metronidazole comes as a tablet and an extended release tablet to take by mouth.

Intra venous (IV) injection.

 

5.       ONSET OF EFFECT OR ACTION- METRONIDAZOLE
Within a few hours. Full benefits seen after 1-2 days.

 

6.       DOSAGE (DOSING INFORMATION) – METRONIDAZOLE
Oral:200-800 mgs three times daily.

Parenteral: 15 mg/kg infused over 1 hour, followed by 7.5 mg/kg every 6 hours.

7.       HALF LIFE (DURATION OF ACTION) – METRONIDAZOLE
Half-life: 25-75 hr (neonates); 8 hr (others); prolonged in patients with hepatic impairment.

 

8.       ADVERSE EFFECTS OR SIDE EFFECTS – METRONIDAZOLE
  • stomach pain, diarrhea;
  • dizziness, loss of balance;
  • vaginal itching or discharge;
  • dry mouth or unpleasant metallic taste;
  • cough, sneezing, runny or stuffy nose; or.
  • swollen or sore tongue.

 

9.       CONTRAINDICATIONS – METRONIDAZOLE
Hypersensitivity to metronidazole or other nitroimidazoles (although cautious desensitization has been applied)

Pregnancy, 1st trimester (controversial)

Use of disulfiram within past 2 weeks; use of alcohol during therapy or within 3 days of discontinuing therapy

 

10.   DRUG INTERACTIONS – METRONIDAZOLE
Acute psychoses or confusion with disulfiram. Additive/synergistic effect with other antimicrobials. Effects reduced with phenobarbital or phenytoin.

Potentially Fatal: Disulfiram-like reaction with alcohol. Increased risk of adverse effects of coumarin anticoagulants, phenytoin, lithium, ciclosporin, fluorouracil. Increased risk of neurological effects with cimetidine.

 

11.     EXCRETION- METRONIDAZOLE
Mainly via urine (as metabolites); via faeces (small amounts). Elimination half-life: 8 hours; longer in neonates and severe hepatic impairment.

 

 

Metronidazole 6

By Medifit Education

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