Metronidazole Drug Study

In making a Drug Study, the following elements must be present: Generic Name and the Brand name (not all brands, just the brand used by the patient), Action, Indication, Pregnancy Category, Drug Classification, and Contraindication, Adverse Effect, Drug interaction and Nursing Consideration/Intervention…. Most clinical instructors preferred this to be in a long bond paper in printed or handwritten with paper in landscape.

Metronidazole

Brand Name: Apo-Metronidazole (CAN), Flagyl, Flagyl 375, Flagyl ER, Flagyl IV, Flagyl IV RTU, MetroCream (CAN), MetroGel, Metro I.V., Neo-Tric (CAN), NidaGel (CAN), Noritate, Novonidazol (CAN), PMS-Metronidazole (CAN), Protostat, Trikacide (CAN)

Pregnancy Category B

Drug classes: Antibiotic, Antibacterial, Amebicide, Antiprotozoal

Therapeutic actions

Bactericidal: inhibits DNA synthesis in specific (obligate) anaerobes, causing cell death; antiprotozoal-trichomonacidal, amebicidal: biochemical mechanism of action is not known.

Indications

· Acute infection with susceptible anaerobic bacteria

· Acute intestinal amebiasis

· Amebic liver abscess

· Trichomoniasis (acute and partners of patients with acute infection)

· Preoperative, intraoperative, postoperative prophylaxis for patients undergoing colorectal surgery

· Topical application in the treatment of inflammatory papules, pustules, and erythema of rosacea

· Unlabeled uses: prophylaxis for patients undergoing gynecologic, abdominal surgery; hepatic encephalopathy; Crohn's disease; antibiotic-associated pseudomembranous colitis; treatment of Gardnerella vaginalis, giardiasis (use recommended by the CDC)

Contraindications

· Contraindicated with hypersensitivity to metronidazole; pregnancy (do not use for trichomoniasis in first trimester).

· Use cautiously with CNS diseases, hepatic disease, candidiasis (moniliasis), blood dyscrasias, lactation.

Adverse effects

Headache, dizziness, ataxia, vertigo, incoordination, insomnia, seizures, peripheral neuropathy, fatigue

Unpleasant metallic taste, anorexia, nausea, vomiting, diarrhea, GI upset, cramps

Dysuria, incontinence, darkening of the urine

Thrombophlebitis (IV); redness, burning, dryness, and skin irritation (topical)

Severe, disulfiram-like interaction with alcohol, candidiasis (superinfection)

Drug Interactions:

· Decreased effectiveness with barbiturates

· Disulfiram-like reaction (flushing, tachycardia, nausea, vomiting) with alcohol

· Psychosis if taken with disulfiram

· Increased bleeding tendencies with oral anticoagulants

Nursing considerations

· Avoid use unless necessary. Metronidazole is carcinogenic in some rodents.

· Administer oral doses with food.

· Apply topically (MetroGel, MetroCream) after cleansing the area. Advise patient that cosmetics may be used over the area after application.

· Reduce dosage in hepatic disease.