Metronidazole
Trade names:
Flagyl
Class: systemic trichomonocide, amebicide
Pregnancy:
(Category B) Action:
• Effective against anaerobic bacteria & protozoa.
•
Inhibit growth of
trichomona & amebae by binding to DNA & inhibit nucleic acid
synthesis cell death .
• Well absorbed from GIT & widely distributed in tissues.
• Eliminated in urine ( primarily) , 20% unchanged red, brown discoloration in urine following
P.O. or I.V. use .
Uses:
A - Systemic:
1. amebiasis, trichomoniasis.
2. amebic dysentery.
3. amebic liver abscess.
4. septicemia
5. Endocarditis
6. Giardiosis
7. 
to anaerobic infections of the abdomen
following colorectal surgery, hysterectomy, emergency appendectomy. B. Topical :
to anaerobic infections of the abdomen
following colorectal surgery, hysterectomy, emergency appendectomy. B. Topical :
1. Inflammatory papules & pustules.
Dose:
§ anaerobic infections (usually treated for 7 days and for 10 days
in antibiotic-associated colitis), by mouth, either 800 mg initially then 400
mg every 8 hours or 500 mg every 8 hours, CHILD 7.5 mg/kg every 8 hours;
§ by rectum, 1 g every 8 hours for 3 days, then 1 g every 12
hours, CHILD every 8 hours for 3 days, then every 12 hours, age up to 1 year
125 mg, 1–5 years 250 mg, 5–10 years 500 mg, over 10 years, adult dose;
§ by intravenous infusion over 20 minutes, 500 mg every 8 hours;
CHILD 7.5 mg/kg every
8 hours
§ high-risk procedures; child 7.5 mg/kg at induction; up to 3
further doses of 7.5 mg/kg may be given every 8 hours for high-risk procedures Contraindications:
• Active organic disease of CNS.
Blood disorders
Lactation.
• 1st trimester of pregnancy. Topical Hypersensitivity.
Side effects:
• Dry mouth , metallic taste, diarrhea, dizziness abdominal
discomfort, furry tongue, ataxia, vertigo & leucopenia.
Nursing
considerations:
• If used IV, drug should not be given by IV bolus.
• If a primary IV fluid setup is used, discontinue the primary
solution during infusion of metronidazole.
• Report any symptoms of CNS toxicity immediately e.g. ataxia or
tremor, which necessitate withdrawal of drug.
• The drug may turn urine brown.
• Explain for the male partner , the necessity to have therapy.
