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DRUG STUDY: metronidazole

Drug Data Generic Name Metronidazole Trade Name Nitroimidazole Flagyl, Metric 21, Noritade Patients Dose Metronidazole 500mg 1 tab TID PO Minimum Dose PO : 250mg TID IV : 100mg /mL Maximum Dose PO : 750 mg TID 610days IV : 100mg/mL Contents Metronidazole Availability Capsules: 375 mg Injection: 5mg/mL Oral suspension: 200mg/5ml Tablets: 200mg,250mg,400mg ,500mg Topical gel: 0.75 %,1 % Routes of administration PO, IV, Topical Source: NDH 2008 p.827 Source: NDH 2008 p.827 Source: NDH 2008 p.827 Source: NDH 2008 p.827 Source: NDH 2008 p.827 Source: NDH 2008 p.827 Source: NDH 2008 p.827 Therapeutic Class: Classification Pharmacologic Class: Mechanism of Action Pharmacokinetics Onset: PO: uknown IV: immediate Topical: unknown Peak : PO: 1-2 hrs IV: immediate Topical: 6-10hrs Duration: PO, IV, Topical: unknown Therapeutic Effects: Hinders growth of selected organisms, including most anaerobic bacteria and protozoa Drug Half Life Indication General Indications >amebic hepatic abscess >intestinal amebiasis >trichomoniasis >retractory trichomoniasis >bacterial infection caused by anaerobic microorganisms >to prevent postoperative infection in contaminated colorectal surgery >pelvic inflammatory disease Contraindications Adverse Reactions CNS: seizures, dizziness, headache EENT: Tearing(topical only) GI: abdominal pain, anorexia, nausea and vomiting, diarrhea, dry mouth, glossitis Derm: rashes, urticarial, mild dryness, skin irritation Hemat: leukopenia Local: Phlebitis at Iv site Neuro: peripheral neuropathy Misc: superinfection Nursing Responsibilities Before >assess pts. Infection >watch carefully for edema because it may cause sodium retention >assess skin for severity areas of local adverse reactions >record number and character of stools >assess pts and familys knowledge of drug therapy During >give drug with meals to minimize GI distress >to treat trichomoniasis, give drug for 7days instead of 2-g single dose >use only after T.vaginalis has been confirmed by wet smear >tablets may be crushed for pts. with difficult swallowing >do not use aluminium needles or hubs, color will turn orange/rust After >tell pt. that metallic taste and dark or red brown urine may occur >instruct pt. to take oral form with meals to minimize reactions >instruct to complete full course of therapy >tell pt. not to use alcohol or drugs that contain alcohol. >may cause dizziness/ light headedness

>hypersensitivity >hypersensitivity to parabens >first trimester of pregnancy

Antibacterial Antiprotozoal

Precautions >history of blood dyscrasias; seizures or neurologic problems >severe hepatic impairment >pregnancy, lactation and children

Pregnancy Risk Category: B

Drug interactions >cimetidine >phenobarbital >warfarin >disulfiram >fluorouracil .