Generic Name: Metronidazole
Brand Name: Flagyl, Metric 21, Noritade, Protostat,MetroGel-Vaginal
Classification: Antibiotic, Antibacterial, Amebicide, Antiprotozoal
Patients Dose:
Metronidazole 500mg1 tab TID PO
Minimum Dose:
PO : 250mg TID IV : 100mg /mL
Maximum Dose:
PO : 750 mg TID 6-10days IV :100mg/mL
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
Pharmacologic Class:
Nitroimidazole
Therapeutic Class:
Antibacterial Antiprotozoal
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
General Indications
- Amoebic 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
- 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)
Nursing Responsibilities
Before
- Assess pt. 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 pt.’s and family’s knowledge of drug therapy
During
- Give drug with meals to minimize GI distress
- To treat trichomoniasis, give drug for 7 days instead of 2-g single dose
- Use only after T.vaginalis has been confirmed by wet smear
- Tablets may be crushed for pt’s. 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
Reference:
- Nursing 2008 Drug Handbook: Lippincott Williams & Wilkins
