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Metronidazole
antiprotazoal drug with activity against anaerobic bacteria
- uses
- mechanism
- dose and half-life
- adverse drug reactions
- counter-indications and drug interactions
- metabolism and excretion
- dependency
Uses
- giardia, trichomonas, Entamoeba histolytica
- bacteriodes and clostridium
- anaerobic or mixed intra-abdominal infections
- vaginitis
- C. difficile colitis
- brain abscess
Mechanism
- unknown; may inhibit DNA synthesis
- reactive reaction appears important for antimicrobial activity; likely targets nucleic acids and proteins
Dose and Half-Life
- orally, well-absorbed and is widely distributed in tissues
- penetrates CSF and brain
- can also be given IV and rectally
Adverse Drug Reactions
short term
- nausea, headache, dry mouth, metallic taste
- vomiting, diarrhea, dizziness, thrush, vertigo, neutropenia
rare
- rare are pancreatitis, CNS toxicity (seizures, ataxia, encephalopathy)
long term
- may be teratogenic and cause tumours
Counter-Indications and Drug Interactions
- potentiates the effects of coumarin-type anticoagulants
- phenytoin and phenobarbital may accelerate elimination of metronidazole
- cimetidine may decrease plasma clearance of metronidazole
- lithium toxicity possible
- alcohol (nausea, vomiting)
Metabolism and Excretion
- half-life of 7.5 hours
- metabolized in liver
- excreted in urine