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Antimicrobials 4- Metronidazole. Pharmacology -2 DSX 455. Dr / Abdulaziz Saeedan Pharmacy College. Metronidazole. Metronidazole ( Flagyl ) is a synthetic nitroimidazole antibiotic that acts against anaerobic bacteria and some protozoa.
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Antimicrobials4- Metronidazole Pharmacology -2 DSX 455 Dr/ AbdulazizSaeedan Pharmacy College
Metronidazole • Metronidazole (Flagyl) is a synthetic nitroimidazole antibiotic that acts against anaerobic bacteria and some protozoa. ► i. e. Antibacterial & Antiprotozoal Agent. Spectrum: • Metronidazole has a broad spectrum activity, It acts against anaerobic bacteria and some protozoa as Amoeba and Giardia. • Anaerobic bacteria cause infections in some areas of the body such as the gum, pelvic cavity, intestine and bones because they do not need oxygen to grow and multiply.
Metronidazole- Action & Mechanism of action • Action: Metronidazole has bactericidal activity. • Mechanism of action • Metronidazole is selectively absorbed then activated (reduced) by the microbial proteins (flavodoxinsandferredoxins) found in anaerobic bacteria and certain protozoa . Once activated, the reduction product of the drug oxidizes DNA causing cell death. NOTE: • Mammalian cells are unharmed because they lack flavodoxins and ferredoxins that reduce the nitro group of metronidazole.
HOW should this drug be taken? • Metronidazole can be given orally or IV. • Oral metronidazole can be taken with or without food. • What should you do if you FORGET a dose? • If you miss a dose of metronidazole, take it as soon as possible. However, if it is the time for your next dose, do not double the dose.
Metronidazole -indications • Metronidazole is indicated for the treatment of: 1- Acute gingivitis and periapical abscess. ► Often used in conjunction with Amoxicillin. 2- Vaginal infections, commonly associated with overgrowth of anaerobes. 3- Abscesses in the liver, pelvis and abdomen that caused by anaerobic bacteria. 4- Used to treat Helicobacter pylori (H. pylori) that causes stomach ulcers. 5- Diarrhea caused by Entamoeba histolytica (Amoebiasis - amebic dysentery) OR Giardia (Giardiasis). ► Metronidazole is the drug of choice for the treatment of all tissue infections with Entamoeba histolytica. ► Metronidazole is the treatment of choice for giardiasis. Efficacy after a single treatment is about 90%
Metronidazole – Adverse Effects 1- Minor side effects include: • Gastrointestinal disturbance in the form of nausea, vomiting, diarrhea, abdominal cramping and constipation. ► Taking the drug with meals lessens gastrointestinal irritation b) Unpleasant metallic taste, furry tongue, glossitis, dry mouth and stomatitis. ► These may be associated with a sudden overgrowth of Candida which may occur during therapy 2- Serious side effects: include seizures and damage of nerves resulting in numbness of extremities. ► Metronidazole should be stopped if these symptoms appear. 3- High doses and/or long-term treatment with metronidazole is associated with the development of leukopenia. NOTE: Although metronidazole has been shown to be teratogenic in some animals, it has not been associated with this effect in humans