Metronidazole: Action, Uses, side effects, Nursing reference

 Metronidazole

Classification 

Antibacterial 

Action 

Bactericidal effects against anaerobic bacterial pathogens as well as several protozoa. Interacts with cell DNA to cause strand breakage and loss of helical structure. The impairment of the DNA is responsible for the antimicrobial and mutagenic actions of the medication. 

Uses

• Asymptomatic and symptomatic trichomoniasis in female and male patients
• Acute intestinal amebiasis, giardiasis, clostridium difficile, and antibiotic-associated colitis 
• Used in combination with tetracycline and bismuth subsalicylate (pepto-Bismol) for treatment of Helicobacter pylori

Precautions 

• Active central nervous system (CNS) disease, blood dyscrasias
• Avoid during first-trimester pregnancy, breastfeeding mothers
• Second and third-trimester pregnancies, use with caution 
• Alcoholism, hepatic disease 

Side effects 

• Nausea, headache, dry mouth, vomiting diarrhoea, vertigo, weakness 
• Metallic taste, darkening of the urine, stomatitis, insomnia 
• Rarely, seizure, peripheral neuropathy, encephalopathy, aseptic meningitis 

Nursing implications 

• Take on an empty stomach if possible, may take with food if nauseated
• Do not use products containing alcohol (cologne, aftershave lotion, or bath splashes) or ingest alcohol products to avoid a disulfiram-type reaction e.g. flushing, nausea and vomiting, palpitations, tachycardia, psychosis ). 
• Mothers should wait until 24 hours after last dose of drug to resume breastfeeding. 
• Teach patient that harmless darkening of the urine may occur.