Sunday, February 23, 2014

Below is my outline of information I have gathered on metronidazole. My intent is to focus the majority of my poster/powerpoint presentation on patient teaching and nursing implications. Is there anything important to know about metronidazole from a nursing or patient standpoint that I have missed? Any information you can offer me is greatly appreciated.
 Thank you!

My outline:

Metronidazole/Flagyl
Antibiotic that impairs DNA function of susceptible bacteria primarily used to treat organisms in the GI tract and bacterial vaginosis.
Indications:
-          Helicobacter pylori
-          Clostridium difficile
-          Pseudomonas aeruginosa
-          Diverticulitis
-          Gram negative infections
-          Anaerobic infections
-          Skin infections
-          Gynecological infections
-          Prophylaxis postop for colo-rectal surgery
Nursing Implications
-          In patients taking warfarin monitor INR as metronidazole may increase INR and increase risk of bleeding
-          In patients taking lithium monitor lithium levels as there is a risk of lithium toxicity due to decreased renal excretion
-          In patients taking phenytoin monitor phenytoin levels, hepatic metabolism function is inhibited and may cause phenytoin toxicity
-          Diabetic patients taking pioglitazone/glimepiride run the risk of hypoglycemia; monitor blood sugar levels closely.

Patient teaching
-          Advise patients taking oral contraceptives to use alternative birth control measures as metronidazole may cause decreased efficacy
-          Absolutely no alcohol consumption when taking the medication and for 48 hours after
o   Facial flushing
o   Severe headache
o   Tachycardia
o   Palpitations
o   Hypotension
o   Dyspnea
o   Sweating
o   Slurred speech
o   Abdominal cramps
o   Nausea/vomiting
-          Side effects
o   Dizziness
o   Headache
o   Confusion
o   Depression
o   Irritability
o   Weakness
o   Insomnia
o   Metallic/bitter taste
o   Dry mouth
o   GI upset
o   Congestion
o   Decreased libido
o   EKG changes
o   Dysuria/incontinence
-          Complete entire regimen
Available routes of administration
-          Oral
-          IV
-          Vaginal gel
-          Topical cream

Contraindications
-          Hypersensitivity to any of the product ingredients
-          Oral metronidazole should not be used in 1st trimester of pregnancy
Black box warning
-          Metronidazole should only be administered for the approved conditions as it has been shown to be carcinogenic in mice and rats


2 comments:

  1. Looks pretty good. Flagyl is used to treat pseudomembranous colitis caused by clostridium difficile, not to be confused with treating pseudomonas aeruginosa infections. Pseudomonas is usually treated with broad spectrum antibiotics (quinolones, antipseudomonal beta lactams). Flagyl is mainly used to treat anaerobic infections.

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  2. Thank you Mr. Dailey

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