Metronidazole/Flagyl

Hello, here is my outline on Metronidazole. As a nurse, I believe the most important focus areas the patient teaching and nursing implications. Thank you for taking the time to review this.

Metronidazole/Flagyl

Antibiotic that disrupts DNA function of susceptible bacteria.

Indications

Used to treat various disorders associated with organisms in the GI tract. Also used to treat intra abdominal infections, gynecological infections, skin infections, lower resp. tract infections, bone and joint infections, septicemia, and endocarditis.

§     Clostridium Difficile

§     Amebic dysentery

§     Amebic liver abcess

§     Trichomoniasis

§     Peptic ulcer disease due to H. Pylori

§     Prophylaxis for colorectal surgery

Dosage/Routes

PO:

Anaerobic infections – 7.5mg/kg Q6Hr

Trichomoniasis – 250mg Q8Hr for 7 days or single 2g dose

Amebiasis – 500-750mg Q8Hr for 5-10 days

H. Pylori – 250mg QID or 500mg BID for 1-2 weeks

Bacterial Vaginoses – 750mg daily for 7 days

IV:

Anaerobic Infections- initial dose 15mg/kg then 7.5mg/kg Q6-8hr or 500mg q2-8hr

Pre-op prophylaxis – 15mg/kg 1 hr prior to surgery, then 7.5mg/kg 6 and 12 hours after

Amebiasis – 500-750mg q8hr for 5-10 days

Contraindications

Hypersensitivity to metronidazole

First semester of pregnancy

Nursing Implications

§  Assess patient for s/s of infection prior to beginning therapy, and throughout the course of the therapy

§  Obain specimens for C&S prior to initiating therapy. First dose can be given before results receiving results.

§  Monitor neuro status during IV infusions. Notify physician if numbness, paresthesia, weakness, ataxia, or seizure occurs.

§  Monitor INR because flayl increases the effects of warfarin

§  Administer PO dose with food or milk to minimize GI irritation.

§  Administer IV dose as a sloe infusion, each dose over 1 hour. Flagyl IV is pre-diluted and ready to use.

§  Phenobarbital may decrease the effectiveness of metronidazole

§  Cimetidine may decrease the metabolism of metronidazole.

Patient Teaching

§  Avoid alcoholic beverages for 48 hours after treatment. May cause a disulfiram reaction resulting in flushed face, headache, tachycardia, palpitations, hypotension, dyspnea, sweating, slurred speech, abdominal cramping, N/V.

§  Instruct patient to finish full course of medication, and take as directed.

§  Instruct patient that this medication may cause reddish brown urine

§  Instruct patient that this medication may cause a metallic taste

Side Effects:

Dizziness, headache, confusion, depression, irritability, weakness and insomnia