Metronidazole
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Antibiotics / Antiparasitics
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- Polymyxins
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- Trimethoprim
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- Daptomycin
- Metronidazole
- Rifamycins (Rifampin, Rifabutin)
- Isoniazid
- Pyrazinamide
- Ethambutol
- Chloroquine
Summary
Metronidazole is an antibiotic medication used to treat a wide variety of parasitic and bacterial infections. It works by creating free radicals, which bind to and damage DNA in pathogens. Adverse effects of metronidazole include a disulfiram-like reaction to alcohol, as well as a metallic taste in the mouth.
Key Points
- Metronidazole
- Mechanism
- Forms toxic free radicals in the bacterial cell wall that damage DNA
- Bactericidal, antiprotozoal
- Clinical Use
- Giardia
- Entamoeba histolytica
- Trichomonas vaginalis
- Gardnerella vaginalis
- Anaerobes (Bacteroides, C. difficile)
- Used to treat anaerobic infections below the diaphragm (clindamycin used above)
- H. pylori (in patients with penicillin allergies)
- Adverse Effects
- Disulfiram-like reaction with alcohol
- Due to inhibition of acetaldehyde dehydrogenase, a toxic buildup of acetaldehyde occurs
- Presents with severe flushing, tachycardia, hypotension
- Metallic taste in mouth
- GI upset (nausea, vomiting, abdominal pain)
- Neuropathy (paresthesias, dizziness)
- Headache
- Disulfiram-like reaction with alcohol
- Mechanism