METRONIDAZOLE

(me-troe-ni’da-zole)
Flagyl, Flagyl ER, Flagyl IV RTU, Flagyl 375, Metizol, Metric 21, Metro I.V., MetroGel, MetroGel Vaginal, MetroLotion, Noritate, Protostat
Classifications: antiinfective; antitrichomonal; amebicide; antibiotic
Pregnancy Category: B

NURSING IMPLICATIONS

Assessment & Drug Effects

Discontinue therapy immediately if symptoms of CNS toxicity (see Appendix F) develop. Monitor especially for seizures and peripheral neuropathy (e.g., numbness and paresthesia of extremities).
Lab tests: Obtain total and differential WBC counts before, during, and after therapy, especially if a second course is necessary.
Monitor for S&S of sodium retention, especially in patients on corticosteroid therapy or with a history of CHF.
Monitor patients on lithium for elevated lithium levels.
Report appearance of candidiasis or its becoming more prominent with therapy to physician promptly.
Repeat feces examinations, usually up to 3 mo, to ensure that amebae have been eliminated.

Patient & Family Education

Adhere closely to the established regimen without schedule interruption or changing the dose.
Refrain from intercourse during therapy for trichomoniasis unless male partner wears a condom to prevent reinfection.
Have sexual partners receive concurrent treatment. Asymptomatic trichomoniasis in the male is a frequent source of reinfection of the female.
Do not drink alcohol during therapy; may induce a disulfiram-type reaction (see Appendix F). Avoid alcohol or alcohol-containing medications for at least 48 h after treatment is completed.
Urine may appear dark or reddish brown (especially with higher than recommended doses). This appears to have no clinical significance.
Report symptoms of candidal overgrowth: Furry tongue, color changes of tongue, glossitis, stomatitis; vaginitis, curd-like, milky vaginal discharge; proctitis. Treatment with a candidacidal agent may be indicated.
Do not breast feed while taking this drug.