METRONIDAZOLE

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(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.

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• 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
• CEFUROXIME SODIUM (se-fyoor-ox’eem) Kefurox, Zinacef CEFUROXIME AXETIL Ceftin Classifications: antiinfective; antibiotic; second-generation cephalosporin Prototype: Cefonicid sodium Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Determine history of hypersensitivity reactions to cephalosporins, penicillins, and history of allergies, particularly to drugs, before therapy is initiated. Lab tests: Perform culture and sensitivity tests before
• AMOXICILLIN AND CLAVULANATE POTASSIUM (a-mox-i-sill’in) Augmentin, Augmentin-ES600, Augmentin XR, Clavulin  Classifications: antiinfective; beta-lactam antibiotic; aminopenicillin Prototype: Ampicillin Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Determine previous hypersensitivity reactions to penicillins, cephalosporins, and other allergens prior to therapy. Lab tests: Baseline C&S tests prior to initiation of therapy; start drug pending
• CEPHALEXIN (sef-a-lex’in) Cefanex, Ceporex_A, Keflet, Keflex, Keftab, Novolexin_A Classifications: antiinfective; antibiotic; first-generation cephalosporin Prototype: Cefazolin Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Determine history of hypersensitivity reactions to cephalosporins and penicillin and history of other drug allergies before therapy is initiated. Lab tests: Evaluate renal and hepatic
• CIPROFLOXACIN HYDROCHLORIDE (ci-pro-flox’a-cin) Cipro, Cipro IV, Cipro XR CIPROFLOXACIN OPHTHALMIC Ciloxan Classifications: antiinfective; quinolone antibiotic Pregnancy Category: C NURSING IMPLICATIONS Assessment & Drug Effects Report tendon inflammation or pain. Cipro needs to be discontinued. Lab tests: Culture and sensitivity tests should be done prior to initial dose. Treatment may be implemented