Adverse Effects Of Metronidazole

Question 1. Describe Metronidazole With Special References To Uses In Dentistry.
Answer:

Use Of Metronidazole In Dentistry

Metronidazole in a dose of 200–400 mg TDS is extensively used to treat dental infections because anaerobic bacteria are frequently involved. Certain oral anaerobes not inhibited by penicillin/amoxicillin are susceptible to metronidazole.
It is the drug of choice for ANUG which is often combined with either penicillin V, amoxicillin, erythromycin, or tetracycline. The response is rapid with the disappearance of the causative spirochete fusobacterium complex from the lesions and resolution of pain, bleeding, ulceration, and bad breath within 2 to 3 days. A 5-day course is often sufficient.
Periodontitis, pericoronitis, acute apical infections, and some endodontic infections also respond well to metronidazole given for 5–7 days. Because it is not active against aerobic and facultative bacteria, metronidazole is mostly combined with a penicillin, cephalosporin, or macrolide antibiotic.

Adverse Effects of Metronidazole: Side Effects and Toxicity

Question 2. Describe Important Adverse Effects And Uses Of Metronidazole.
Answer:

Adverse Effects Of Metronidazole

Gastrointestinal: Nausea, anorexia, metallic taste, xerostomia, abdominal cramps. Occasionally there can be vomiting and looseness of stools.
Allergic reactions: Skin rashes, urticaria, itching, and flushing.
CNS effects: Irritability, dizziness, vertigo, confusion. At times convulsions and ataxia may occur. If chronic therapy is given polyneuropathy may occur.
Disulfiam-like reaction: This can occur if metronidazole is taken with alcohol. The patient has nausea, vomiting, abdominal cramps, headache, and flushing.

Metronidazole Side Effects: Nausea, Vomiting, and More

Uses Of Metronidazole

Amoebiasis: Metronidazole is the first-line drug in the treatment of amoebiasis. For invasive dentistry and liver abscess 800 mg TDS is given for 7–10 days. For mild intestinal disease, 400 mg TDS is given for 5–7 days.
Giardiasis: It is highly effective at a dose of 400 mg TDS for 7 days.
Trichomonas vaginitis: It is the drug of choice and is given 400 mg TDS for 7 days.
Anaerobic bacterial infections: These occur after colorectal or pelvic surgery or appendicectomy. Brain abscess and endocarditis may be caused by anaerobic organisms. Metronidazole in combination with gentamycin or cephalosporins is equally effective.
Pseudomembranous enterocolitis: Oral metronidazole 800 mg TDS is effctive.
H. pylori gastritis/Peptic ulcer: Metronidazole 400 mg TDS is frequently used along with amoxicillin/clarithromycin.

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