Therapeutic Uses Of Metronidazole

Therapeutic Uses Of Metronidazole

Question 1. Mention The Basic Use Of Metronidazole In oral-dental infections.
Answer:

Metronidazole is of very high value in anaerobic or dental infections caused due to Bacteroides spp, Borrelia vincenti, Fusobacterium, Peptostreptococcus, and various other anaerobic microorganisms.

• Metronidazole is used in the treatment of alveolar abscesses, pericoronitis, periodontitis, etc.
• Metronidazole is used in acute ulcerative gingivitis or Vincent’s angina. It is given as 200 to 400 mg for a week. The drug is highly effective in Vincent’s angina as it is secreted in the saliva.

Question 2. Write In Short On Metronidazole.
Or
Write A Short Note On Metronidazole.
Or
Write a Short Note On The Therapeutic Uses Of Metronidazole.
Answer:

• It is a highly active amoebicide.
• It has broad-spectrum tidal activity against protozoa, including Giardia lamblia in addition to the above two.
• Many anaerobic bacteria, such as Bacteroides fragilis, Clostridium perfringens, Helicobacter pyroli, spirochetes, and anaerobic Streptococci are sensitive.

Metronidazole Mechanism Of Action

Metronidazole Pharmacokinetics

Metronidazole can be given orally, IV, and topically. The drug is well absorbed after oral administration and is poorly bound to plasma proteins.

Metronidazole diffuses well into the tissues, including the brain. Its therapeutic levels are achieved in saliva, semen, vaginal secretion, bile, breast milk, and cerebrospinal fluid.

The drug is metabolized in the liver, and metabolites are secreted in the urine.

Metronidazole Adverse Effects

• 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 give,n polyneuropathy may occur.
• Disulfiram–like reaction: This can occur if metronidazole is taken with alcohol. The patient has nausea, vomiting, abdominal cramps, headache, and flushing.

Therapeutic Uses of Metronidazole: Indications and Applications

Metronidazole Contraindications

It is contraindicated in:

• Neurological diseases
• Blood dyscrasias
• The first trimester of pregnancy
• Chronic alcoholism.

Metronidazole Uses

• 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 effective.
• H. pylori gastritis/Peptic ulcer: Metronidazole 400 mg TDS is frequently used along with amoxicillin/clarithromycin.

Metronidazole: Uses in Amoebiasis, Trichomoniasis, and More

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.