METRONIDAZOLE and ALBENDAZOLE

Metronidazole

Mechanism of Action

• It interferes with DNA-function of anaerobic microorganisms and amoeba, by forming cytotoxic substances.
• The Nitro-Group of Metronidazoleaccepts electrons, forming reduced cytotoxic compounds that bind to proteins and DNA of microorganisms. This leads disruption of DNA-structure causing lysis of cell.

Indication:

• Amoebic dysentry caused by Entamoeba histolytica.
• Amoebic liver abscess.
• Trichomoniasis, refractory trichomoniasis.
• Giardiasis,
• Gynecologic infections, Bone and joint infection due to anaerobic bacteria.

Dose:

• Adult:
  • For Dysentry and Anaerobic Infection: 400 mg tds for 7 days
  • Amoebic Liver Abscess: 800mg tds for 10 days
  • Anaerobic Infection: IV 500mg tds for 7 days
• Child:
  • Intestinal Amoeabiasis and Amoebic Liver Abscess: 10-15 mg/kg eight hourly for 10 days
  • Anaerobic Infection: 7.5mg/kg tds

Contraindication:

First trimester of pregnancy, active CNS disease, severe hepatic disease.

Side Effect:

Seizures, headach, dizziness, leukopenia, thrombocytopenia, aplastic anaemia, metallic taste (unpleasant taste), diarrhoea, anorexia, furry tongue, nausea, vomiting, diorrhoea, dry mouth, abdominal cramps, dark urine, superinfection, mood changes, vision changes

Nursing Consideration

• Before swallowing, an oral pill should not be crushed. With a glass of water, it needs to be completely consumed.
• To lessen GI distress, it should be taken with food or milk after meals.
• One dosage of IV solution should be administered gently per hour. Watch for phlebitis at the IV site and keep an eye on your CBC and LFTs.
• Well before administration, suspension rattles.
• Tell them they must finish the entire therapy program.
• If your patient exhibits any neurologic symptoms (such as numbness, paresthesia, weakness, ataxia, or seizures), keep an eye on them and let your doctor know.
• Recommend to trichomoniasis patients receiving treatment that sexual partners may be asymptomatic sources of reinfection and should receive treatment at the same time.
• When using Metronidazole, avoid drinking alcohol since it may produce a disulfiram response.
• After cleaning the area, rub a small amount of the topical preparation into the affected area.
• Inform the patient that possible symptoms include dark or reddish brown urine, nausea, vomiting, and a metallic taste.
• may make the patient groggy or dizzy, making it unsafe for them to drive.

Albendazole

It is a benzimidazole carbamate derivative drug.

Mechanism of Action

It acts by blocking the glucose uptake in the parasite and depletion of glycogen storage. Intracellular microtubules in the cells of worm are gradually lost. Hatching of parasite eggs and their development may be hampered. Affected parasites are expelled with the faeces.

Indication

• Round worm, hook worm, pin worm, tape worm, tape worm infestation Adjunct to surgery in hydatid cysts caused by Echinococcus granulosus or Echinococcus multilocularis.

Dose

• Adult and Child over 2yrs: 400mg hs single dose.
• Hydatid cysts (echinococcus): 400mg bid for 28 days. The therapy may be repeated after 14 days interval for a total 3 cycles.
• Neurocysticercosis: 15mg / k * g / d * ay one month.
• Strongyloidiasis/taeniasis/H.nana infestations: 400 mg od for three days

Child:1-2 yrs: intestinal nematode infections 200 mg hs single dose.

Contraindication

1st trimester pregnancy, children under 1 year

Side Effect

GI disturbances, nausea, vomiting abdominal pain, headache, dizziness, chages in liver enzymes, alopecia, seizure, vision problems.

Nursing Consideration

• Meals should be consumed with the oral dosage. A fatty meal dramatically increases absorption.
• Tell the patient to chew or crush their albendazole before taking it. Avoid taking the pill whole.
• Before administration, the suspension should be well shaken.
• While using albendazole for a long time, complete blood counts and liver function tests are conducted. If hepatic enzyme levels significantly rise, stop the therapy.
• If your blood cell count decreases in a clinically significant way, call your doctor right away.
• test for pregnancy in women with reproductive potential before treatment
• Neurocysticercosis patients should get the proper steroid and anticonvulsant medication as needed. During the first week of treatment, oral or intravenous corticosteroids should be taken into consideration to prevent cerebral hypertensive episodes.
• All family members should be examined and treated at the same time because pinworms are easily passed from one person to another.