Doctor’s order / Generic Name / Mode of Action indication contraindication Adverse effect Nursing

Classification responsibility

Doctors order: Undergoes Metronidazole is Breastfeeding, Adverse Reactions •Use cautiously in

Metronidazole 500mg/tab 1 tab intracellular one of the hypersensitivity to CNS: Aseptic patients with
3x a day chemical reduction mainstay drugs for metronidazole or its meningitis central nervous
Genetic name: Flagyl during anaerobic the treatment of components, (parenteral form), system diseases.
Classification: Antibiotic, metabolism. After anaerobic bacterial trichomoniasis ataxia, confusion, •Give I.V. drug by
antiprotozoal metronidazole is infections, during first depression, slow infusion over
reduced, it damages protozoal trimester of dizziness, 1 hour; don’t give
DNA’s helical infections, and pregnancy encephalopathy, by direct I.V.
structure and microaerophilic fever, headache, injection.
breaks its strands, bacterial incoordination, •Discontinue
which inhibits infections. It is insomnia, primary I.V.
bacterial nucleic a cytotoxic to irritability, infusion during
facultative lightheadedness, metronidazole
anaerobic peripheral infusion. •Monitor
microorganisms. neuropathy, patient with
seizures (high severe liver
doses), syncope, disease because
weakness, vertigo slowed
EENT: Dry mouth, metronidazole
lacrimation (topical metabolism may
form), metallic cause drug to
taste, nasal accumulate in
congestion, optic body and increase
neuropathy, the risk of adverse
pharyngitis GI: effects. •If skin
Abdominal cramps irritation occurs,
or pain, anorexia, apply topical
diarrhea, nausea, metronidazole gel
pancreatitis, less frequently or
vomiting GU: Dark discontinue it, as
urine, vaginal ordered. needed.
candidiasis (oral, •Monitor patient’s
parenteral, and neurologic status
topical forms); throughout
burning or irritation metronidazole
of sexual partner’s therapy. If
penis, candidal abnormal
cervicitis or symptoms occur
vaginitis, dysuria, discontinue drug
dryness of vagina or patient teaching
vulva, urinary •Instruct female
frequency, vulvitis patient to notify
(vaginal form) prescriber if she is
HEME: Leukopenia pregnant, intends
MS: Back pain, to get pregnant,
dysarthria SKIN: or is
Burning or stinging breastfeeding.
sensation, dry skin •Urge patient to
(topical form); take
erythema, flushing, metronidazole at
pruritus, rash, evenly spaced
Stevens-Johnson intervals during
syndrome, toxic the day and with
epidermal food to minimize
necrolysis, urticaria adverse GI
(oral and parenteral reactions. •Urge
forms) Other: patient to
Injection-site complete the
edema, pain, or entire course of
tenderness therapy. •Advise
patient to avoid
hazardous
activities until
drug’s CNS effects
are known and to
report any
abnormal
neurologic signs
or symptoms,
such as weakness,
numbness,
seizures, or vision
changes. •Instruct
patient to notify
prescriber if no
improvement
occurs within a
few days of taking
tablets or
capsules. •Direct
patient using
topical gel to wash
hands and
affected area with
a mild,
nonirritating
cleaner; to rinse
well and pat dry;
and then to apply
a thin film of drug
and wash hands
again. •Advise
patient with
rosacea to keep
topical gel away
from his eyes. If
drug gets into his
eyes, urge him to
wash them
immediately with
large amounts of
cool tap water and
to call prescriber if
eyes continue to
hurt or burn.
•Teach patient
how to fill, insert,
and clean vaginal
cream or gel
applicator after
use. Instruct her
to wash her hands
before and after
administration. •
•Inform patient
with
trichomoniasis
that her male
sexual partners
should wear
condoms during
her treatment and
that they may
need treatment
themselves to
prevent
reinfection.