Main representative

The main representative of the nitromidazoles is metromidazole.

Classification

This substance belongs to the group of nitroimidazoles. In addition to metronidazole, this relatively small group of substances also includes the drugs tinidazole and nimorazole. Metronidazole is also known under the trade name ClontR. It is a standard drug and a cooperative drug in the treatment of anaerobic infections. Metronidazole is tissue-permeable and can be administered as a short infusion (via the venous blood system), in tablet form (oral), as a suppository (rectal) and vaginally.

effect

Metronidazole inhibits the nucleic synthesis of anaerobically growing bacteria and protozoa (single cells). Compared to the antibiotics of other groups of substances, the nitroimidazoles are the only ones that work in this way. The drug works by inhibiting it kills bacteria.

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Areas of application

Metronidazole and the other drugs in the nitroimidazole group are primarily effective against anaerobically growing germs and protozoa (unicellular organisms). Apart from actinomycetes and propionibacteria, metronidazole is effective in all anaerobically growing bacteria. Among the protozoa, Entamoeba histolytika, Trichomonas vaginalis and Gardia lamblia should be mentioned. In addition, metronidazole acts against the Gardenella vaginalis germ, which mainly causes gynecological infections.

Areas of application are gastrointestinal and vaginal infections and abscesses caused by anaerobes as well as prophylactic before gastrointestinal interventions and gynecological operations. Also for non-infectious gastrointestinal diseases, such as inflammatory bowel diseases Crohn's disease and Ulcerative colitis Metronidazole is used.

Side effects

Above all, complaints of the gastrointestinal tract, especially stomatitis and glossitis, must be feared. Taste irritation and an especially metallic taste when taking metronidazole have also already been described. In addition, these drugs interact with alcohol and cause alcohol intolerance. Neurological complaints have also been observed, including a headache, dizziness, Unsteady gait (ataxia) and sensory disorders (neuropathy). A carcinogenic effect could be demonstrated in animal experiments. Since the drug is in the liver is metabolized and excreted in the urine, a urine coloration is to be expected during ingestion.

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Please also read our article on this Antibiotic side effects

Interactions

As mentioned above, metronidazole should not be used because of the development of intolerance alcohol be combined. If the drugs barbiturates and phenytoin are administered at the same time, a faster breakdown of metronidazole and the resulting weakened effect must be expected due to the acceleration of the enzymes. If blood thinners (anticoagulants) are combined with metronidazole, an interaction and an increased tendency to bleed must be expected. When treating depression with lithium, there is a risk that the lithium level will rise dangerously high as a result of a combination with nitroimidazoles and cause side effects.

Contraindications

At Diseases of central nervous system or the hematopoietic system as well as severe liver disease, pregnancy and Lactation Metronidazole and similar preparations from the same group of substances should not be administered.


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