"Metronidazole": pharmacological group, mechanism of action, indications for use and contraindications

We learn from the article which pharmacological group Metronidazole belongs to and which diseases can be treated with this drug.

It is a medication that relates to antiprotozoal agents with antibacterial functions. The trade name is Metronidazole. This medication is prescribed for etiotropic treatment (treatment aimed at destroying the causative agent of a pathological infectious process) of infectious pathologies of various localization, which are provoked by pathogens sensitive to the active element of the pharmacological agent.

Composition and shape

Not everyone knows the pharmacological group of Metronidazole. This drug is in the form of injectable solutions and tablets. The solutions are poured into plastic bottles and 1 pc. packed in cardboard boxes. The medication contains metronidazole as the main substance.

The composition of the drug is described in detail in the instructions.

The tablets have a white or white color with a green-yellow tint, a flat cylindrical shape and a dividing risk. The main active element of the tablets is metronidazole, the content of which in each of them is 250 mg. In addition, the composition includes additional components - talc, stearic acid, potato starch. The tablets of the medicinal product are packaged in blisters of 20 and 10 pieces. Cardboard packaging contains from 1 to 10 blisters and instructions for use of the drug.

What is the mechanism of action of Metronidazole?

Pharmacological properties

The active substance of this pharmaceutical preparation is a chemical derivative of 5-nitromidazole, which biochemically normalizes the 5-nitro group of transport intracellular proteins of anaerobic bacteria and unicellular protozoa. The reduced 5-nitro group subsequently interacts with DNA, inhibits (inhibits) the synthesis of nucleic acids, which leads to the destruction of microorganisms. The medicine has high activity against a number of pathogenic microorganisms:

• Anaerobic bacteria that can multiply and develop only in the absence of oxygen: Bacteroides spp. (including. Bacteroides distasonis, Bacteroides fragilis, Bacteroides ovatus, Bacteroides vulgatus, Bacteroides thetaiotaomicron,), Fusobacterium spp. and some gram-positive anaerobes (susceptible strains of Peptococcus niger., Eubacterium spp., Clostridium spp., Peptostreptococcus spp.).
• Unicellular protozoan microorganisms sensitive to metronidazole - Entamoeba histolytica, Trichomonas vaginalis, Giardia intestinalis.
• In combination therapy with antibiotics, representatives of the class of semi-synthetic penicillins (Amoxiclav), tablets have a bactericidal effect against pathogens of gastritis and gastric ulcer, for example, Helicobacter pylori.

Aerobic bacteria (which develop only in the presence of oxygen) and optional (optional) anaerobes are not sensitive to the drug.

The mechanism of action of Metronidazole is quite simple. After taking this pharmacological drug inside, the main active element is rapidly and almost completely absorbed into the systemic circulation from the small intestine and uniformly penetrates the body tissues and central nervous system structures through the blood-brain barrier and breast milk during the lactation process. There is a metabolic process in the liver cells to inactive decay products, which are excreted through the urinary system.

Indications for the use of the drug "Metronidazole"

A pharmacological agent is indicated for the etiotropic treatment of infectious pathologies caused by pathogenic microorganisms sensitive to it:

• infectious protozoal diseases - trichomoniasis (an inflammatory process in the organs of the urogenital tract), extraintestinal amebiasis, including damage to the liver with the formation of abscesses in it (a limited cavity filled with pus), intestinal amebiasis (an inflammatory process that affects the large intestine);
• infectious processes provoked by anaerobic microbes, in particular, bacteroids - abscessed inflammation of the central nervous system, endocarditis (inflammation of the inner layer of the bones of the bone tissue), meningitis (inflammation of the brain or spinal cord), pneumonia, lung abscess, sepsis;
• pathological processes caused by anaerobes peptostreptococci and clostridia - pathologies of internal organs, including liver abscess and peritonitis, damage to the pelvic organs (endometritis, abscesses of the fallopian tubes and ovaries, damage to the vaginal vault);
• with complex therapy of peptic ulcer;
• elimination of the risk of infectious complications after surgical interventions on the large intestine;
• pseudomembranous colitis, which is a specific inflammatory process that affects the walls of the colon, which is often triggered by prolonged use of antibiotics.

In addition, the drug is used in the complex treatment of tumor pathologies requiring radiation.

Below we consider the instructions for the use of Metronidazole in gynecology.

Gynecological practice

This tool is also available in the form of vaginal gels, which are widely used along with the systemic use of the drug in the field of gynecology. The drug is prescribed in the presence of the following pathological processes:

• an abscess of the fallopian tubes or ovaries;
• infectious diseases of the vaginal fornix and ovaries;
• trichomoniasis;
• endometritis;
• Trichomonas or bacterial vaginitis;
• urethritis.

It is highly advisable to use the drug for the prevention of gynecological inflammation in the postoperative periods.

Are there any contraindications for Metronidazole?

Contraindications

Acceptance of this drug is contraindicated in several physiological and pathological conditions, which include:

• intolerance to metronidazole or additional components of the drug in question;
• organic pathologies of the CNS structures associated with structural disorders in the tissues, including epilepsy (the occurrence of tonic-clonic seizures in the form of seizures);
• liver failure, especially in the case of the appointment of high doses of the drug;
• I trimester of pregnancy, lactation.

With some caution, the medication should be used in the II and III trimesters of bearing a child, as well as with an average degree of liver and kidney failure. Contraindications "Metronidazole" must be taken into account.

Dosage and administration

Injections of Metronidazole are indicated for severe stages of the infectious process, as well as the inability to take the drug orally. Tablets are taken during or after meals, not chewed, washed down with any liquid (preferably milk).

How to use according to the instructions for use of Metronidazole in gynecology? Suppositories and vaginal gel are used once a day, usually before bedtime.

The average dose for trichomoniasis is 250 mg for 10 days or 400 mg 2 times a day for 5-7 days. In severe forms of the disease, it is recommended to repeat the therapeutic course with tablets, increasing the daily dosage to 1000 mg. The time interval between courses is 3-4 weeks.

The dosage of Metronidazole for adults and children is as follows:

• children under 1 year of age are prescribed 125 mg per day;
• 2-4 years - 250 mg;
• 5-8 years - 375 mg;
• over 8 years old and adults - 500 mg in two divided doses.

For the treatment of amoebiasis, the dose of the drug can be increased to 3 g per day in three divided doses, the course of therapy is 5-7 days.

With liver abscesses - 2.5 g 2 times, 3-5 days with concomitant treatment with other antibacterial drugs (for example, tetracyclines).

In the treatment of pseudomembranous colitis, the dose of the drug is 500 mg 3 times a day. In severe infections, the dosage can be increased to 2 g per day.

Treatment of gastric ulcer associated with Helicobacterpylori should include the use of this pharmacological drug in doses of 500 mg 3 times a day for one week. In the presence of liver or kidney failure, the dosage is usually reduced.

We examined all methods of using Metronidazole.

Side effects

Acceptance of funds can lead to the occurrence of some undesirable phenomena on the part of certain systems and organs:

1. Digestive system: dyspepsia, diarrhea or constipation, intestinal colic, dry mouth and a “metallic” taste in the mouth, inflammatory reactions of the oral mucosa (stomatitis), tongue (glossitis) and gums (gingivitis).
2. Nervous system: cephalalgia, change in coordination of movements, excessive irritability and irritability, depressive states (prolonged decline in mood), general weakness, insomnia, decreased ability to work, hallucinations, confusion, convulsions.
3. Red bone marrow and blood: a decrease in the number of neutrophils and white blood cells.
4. Genitourinary organs: candidiasis (activation of a pathogenic infection in the body), inflammation of the bladder, (increased volume of excreted urine), urinary incontinence, red and brown urine.
5. Allergic phenomena: skin rashes, accompanied by itching, hives, nasal congestion, allergic fever (high fever), arthralgia (joint pain),

If negative side effects occur, the medicine may be canceled.

Drug Interactions "Metronidazole"

The effect of indirect anticoagulants is enhanced by taking the medication. Concomitant use with lithium preparations leads to an increase in the concentration of the latter in the blood and the development of intoxication. The effects of metronidazole are reduced by phenytoin and phenobarbital, since the liver microsomal system is activated and metabolism and excretion are accelerated. Cimetidine inhibits the metabolism of metronidazole, which leads to an increase in its concentration in the blood serum and the risk of side effects. Are Metronidazole tablets and alcohol compatible? The medication should not be combined with alcohol (this will lead to an antabuse-like syndrome). Concomitant use with disulfiram provokes the development of various neurological symptoms. Combination with non-depolarizing muscle relaxants (vecuronium bromide) is not recommended. Sulfanilamides enhances the antimicrobial effect of metronidazole.

Special recommendations

Before taking this medication, you should carefully study the annotation to it. There is also a list of specific recommendations to which you should pay attention:

1. During the period of therapy, the use of alcohol is contraindicated, since ethanol is capable of provoking the development of spastic abdominal pain, dyspeptic symptoms, flushing of the face and cephalgia.
2. The use of the drug "Metronidazole" in combination with amoxicillin up to 18 years is not recommended.
3. With a long therapeutic course, regular laboratory monitoring of the blood condition should be carried out.
4. Ataxia, dizziness and other neurological disorders require discontinuation of this medication.
5. "Metronidazole" from the pharmacological group of antiprotozoal agents can provoke a dark color in the urine.
6. During the treatment of trichomoniasis of the urogenital tract, abstinence from sexual contact is recommended, as well as treatment with a sexual partner.
7. During menstruation, the use of the medication continues.
8. After the treatment of giardiasis, the symptoms of the pathological process can persist for a month, therefore, monitoring the effectiveness of the treatment process is carried out using laboratory tests.
9. In the treatment with this pharmacological agent, work requiring high concentration of attention, as well as the speed of mental and motor reactions, should be abandoned.

Overdose symptoms

With a significant increase in the therapeutic recommended dosage of the drug, severe nausea, vomiting, impaired functioning of the nervous system, and epileptic seizures may develop. In such cases, symptomatic therapy is carried out.

The average cost of a pharmacological agent, depending on the form of release and dosage, may vary, and is approximately 10-130 rubles.

Analogs

The following medications are similar for the Metronidazole drug in terms of the active element and therapeutic effect:

1. "Trichopolum" is a medicine that is produced in tablet form and contains the substance metronidazole as the main element of exposure. This pharmacological drug is prescribed to patients in the treatment of trichomoniasis, bacterial vaginosis, giardiasis, amoebiasis (pathology of intestinal and other localization, including amoebic dysentery), ulcerative gingivitis, infectious periodontal pathologies, gynecological diseases provoked by anaerobic flora, sepsis, endocarditis, respiratory organs, endocarditis .d.
2. "Klion" is a medicine that belongs to the category of antimicrobial and antiprotozoal medicines derived from 5-nitroimidazole. Its action is to restore the 5-nitro group of metronidazole transport proteins inside the cells of simple microorganisms. A medical device can provoke disulfiram-like reactions. It is prescribed for a variety of infectious processes of internal organs, including the pelvis.
3. "Metrogil" is a medication that is an absolute analogue of the drug "Metronidazole", but is available exclusively in the form of gels that are applied intravaginally. This pharmacological agent is used in gynecological medical practice in the treatment of infectious processes of the female genital area.

Reviews

This medicine has been produced for many decades by a wide variety of pharmaceutical companies, both foreign and domestic. The experience of its use is burning that this tool is the main and most effective in the treatment of a variety of bacterial infections.

Patient reviews reflect the information that Metronidazole very well helps with any diseases that are associated with the introduction into the body of an infection that is sensitive to its basic substance.

Women who used this medicine for gynecological diseases noted its effectiveness and good tolerance. They say that the pathological symptoms of female inflammation during treatment become less pronounced after a few days of admission, and subsequently completely disappear.

As for the side effects from the use of Metronidazole from the pharmacological group of antiprotozoal drugs, almost all patients tolerated it well, with the exception of some rare cases when the drug caused slight dizziness, nausea, and stool disorders. However, such phenomena were observed only in the initial stages of therapy.