Week 10: Metronidazole, Tinidazole, and Topical Agents Flashcards
Metronidazole MOA/Indiations
Flagyl
- interacts with DNA structure causing strand breakage, inhibition of protein synthesis, and cell death - broad spectrum (bacterial and fungal)
Indications: C. diff, bacterial vaginosis, stool infections, trichomoniasis (think below the belt infections) - anaerobic, protozoans, fungals
Metronidazole ADRs
- metallic tast
- dark urine
- hepatotoxicity
- superinfections (rare)
Metronidazole cautions/CIs/pt education
- do not use in the 1st trimester of pregnancy
- take with food
- avoid alcohol during and for 2 days after tx (can cause disulfiram rx: N/V, H/A, flushing, dizziness, chest and abdominal discomfort)
- BBW: potentially carcinogenic
Tinidazole MOA/indications
- thought to cause cytotoxicity by damaging DNA and preventing DNA synthesis - newer, more expensive
Indications: bacterial vaginosis, trichomoniasis - more for fungal, protozoan, parasitic infections - not as much bacterial
Tinidazole cautions/CIs
- avoid in pregnancy
- BBW: potentially carcinogenic
Impetigo treatment
Mupirocin (Bactroban) topically 3x/day for 5-14 days for up to 5 lesions
Cephalexin (oral) if there are 5 or more impetigo lesions
Oral medication options for skin lesions
- give if moderate to severe impetigo (5 or more lesions), boils, perianal strep, cellulitis
cephalexin, bactrim (amox/clavulanate), dicloxacillin
If MRSA skin infection is suspected: CBD (cephalexin, bactrim, doxycycline)
Oral candidiasis treatment
- nystatin or clotrimazole loxenges
Topical antifungal agents
- used to treat vulvovaginal yeast infections
- topical miconazole and clotrimazole - Fluconazole oral (systemic) x 1 dose
Topical treatment of tinea pedis (athlete’s foot) or tinea corporis (ringworm)
- thin layer of terbinafine, miconazole, ketoconazole, clotrimazole - use BID - wash hands well before and after use
Topical herpes simplex treatment
- topical acyclovir (zovirax) , penciclovir (denavir, and OTC docosanol (Abreva)
- start as soon as possible
