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USMLE : Metronidazole

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Anti Microbial drug

Metronidazole metronidazole is an antibiotic and antiprotozoal drug metronidazole kills bacterial cells and protozoal cells by free radical mediated damage to their dna metronidazole is used to treat anaerobic infections below the level of diaphragm one most important thing that you should note here if metronidazole ends with azole there are other drugs also that

Ends with azole for example clot re muscle and methi masol clautrimazole is an anti-fungal drug whereas methymazole is used to treat hyperthyroidism so you should not confuse between metronidazole clottery mussol and methimazole so please do not confuse this azole of metronidazole with chlorimazole fluconazole and methymazole mechanism of action free radical

Mediated damage to dna of bacterial and protozoal cell here this free radical mediated damage is very very important clinical uses anaerobic infections above the level of diaphragm are treated with clindamycin whereas anaerobic infections below the level of diaphragm are treated with metronidazole some common examples for anaerobes are fusobacterium actinomyces

Clostridium bacteroides metronidazole is used to treat giardia infections giardia causes non-bloody fall-smelling fatty diarrhea diagnosis can be made by cysts or trophozoites with many nuclei seen in stools most important thing is people who are deficient in iga i g a type of antibody are at increased risk for gr diastasis it is also used to treat and damage

Histolytical infections and damoiba causes bloody diarrhea here in giardia it was non-bloody whereas in endemia it is bloody it is very very important that you make this difference and diamaiba also causes abscess in liver on colon biopsy you can see flask shaped ulcer this is apex of the ulcer and this is base of the ulcer metronidazole is used to treat common

Vaginal infections like bacterial vaginosis and trichomonas vaginitis here in trichomonas vaginitis we already know that itis i this means inflammation so there will be an inflamed red cervix whereas in vaginosis there is no itis so there will there won’t be any inflammation so bacterial vaginosis is caused by gardenerella vaginalis that is a biomorphic gram

Variable rod bacteria whereas trichomonas virginity vaginitis is caused by trichomonas vaginis it is a protozoa vaginosis is not sexually transmitted hence there is no need to treat sexual partner whereas vaginitis is sexually transmitted hence the sexual partner must also be treated again here in vaginas there is no inflammation whereas here in vaginitis there

Will be inflamed red cervix we also call it as strawberry cervix in vaginosis there will be white discharge with fishy smell whereas in vaginitis there will be grainish fall smelling discharge from the vagina in bacterial vaginosis if you mix white discharge with potassium hydroxide solution there will be more fishy order this test is called a mine wave test

On microscopy you can also see vaginal epithelial cells covered with gardenerella these cells are also called as glue cells in vaginitis on microscopy you can see motile trophozoites in the discharge metronidazole is used to treat h pylori infection in patients who have penicillin allergy h pylori causes gastritis and deodorant ulcers h pylori is a risk factor

For malt lymphoma and gastric adenocarcinoma contraindication do not give metronidazole with alcohol as it causes disulfiram like reaction other drugs that also show this reaction with alcohol are chloropropamide tall butamite these are first generation sulfonyl ureas and which are antibiotic anti-diabetic drugs cephalosporins also show disulfiram-like reaction

Glycophorvin and procarbazine also shows disulfiram like reaction thank you if

Transcribed from video
USMLE : Metronidazole By Dr WRK