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mae oa Metronidazole ge teas ano. Flagyl 200 8x 4x15 Tablets ED anvote metronidazole (flagyl) ojga Jleiollaic Meu sorllarc digoto ‘gai Rx Metronidazole Tablets |.P. Flagyl° 400 sats 100 9x 4x15 Tablets PEERY Antimicrobial drugs. Lecture:12 Metronidazole & tinidazole No sa; lagls gau03 9! 9>y2d lagls ou >! metronidazoleJ! 6) 8 9¢4a! antibiotics J! Yalss bb 12; antibiotics! ssl .§ metronidazole)! 4 “23 o4<9 penicillinJ! Wad galls 03S Araze 09% antibiotics Hl Bras ye ell co 092 ot anti-protozoal drug 252 4 9cly Slo! Gaol dels SU hy eS 46 protozoal 844 25M golasuul 3 035 tyme dd shy Ly cS! yo gue ELAS le Jarre ail clade cyaiil dam SS 8 ass of dyad God layls (Ametronidazole (Flagyl) (Atinidazole ay Wh Joss Ajrle tog 2.0%! 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Gléls dy.t0 duaS) metabolism .4@ lo gh Jodl 8 S33 unchanged (Excretion: IPUTI 4g gle! 5331 Jo dle while lesa alll gal os Jigudl rll ail 9! vs gol urine JS! 8 Jee ols L metronidazoleJ! ail dygat amy Sotum WPad UTI ge sdruw ard Sao alsi glac Igals ly) UI claw! 09a 1i2 metronidazole! anaerobic joe 09% .anaerobic organism J! 42 ..anaerobic bacteriaJ! eu3 Gasiyg Stusl Wil layac anaerobic Jl yibans le paz lal UTI J! lalsg 2 JS sae 9! E.coli! elo aerobic bacteriaJl Jorx visa UTI puis sole hx Soo to 4 .aerobic bacteria prciuan le dyac adil yil 345 anaerobic 4! hI dao Mall (ue lail UT] 91¢ 1>19 EMI metronidazole wil gia GUL a5 ol) ga 44 Ul urine J! 8 Jia la! 9zely metabolite J! bL>! urine brown color!) 22 urineJ! 8 Jie HI %30J! 2 da) Jodl 80 dark brown color 9! deep brown s! 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(requiring aceeptor of its nitro group oo ferum 039 DNA damage Jes: e929 radical 443 anaerobic organism J! 1) cour LYE ye lle Glo 4 hud ySiao aslo cube 1? metronidazole Jl 3s gl See Jo 03 APY! yoluee Lol yl yayilee le dyes Y SLY ..(PFOR) V7 abuse J Lol yamuS gl le yiuey Lo! aerobic Kaus LYE gl 30s al yuelexe Yio Krebs cycle aul dele Gc 2 > Ug Aue Yo gus Ysg>90 pha 090 GO ao l> od aapul lado UI SLI JS aerobic bacteriaJ! Josue 0 metronidazoleJ! 2 yele _.5 44 (PFOR) pesca royals inert & o9@ 4) 4a.5 Y oS 9.u83 metronidazole J! 999 g2 Ail go eee Breall gzled alld dels cl dole inactive Joxx9 electrones wuxSQ) 03 JRL reduction Islan. (free radicals J! metronidazole) 258 (gale yay oi>9 8yq0 Sos g98 UI UI fy dled! UI cle metronidazole J! Iai (Cosgdl Jausl dy qual! >) Wad Walls dn ole 32) inactive GLa b Jad! Ayla ail Le gj 04S dyke 45 UI nitro groupJ! y2 De Lond lee at JSs2 be Sol free radical sles asa nitro-reduction slele asa: PFOR sau! Ul axis! 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(2 le 45 Elbd Je Jled metronidazole! .bacteria 128 aul Jasd Sao Lyell eSgll go Lal ‘ob: metronidazole resistance! 9! 4ckall yobs ers YAN of elo Joss Mas Joled Lil Jol dayybll 5 Lys Jss4 (2sl2e metronidazoleJ! to develop certain mechanism [gil :¢3LII 483 )bII ot! iy Le ye eloall g 54 (223 pumping out Jasz [gfialim de uu) dum Lalor Jorg Lys yo 230 clout giles: le ail Cass (effluxd] gj de Iglanza) Is loo sbaig JS I9H>5 toxic molecule J! Jsxx:9 PFOR enzymeJ! pg Seo cBal po cdl WU juris all Jos 42 metronidazole! gous! UI asSZ! le 8 mutation Lary ySae Jo uub JI metronidazole S! Jorg Usysa0 099 i] Cao PFOR 1? toxic compound wn BMY Le sylo ue 05 gil 12 SLol g2tsbo 09m igztsbbg ale LilS oS ail oY ~~ electrones Jay 24 dl 924.59 09 oxidoreductase metronidazole! 3.2 3403 Sys. le ojac arpzly ha J ba wld! lem (gle Joti Ul normal substrateJ! sw 2 catia mutation Jest (gil slsozul yolasion Lyla 440 (gd laxc metabolism dub critical esi! S33 vx» 4 generation of ATP! ..§ 3 enzymeJ! te oraiae oetiybll resistance! sshze ayo lal Wle gzol uo edule ell 95 UI _ spectrum: WALL anaerobic bacteria: «98a anaerobic bacteriaJ! IS wee !2gram positive 49 gram negative 95.2 Pe GT! '?bacilli Ja cocci s954 WPosS Jodie: a oH Clindamycin saul gS Ul clo! ge9 dee gy ylac lJ (Lincosamides 8,l2) 7 3) 92.4,4)1 8 Ioz> pcb UI Syled lars UI dq 40 04 ClindamycinJ! ai! -L9s ai] elldg lgogs 4 anaerobic bacteriaJ! te anaerobic gram negative J! cx. Clindamycin! SWI wow isl& bacteria JS cle aud unig Slew! metronidazole! os;lau! anaerobic J! 3 %99) lgclsil JS: anaerobic bacteria! lab (metronidazoleJt: ste bacteria bactericidal +!) 94> 4 Ui! UI JSJl; metronidazole J! .DNAJ! 3239 Joo ad (ZEntamoeba histolytica: intestinal Lbesx UI protozoa gs Gia & byw Yio os pel lolg>9 protozoa {gil & a> egud lail amebiasis entamoebaJ! anaerobic 42 923) y2 PFOR go! I WW ag Ul aM Wolge B icyareuS gl le tiyars Le go toxic J! Jaxx metronidazoleJ! (PFOR) &all! -95 |giga19 Compound (Atricomonas vaginalis: 9.5) dey Blels Glad! se genital infection Jaxx UI (git (PFOR) 02 e282! 5 protozoa 52» T.vaginalisJ! [Qe4 metronidazoleJ! 4 anaerobic (Giardia lambilia: 9 abdominal colic pglasxg JUbW ae Il \gs3 952 GiardiaJ! GIT (WS 045 Sl» malabsorption g intestinal parasite 42 95); 045 entamoebaJ! <3 (4 Csgazm9 03 PFORJ! 4.8 9.59 protozoal Ubloge GLe L metronidazoleJ! 42 «metronidazole J! 09% 039 «sls5 anti-protozoal 99M 03 us antibacterial wleguds 251 Igolsszus! |_therapeutic uses: WAALL anaerobic infections: sensitivity 9 culture I9laco infection sxe asl 4 gl anaerobic ¢ infection)! Igldele UI Ly eS cud eud ud yg Swill Suda Job Je bacteria metronidazole orally s+ «metronidazole (Flagyl )J! anaerobic infection 09% Wlb lail agJl 3 Sle OW Gare siya> metronidazoleJ! 22: IV gasstud Jas] 8hr JS 9! 12hr JS sod! S lal) (giles vials 100ml «+ -severityS! wus Je I? anaerobic infectionsS! «2! <3 peritonitis: anaerobic J! a2 2 mixed infection «4 peritonitis J! -bacteria - dental infection - gas gangrene je Bots Lol yl ca AS jodl Gaul bo LS elle aSla Ul Lail bacterial asl D> lor glo die’ SIS alll S females) Siu uw 2>l «3 BVJI vaginosis (BV) oe Lalo vaginaJ! 8 bacterial overgrowth aglore case lim. 0159 discharge Je229 anaerobic 4) vaginal discharge lwsic il lla.ogi 045 os>o) osylinw BV J! dele dyg.all Use 223 yl Syle tuog 12.4 al ede aa, cuuys UI le gj anaerobic bacteria g» BV Wlb I9)95 gol 5331 metronidazole >Me go9 eds¢9 33-6 js839 agdl S Sle SM metronidazole oral tab J! cream «+ s9>9« metronidazole! docal application ..Wash 420 39>949 dle Garey jule docal application io Josd cu! sa discharge l@.:29 pregnant 3 Cuil yl Uois9 dLuall Whol 953 35! dire tuto Ig)q8 yl Byle hog ol IgJ98 Hpregnant 2 Jel 4 Wa «metronidazole oral vileaue Y pregnancy! Gallé aiSitie tude 09a Syle LI wJSlica I (intestinal amebiasis: Gas Ul intestinal amebiasis 945 s> gd gossius GS Bya> Us Lhes UIE histolyticaJ! 65 48 Goyal! Cub yoga lye GM 098 metronidazole lol 443 allall JS 3 metronidazoleJ! Jos3 I?mg — 250mg ~ 500mg 250mg! 25 Gl agall B lye OMG Goj8 asly Lal Lol B ALT Boll yur gud ys pow S Sle SM double 500mg ol IS} ay gil clo! gy Ul Ul indications! aur le a alolc9 intestinal amebiasis Ys E.histolytica J)lsi ..04S bacterial vaginosis! <3 application 7-5 396 AS yao all 10 si bys ye T.vaginalisS! lay ao Toil poy a Sb So rdall Toil 9S 9 abl dlele 43 trichomonasJ!9 sexually transmitted ¢3 52 sla oo Talla Te Sem cud! 4 13.59! 4 infection (AGiardia lambilia infections: oe Saty Jab ie) Jab Ole I3! giardia lambiliaJ! Jub Iglilac auily popu Lyslsg jlyaxuls abdominal colic -Ul89 stool analysis J! 3 05 laboratory JI 59:52 Weg sob ae Lo Giardia lambilia 9x 41 os yt clos Ax1 Sao 09m l/l metronidazole orally Pll 5-3 eye Lee A Gs Ball Guy Gye OW oj pro diilee | adverse effects: common ad.effects with metronidazole: ~ GIT upset: Suis Ahem ySeo metronidazoleSb alex UI Ways metalic taste 9! daz gilt 059 Nausea & vomiting ws et > 98; B Agize alec bbl> gilS 045 jv pab 22) Gh BS Gaye pab Jase 03 Somscs Ul cloall sgSa3 Mods metalic taste saul os clad] wytl Byle jhe muall ole din si5|5209 very Common 9 G@Nausea vomiting (metalic taste - neurological toxicity: (See BBBJ! 54209 metronidazole small molecule! gt headache aalS Jol yo bag brainJ! 2 sae gl lea, vo 8 Oss Nias jSyo ute 42 confusion ¢lre chy aly La! 55 yao ylexodl edji9 metronidazole! Jo 95 yS yao vertigo gurus chy Aly jSyo sulieg 035 (4420 S93) seizures del etm gs LS Ag ad rem ihee gs E pall Arg) Guy 21 epilepsy 9-2< already .w! patient!) brain JI 42 gl Jas Seo Gls b metronidazoleJ! oJ Ul ee Ute gs seizures)! 4 including seizures JlbYl a2) 8 Epo ue already o9% patientJ! yS ..metronidazole,J! !gs+! le 12: ease epilepsy S! jasasl pila yasutze sho uw epilepsy oie lS Veo Jib 5 Le canal gl Lo Syl ig pall Elgil ya Goi gase Lgl ol ytd yoza ghSo y95sl ely abdomen! 3 all gl ye Saal ol Bys5 by 389 Eyall dy93 glee 945 ba metronidazole crcl wlSe wt epilepsy orc fol 5 o9@ os Jab! le metronidazole J! 431 Uh ss Wo! Lm yo Ay Wh ghiad Sao ¢ pall 4395 GY epilepsy ove iyo GI eS @headache @confusion @vertigo G induced epilepsy episodes Drrare ad.effects with metronidazole: alse dys [gil Bol gusd Gus Syghsll axe BOLL ao ~ Steven Johnson syndrome: GI sulfonamide! ely G8 MI gua) Job Le sacl 4.0 lI Steven Johnson syndrome ge Jroadlh sual LSSI lal yIS .alil8 auulu> severe skin reactions lols. Liss severe plastering dS sau> 805 aldo ayo ale Steven esd ySeo «549 mucus Membrane 9 eYe.0 -extremely rare J Johnson e>x ¢» steven JohnsonJ! o! Jss reports 5 we saul i clos olee 15.9 metronidazole 2+ yall 9! 55! Lud azil clos La L os mebendazoleJ! «mebendazole gly IgeSy Lo! antiparasitic drug 0 as tusawe ..mebendazoleJ! ad! acy JS.2 ySeo metronidazole)! go e419 aitig) 5 Stl oJ 05 reports! JS 3 Steven Johnson syndrome & ysl! steven ss metronidazole! 4! 32 Gssxy I 4 «mebendazoleJ! olze Si! ai] eSsle cilS Johnson le gle Jaxts azilg 0s combination J! ¢¢ Wh 136 AlStead lal 2d ssi BM suppression: canemiaJ! Elsi yo €95 Jess metronidazoleJ! jSoo itis Bod! yu25 4S) thrombocytopenia Jac Yeo 4.395 rare PEApts Assi ola Uly.,

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