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
PEERYAntimicrobial 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%! EY! 090 05 tinidazoleJ!
tinidazoleJl Ulage tuo We ozaall oga a go)
le 9 gauulis metronidazole! 8 lagls Jlgud! tle.
go ydum MN eV! judi yrel o9@ 4 tinidazole 8 Jlgul
..metronidazole J! eleSy4ll (tinidazole) s2o°l EY! te Sdeuwe Lyall psi jus
ed alle WL ulate oo 8 Legal Y day Sle eeiy
gausl UI Lae gall clowll le 359 tinidazoleJ!
Say Wdlbs pS Csi clos Ld lL 04 9 metronidazole
43 Ubu yorzaall ail Bylo 8:18 pS
lals B undergraduate Ub goto! 2! ld oa daulall Ul
eee p92 IS Ung pos JS dotium All AzosAl B gira)
od Igimcel tues anticancer drugs J! 3 Wes Igimzel
Lagls Lo! uy dage .@ CSS lg antiarrythmic drugs!
.postgraduate J! lad gozai gs duos! ss
| structure:
(cog Jal Byqall Lod!) 03 clolad UI structure!
membered ring-5 442 ¢3 Wastes ail UI dpulasdt aalodl
cnedl le es jmidazoleJ! imidazole ring oan.
Jladd! le «Slag methyl group 42 UI CH3¥
sag OXYGEN Cal 8 Suse Ul aro rth
imidazole z+ methyl group Ls yas: le gs dls!
ellslias LYS! _§ 035 aglls! Nitro group zg ring
degame yo Uh sb Ajsle LI 39) metronidazole
WIS oll aun oe of oxygen gel 3 Sule2 Nitro groupJ! 2 202 metronidazoleJ! 4.4:
ks bos Lolsd UI moleculeJ! ges WL slg
very small 2: 137Da s¢lz molecular weight J!
libs hae Bydo dol 22) 300 oe JS! 22) molecule
ral By Gad Gals gicly kinetics! ae
complete .4. sls absorptionJI
BBB g32.0f4
Laail very small M.wt 259 gl sleeb placenta g2.0f]
SLs bh
cle 535) bla metronidazoleJ! ely JSadl cas be sa)
oles 08 LY ylic NitroJ! 4c 90-0pharmacokinetics:
absorption:
very small 2: 137Da °52 M.wtJ! al elld98 UI
%100 9g 9) 32s
WS Gly.
J metronidazole)! ++ las 25% lactating s>9 wb
WP 05 2d 30 Ul ad! cle Byghas 8
wl gd) dled.
ool 5483 UI dy955l yo metronidazole J!
.breastfeedingS!
(metabolism:diver! 8 sel metabolismJ! I 8 dsl JS 53 925
metabolism J! extensive olsen be liver J! ost! ju
ass 035 golgl te gisly liver! 22: dittle sely
kidney J! us $35 dyaSd! 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) ga44 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!
OOD lott qialed Sy o> asild Glas Arsall Sao 5 gale
(gin yd tendo pegmentS Jorte clos! cloall yo os
tala Log 04 oll Mase 2 lig) UI pegmentS! yal
162 USSU! go galls
clin drgastt
joo (4) lil Mechanism of actionJ! 3 Js4 be 15
AyS83 am yig 03S ull 8 apg Apacs 10) dygct ular |
gauss oasledl LI gS ID a) ad agalacls gail dele cla IL
lad go deglaall Mechanism of actionJ! ..3 8422 doglao
gpl lel B iss wl she! dely Slogledl 4c
lagls Oxidation & reduction aalS wos 045 glo} 8 lS
Gals oy) glo} cylirze LS «6 9iB9 gilacl co lo} yjSau cAls
Hydrogen !#bs2 reduction 9 oxygen l#ks. Oxidation
GS W which is absolutely wrong 45 gulsxe LS WS
wero yo 09 aS! gy! LS jc 8)
Oxidation J! 431 Wold daal> dls yo clog Lal azilg
29 oxygenJlL ary by uo 03 reductionJls
in Jes2 oxidationS! ¢Sao os Walle hydrogenJtabsence of oxygen J!sreduction }e>2 in absence of
hydrogen ls!
bauiyo 03 € 9.590)! reductionJl9 4 oxidation! WE
compound A & sauc ubiya> 9) 12) electronesSL
compound JI gs SBo SI! ach oJ cliye> compound B
Lodi ode 8 LW Sous de (qze 3) bg eS axe cL 0s A
oxidized e+e! compound J! lia al Joa eb
AylSodl pus Yely pogiall & cs ULI! 5 Oxidation 4.
lig .electrones &!S> a4ylSoJ! SY oxygen 41> yo a
cab oxidation Jorx 23! 84 electrones ¢33
hut i Sa) TOD q Welggll 8 jubazay S Sg wg
448 clad ait 18 ol electron acceptor ogauu 443
..electrones
reduced 8x9 gl>oy5 9) 448 chtee Sg SII UI CSyall
laisse Oxidation 4/5 44 reduction gha> ail ae Sli ol
bo) GlS! lobes reduction dalS lg nS ¢ 35
L5ySS y935s4 ollly ed g59 2891s gina Lec} lab polurzo
OIL RIG go 4alS\ jS28) jtamludd le gle slo) Sle by
(Zo: Oxidation
MAI: is
LAL: loss of electronesWAR: Reduction
MAI: is
(AG: Gain of electrones
Mechanism J! ..3 s220 32 adage doglaa 4 Abi )S5 3)
«G9 egleal! a>y! JI of action
|mechanism of action:
JS Lal 3 pale A metronidazole cuhel 9) bias
Iglar. los active uptake Jase gau> 5 UI Lyd
active V loss le LyuSJI 23 active uptake
$5 19sSaxm 44 221 small molecule 52 32 mechanism
44a Ul gs small! ole bJls glucoseJ!s amino acidJ!
ulalas Jalexzs
CSS clgw clos uptake Jere LyeSdl Eloi guar gil
gram ¢! gram positive » anaerobic 9! aerobic
Yo Jauiue 40 metronidazole! slo! lia YI negative
anaerobic ¢! anaerobic organism! 5 4! 40.5 Iino
anaerobic g! «yc bys 2» organism
bo Jol gt 1) 4 od wlg> Jaxt.@ metronidazole!
.PFOR sau! e235! bla Lyd! [543 metronidazoleJ!PFOR: pyruvate ferrotoxin oxidoreductase
WP lglaa>! 252 (PFOR) 05 eaidl Jo ub
MW S3l Sao ye a> Igbsed of UL!
ssé 4 Mechanism J! gc 0/5 “9819 metronidazoleJ!
sae ea Pl Lda 1) ad (PFOR) 05 bz! LBS 495 lo
3 39>90 5.¢ 48 anaerobic bacteriaJ! 8 YI »9>96
ad 9.2) aerobic Ly yl 8 s9>90 Yo Laue LYS
24
ckrebs cycle! ieg gue Jlaall ys2l og os eapY! gL
44 UI ATP auai iol y! IDb.uc krebs cycle! 4&9 4!
oS 40 energy generation! 9! energy productionJ!
| salele oxygenJ! ge Jolzzi Y anaerobic bacteriaJ!
-Wigag oxygen J! os Gal guru 9th dle
ATP 982 VP 8 lil ATP 39S SI ATP 39S ojule aa
Ely Jpléall os ...yut95 (PFOR) seus! Ul aiid Sac Luas
lat ly wists Lo g3 (PFOR) 02 355! Lae krebs cycle!
ldlbeg dail 488 anaerobic organism! .3 YI 399 jhe
SS Ul os Lae (oxidoreductase) O45 sau! yo cl95
Hl cla S_drgn#t) gic ells 98 I background! lbs!
(835anaerobic J! Ly .SJl 19> 9244169 (PFOR) a2b2! lio
oxidation & reduction! wes! ¢0 dLuls Jass 928) 9
I> OLS yo yo Gg Sash Jloc grabs 123 22) po
Bg SIH betty grabo 3 cS! SUS yal gdoosg yy Sst
SW compound yo Sa II! Ldteg Lo cliily Ligh Lim co
oliyouw UNS ATP! generation joss Jlec SLU
in the same time WS SlLlesl! Jaren ai! oxidoreductase
0s e2NW 8Yo9 Ly wSUI 19> Js metronidazole! be!
s>/ metronidazole J! 4! 2.0 (PFOR) e232! (PFOR)
gels substrates JI s>/ Lalas Jolaxy I aminoacid!
C9! suo Gt pgs 045 oy oI 3} electrone J bat S
aug co [gas UI Nitro groupW! sox gus IP_&
lox cag dinmuSgl: 598 yo Susle Ul eld y3II die ayia
gre 9 l8 dSuslo
T9H Slo agai co Nitro groupsH sol cay le Jol
lag tinea yzall S ably UI Shyu 9 hagsos
double bond J! asa electrones Ionut go SkaraS oil
3S uruS ol 3 ui] double bond J! Wb .uss
goles S3ISAI ail, 99320 sural gL MDa tars 23 240
wench ay clues asd 33
elgg! B oS cyelyall Ssegd .gia Elys Oyu 04S ailIgSutey dale 9849 Nuns Lay be sod (Sp uSl UI bondJ!)
23.03 jbaial) Jog Lill 3 CSyo gl call pce 13) clad
Ul Joi dS metronidazoleJ! ¢4z molecule! al ok2«
17.4! 32: free radical¥J! free radical
Jody le gh Bile a hts co moleculeJ! a 32
daly lS utd ojyle igs dirwS Ml 1g 4tlo 3 9>9)
oF gp DNAS sae Que da Ly eS! 8 BdLam Lie a.m
3 floating 41 Syle ail le cj Ly ed! gly DNAJ!
tbgate DNAS! Laue Ws 8 Lire >! cytoplasmJ!
Ll «nucleus JS! 442 UI nuclear membrane Wau! 4>by
os membrane J! sle.8 Le nucleus led be Ly SI
pyle cytoplasm! 4 ele 045 DNA floating)! Wa
03 PFORJ! 09% I aypal Gam
aalS 8555 leo electrones ~X metronidazole J! 5
osS aad us Jodi uyao Sao os electrones wuS2
reduction Igla> .035 Laail xe (reduction IsLa>)
islSe tas oxidoreductase gous! lil agi Ssclua;
cytotoxic free J! 4 Joo bail 035 Jans ail jolls Ios0d
radicals03 Elly os EL! co. LAY JS 22: cytotoxic!
DNA Islas29 DNAS! 8 I9Sutes (Out UT bondsJ!)
anaerobic organismJ! _$ ¥l s4 ling damage
gous QUI ayPUl Ma seo are oye of Le elgus
Ig8uu5 23% oxidoreductase J94%e9 oxidoreductase
pyruvate ferrotoxin 5945 pyruvate ferrotoxin 4a
..PFOR Js43 9! oxidoreductase
metronidazole! 24 (PFOR) a2}! lia s>93 lax
Le! UI a bIb9 toxic compound J! siscluas Jorxm
by ) 9! (by reduction of its Nitro group) ss !aW95
free J! Jsxx. (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 gl30s 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!
JS two oxygen atoms! le 03 pool yop [sso
free radical J! J9a59 yo SII Oss aru]
toxic molecule 4 942; Je 95 015 moleculeS! eo!
035 le (DNA damage !9las3 co s39 Yur DNAS! So
aalS I’?metronidazole prodrugJ! s+! 538! Ja »9Ssy
general J! dey Slag aI S glo} lolie 4 b>! prodrug
lol ol Aygsill le Sly Place 03 prodrugJ! ld 959
VP aal 222 Age gall 93 Guys Quauis
Saclua; Jor a inactive ded! gio 4 YS clos us)
cab vactive ele MI Lyell 8 ol pull 8 055 iil ol
..prodrug J! os
!2metronidazoleJ! Ne Stay 09 995 hl Jo ub
sol gLol gs dalSIl (S940! prodrug aalS 03 es dled
oS Led! 8 at metronidazole! 052 gue ada
Il Jad 092 UI activation Ise>9 inactive compound
anaerobic bacteria! !9> J+ la) 445 toxic compoundfree radical J! Ilo Ul esd! a gle
| bacterial resistance:
17 g09lii9 resistance 410 13 U ¢ Sao byw! Jo
oss lQul sod Bol uurdg die eo gas 03 Guy (See agi
anaerobic J! (2 le 45 Elbd Je Jled metronidazole!
.bacteria
128 aul Jasd Sao Lyell eSgll go Lal
‘ob: metronidazole resistance! 9! 4ckall yobsers 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! sw2 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 UISyled 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 JeI? 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 application7-5 396 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 5Le 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 Johnsone>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.,