The mechanism of action of metronidazole is in biochemical restoration of 5-nitro group of metronidazole by intracellular transport proteins of anaerobic microorganisms and protozoa. The recovered 5-nitro group of metronidazole interacts with nandrolone phenylpropionate profile microbial cells by inhibiting synthesis of nucleic acids, which leads to the death of the bacteria.
When administered intravenously, 500 mg of metronidazole over 20 minutes anaerobic infection in patients with serum drug concentration one hour was 35.2 g / ml after 4 hours – 33.9 ug / ml 8 through watches – 25.7 ug / ml. The drug has a high penetrating power, achieving bactericidal concentrations in most tissues and body fluids, including the lungs, kidneys, liver, skin, spinal fluid, brain, bile, saliva, amniotic fluid, oral abscesses, vaginal secretions, semen, breast milk . Binding to blood proteins weak and does not exceed 10-20%. In normal bile concentration of metronidazole in bile after intravenous administration can significantly exceed the concentration in the blood plasma metronidazole.
Excretion metronidazole carried kidney nandrolone phenylpropionate profile(20% of drug is excreted in unaltered form). The half-life of metronidazole is 6-7 hours. Renal clearance of 10.2 ml / min. In patients with impaired renal function after repeated administration of the drug may be a cumulation of metronidazole in blood serum. Therefore, in patients with severe renal insufficiency receiving frequency of metronidazole should be reduced.
Metronidazole, solution for infusion is indicated for the treatment of infections caused by susceptible to malaria infections:
- prevention and treatment of anaerobic infections in surgical interventions, mainly in the abdominal organs and urinary tract;
- Combination therapy of severe mixed aerobic-anaerobic infections; severe intestinal and hepatic amoebiasis;
- gynecological infections;
- pelvic abscesses and brain;
- abscessed pneumonia;
- gas gangrene;
- infections of skin and soft tissues, bones and joints.
- Hypersensitivity to nandrolone phenylpropionate profile metronidazole or other nitroimidazole derivatives;
- organic lesions of the central nervous system (including epilepsy);
- leukopenia (including history);
- hepatic insufficiency (in the case of the appointment of high doses);
- I trimester of pregnancy;
- pregnancy trimesters II and III (only for health reasons);
- renal and / or hepatic impairment.
Use during pregnancy and lactation
Metronidazole crosses the placenta and should not be prescribed the drug in the first trimester of pregnancy, in the future should only be used if the potential benefits of the drug for the mother than the potential risk to the fetus.
Because Metronidazole passes into breast milk, reaching its concentration close concentration in the blood plasma, it is recommended to stop breast-feeding during treatment with the drug.
Dosing and Administration
Intravenous metronidazole is indicated for severe infections, as well as the absence of the possibility of taking the drug inside.
Single dose of 500 mg, the rate nandrolone phenylpropionate profile of intravenous continuous (jet) or drip over 12 years for adults and children – 5 ml per minute. The interval between injections – 8 hours. Duration of treatment is determined individually. The maximum daily dose – not more than 4 g According to testimony, depending on the nature of the infection, make the transition to maintenance therapy with oral metronidazole forms.
Children under 12 years of metronidazole administered 7.5 mg / kg of body weight in 3 divided doses at a rate of 5 ml . per minute
for the prevention of anaerobic infections before elective surgery on the pelvic organs and the urinary tract in adults and children over 12 years of metronidazole administered in the form of infusion at a dose of 500-1000 mg, in the day of surgery and the next day – 1500 mg / day ( 500 mg every 8 hours). After 1-2 days usually move on to maintenance therapy with oral metronidazole forms. Children under 12 years recommended the introduction of metronidazole intravenously in the same manner at a dose of 7.5 mg / kg body weight. The maximum daily dose in children aged up to 12 years -. 22.5 mg / kg body weight
For patients with severe renal impairment (creatinine clearance less than 30 ml / min) and / or liver daily dose of metronidazole is 1000 mg, the multiplicity of the introduction of 2 times.
Metronidazole, the solution for infusion is not recommended to mix with other drugs!
From the gastrointestinal tract: epigastric pain, nausea, vomiting, diarrhea, constipation, intestinal colic, loss of appetite, anorexia, taste disturbance, unpleasant “metallic” taste in the mouth, dry mouth, glossitis, stomatitis; very rarely – abnormal test results on liver function, cholestatic hepatitis, jaundice, pancreatitis. On the part of the central nervous system: long-term use – headache, dizziness, incoordination, ataxia, peripheral neuropathy, anxiety, irritability, depression , sleep disturbance, drowsiness, weakness; in some cases – confusion, hallucinations, convulsions; very rarely – encephalopathy.From the urogenital system: dysuria, cystitis, polyuria, urinary incontinence, vulvovaginal candidiasis, pain in the vagina, urine staining in red-brown color. Allergic reactions: skin rash, pruritus, urticaria, erythema multiforme exudative, nasal congestion ., fever From the musculoskeletal system: . myalgia, arthralgia From the hematopoietic system: leukopenia; rarely – agranulocytosis, neutropenia, thrombocytopenia, pancytopenia. Local reactions: thrombophlebitis (pain, redness or swelling at the injection site). Other: flattening of the T wave in the nandrolone phenylpropionate profile; rarely – ototoxicity; pustular rash; gynecomastia.