{"id":133,"date":"2019-09-22T17:54:56","date_gmt":"2019-09-22T17:54:56","guid":{"rendered":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/chapter\/3-17-antiprotozoals\/"},"modified":"2021-12-07T11:06:40","modified_gmt":"2021-12-07T11:06:40","slug":"3-17-antiprotozoals","status":"publish","type":"chapter","link":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/chapter\/3-17-antiprotozoals\/","title":{"raw":"3.17 Antiprotozoals","rendered":"3.17 Antiprotozoals"},"content":{"raw":"[caption id=\"\" align=\"aligncenter\" width=\"323\"]\"Microphoto Figure 3.14 Giardia lamblia[\/caption]\n\nAntiprotozoal drugs target infectious protozoans such as Giardia, an intestinal protozoan parasite that infects humans and other mammals, causing severe diarrhea (see Figure 3.14 for a microscopic image of Giardia). [footnote]\"Giardia lamblia SEM 8698 lores.jpg\"<\/a> by CDC\/ Janice Haney Carr is licensed under CC0<\/a>[\/footnote]\n\nIndications:<\/strong>\u00a0 Metronidazole is an example of an antiprotozoal antibacterial medication gel that is commonly used to treat acne rosacea, bacterial vaginosis, or trichomonas. Metronidazole IV is used to treat Giardia and also serious anaerobic bacterial infections such as Clostridium difficile (C-diff).\n\nMechanism of Action:<\/strong> Many antiprotozoal agents work to inhibit protozoan folic acid synthesis, subsequently impairing the protozoal cell.[footnote]This work is a derivative of Microbiology<\/a> by OpenStax<\/a> licensed under CC BY 4.0<\/a>. Access for free at https:\/\/openstax.org\/books\/microbiology\/pages\/1-introduction<\/a>[\/footnote]<\/sup>\n\nSpecial Administration Considerations:<\/strong> It can be administered PO, parenterally, or topically. Orally is the preferred route for GI infections. The nurse should monitor the patient carefully for side effects such as seizures, peripheral neuropathies, and dizziness. Psychotic reactions have been reported with alcoholic patients taking disulfiram.\n\nPatient Teaching & Education<\/strong>\n\nPatients taking antiprotozoal medications should receive education regarding the need for medication compliance and prevention of reinfection.\u00a0 They should be advised that the medication may cause dizziness and dry mouth.\u00a0 Additionally, the medication may cause darkening of the urine.\u00a0 They should also avoid alcoholic beverages during medication therapy to prevent a disulfiram-like reaction.\n\nIf patients are being treated for protozoal infections such as trichomoniasis, they should be advised that sexual partners might be sources of reinfection even if asymptomatic.\u00a0 Partners should also receive treatment.[footnote]uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a>[\/footnote]<\/sup>\n\nPatients teaching should include the avoidance of alcohol during therapy.\n\nNow let's take a closer look at the medication grid in Table 3.17.[footnote]Daily Med, https:\/\/dailymed.nlm.nih.gov\/dailymed\/index.cfm<\/a>, used for hyperlinked medications in this module. Retrieved June 27, 2019[\/footnote]<\/sup>\n\nTable 3.17 Metronidazole Medication Grid\n\n\n\n\n
Class\/Subclass<\/strong><\/th>\nPrototype\/Generic<\/strong><\/th>\nAdministration Considerations<\/strong><\/th>\nTherapeutic Effects<\/strong><\/th>\nSide\/Adverse Effects<\/strong><\/th>\n<\/tr>\n
Antiprotozoal-antibacterial<\/th>\nmetrogel<\/a>\n\nmetronidazole IV<\/a><\/td>\nCheck for allergies\n\nTopical, vaginal, PO, or IV\n\nDon't give by IV push. Infuse over 30 to 60 minutes\n\nContraindications: pregnancy, hypersensitivity, use of alcohol or disulfiram during therapy\n\nUse cautiously with hepatic impairment, blood dyscrasias or CNS diseases<\/td>\nImprovement of symptoms<\/td>\nSeizures\n\nPeripheral neuropathy\n\nPsychotic reactions\n\nHepatotoxicity<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n \n

Critical Thinking Activity 3.17a<\/strong><\/h2>\nUsing the above grid information, consider the following clinical scenario question:<\/strong>\n\nA patient develops C-diff after taking multiple antibiotics for a non-healing wound. What medication is commonly used to treat C-diff, and what route is used?\n\nNote: Answers to the Critical Thinking activities can be found in the \"Answer Key\" sections at the end of the book.","rendered":"
\"Microphoto
Figure 3.14 Giardia lamblia<\/figcaption><\/figure>\n

Antiprotozoal drugs target infectious protozoans such as Giardia, an intestinal protozoan parasite that infects humans and other mammals, causing severe diarrhea (see Figure 3.14 for a microscopic image of Giardia). [1]<\/sup><\/a><\/p>\n

Indications:<\/strong>\u00a0 Metronidazole is an example of an antiprotozoal antibacterial medication gel that is commonly used to treat acne rosacea, bacterial vaginosis, or trichomonas. Metronidazole IV is used to treat Giardia and also serious anaerobic bacterial infections such as Clostridium difficile (C-diff).<\/p>\n

Mechanism of Action:<\/strong> Many antiprotozoal agents work to inhibit protozoan folic acid synthesis, subsequently impairing the protozoal cell.[2]<\/sup><\/a><\/sup><\/p>\n

Special Administration Considerations:<\/strong> It can be administered PO, parenterally, or topically. Orally is the preferred route for GI infections. The nurse should monitor the patient carefully for side effects such as seizures, peripheral neuropathies, and dizziness. Psychotic reactions have been reported with alcoholic patients taking disulfiram.<\/p>\n

Patient Teaching & Education<\/strong><\/p>\n

Patients taking antiprotozoal medications should receive education regarding the need for medication compliance and prevention of reinfection.\u00a0 They should be advised that the medication may cause dizziness and dry mouth.\u00a0 Additionally, the medication may cause darkening of the urine.\u00a0 They should also avoid alcoholic beverages during medication therapy to prevent a disulfiram-like reaction.<\/p>\n

If patients are being treated for protozoal infections such as trichomoniasis, they should be advised that sexual partners might be sources of reinfection even if asymptomatic.\u00a0 Partners should also receive treatment.[3]<\/sup><\/a><\/sup><\/p>\n

Patients teaching should include the avoidance of alcohol during therapy.<\/p>\n

Now let’s take a closer look at the medication grid in Table 3.17.[4]<\/sup><\/a><\/sup><\/p>\n

Table 3.17 Metronidazole Medication Grid<\/p>\n\n\n\n\n
Class\/Subclass<\/strong><\/th>\nPrototype\/Generic<\/strong><\/th>\nAdministration Considerations<\/strong><\/th>\nTherapeutic Effects<\/strong><\/th>\nSide\/Adverse Effects<\/strong><\/th>\n<\/tr>\n
Antiprotozoal-antibacterial<\/th>\nmetrogel<\/a><\/p>\n

metronidazole IV<\/a><\/td>\n

Check for allergies<\/p>\n

Topical, vaginal, PO, or IV<\/p>\n

Don’t give by IV push. Infuse over 30 to 60 minutes<\/p>\n

Contraindications: pregnancy, hypersensitivity, use of alcohol or disulfiram during therapy<\/p>\n

Use cautiously with hepatic impairment, blood dyscrasias or CNS diseases<\/td>\n

Improvement of symptoms<\/td>\nSeizures<\/p>\n

Peripheral neuropathy<\/p>\n

Psychotic reactions<\/p>\n

Hepatotoxicity<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Critical Thinking Activity 3.17a<\/strong><\/h2>\n

Using the above grid information, consider the following clinical scenario question:<\/strong><\/p>\n

A patient develops C-diff after taking multiple antibiotics for a non-healing wound. What medication is commonly used to treat C-diff, and what route is used?<\/p>\n

Note: Answers to the Critical Thinking activities can be found in the “Answer Key” sections at the end of the book.<\/p>\n

  1. \"Giardia lamblia SEM 8698 lores.jpg\"<\/a> by CDC\/ Janice Haney Carr is licensed under CC0<\/a> ↵<\/a><\/li>
  2. This work is a derivative of Microbiology<\/a> by OpenStax<\/a> licensed under CC BY 4.0<\/a>. Access for free at https:\/\/openstax.org\/books\/microbiology\/pages\/1-introduction<\/a> ↵<\/a><\/li>
  3. uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a> ↵<\/a><\/li>
  4. Daily Med, https:\/\/dailymed.nlm.nih.gov\/dailymed\/index.cfm<\/a>, used for hyperlinked medications in this module. Retrieved June 27, 2019 ↵<\/a><\/li><\/ol><\/div>","protected":false},"author":2,"menu_order":17,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":"cc-by"},"chapter-type":[49],"contributor":[],"license":[53],"class_list":["post-133","chapter","type-chapter","status-publish","hentry","chapter-type-numberless","license-cc-by"],"part":84,"_links":{"self":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/133","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/users\/2"}],"version-history":[{"count":1,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/133\/revisions"}],"predecessor-version":[{"id":134,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/133\/revisions\/134"}],"part":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/parts\/84"}],"metadata":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/133\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/media?parent=133"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapter-type?post=133"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/contributor?post=133"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/license?post=133"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}