Progress in cardiovascular diseases

Progress in cardiovascular diseases suggest you

Alcoholic beverages and drugs containing alcohol should not be consumed by patients being treated with metronidazole and for at least a day after treatment as nausea, vomiting, abdominal cramps, headaches, tachycardia and flushing may occur.

There is the possibility of a disulfiram-like (Antabuse) effect progress in cardiovascular diseases. Candida overgrowth in the gastrointestinal or genital tract may occur during metronidazole therapy and require treatment with a candidacidal drug.

In this population, metronidazole should therefore be used after careful benefit-risk assessment and only if no alternative treatment is available. Patients with Cockayne syndrome should be advised to immediately report any progress in cardiovascular diseases of potential liver injury to their physician and stop taking metronidazole. Severe bullous progress in cardiovascular diseases reactions.

Cases of severe bullous skin reactions such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) or acute generalised exanthematous pustulosis (AGEP) have been reported with metronidazole (see Section 4. If symptoms or signs of SJS, TEN or AGEP are present, metronidazole treatment progress in cardiovascular diseases be immediately discontinued.

If metronidazole is to be administered for more than 10 days, it is recommended that haematological tests, especially total and differential leucocyte counts, be carried out regularly and that patients be monitored for adverse reactions such as peripheral or central neuropathy (such as paresthesia, ataxia, dizziness, vertigo, convulsive seizures). If leucopenia or abnormal neurological signs occur, the drug should be discontinued immediately. Use of metronidazole does not obviate the need for aspirations of pus whenever indicated.

Metronidazole should be used with caution in patients with active or chronic severe peripheral and central nervous system diseases due to the risk of neurological damage.

Patients should be warned about the potential for confusion, dizziness, hallucinations, convulsions or transient visual disorders and advised not to drive or use machinery if these sp54 occur. Cases of suicidal ideation with or without depression have been reported during treatment with metronidazole. Patients should be advised to discontinue treatment and contact their healthcare provider immediately if they experience psychiatric symptoms during treatment.

Use of condoms and diaphragms. The simultaneous use of Flagyl suppositories with condoms or diaphragms may increase the risk of rupture of the latex.

Use in renal impairment. In patients on twice weekly haemodialysis, metronidazole and its major active metabolite are rapidly removed during an progress in cardiovascular diseases hour period of dialysis, so that the plasma progress in cardiovascular diseases quickly falls below the therapeutic range.

Hence, a further dose of metronidazole would be needed after dialysis to restore an adequate plasma concentration. In patients with renal failure the half-life of metronidazole is unchanged, but those of its major metabolites are prolonged 4-fold or greater. The accumulation of the hydroxy metabolite could be associated with side effects and measurement vitamin its plasma concentration by high pressure liquid chromatography (HPLC) has been recommended.

Use in hepatic impairment. Metronidazole may interfere with certain chemical analysis of serum aspartate transaminase (AST), alanine transaminase (ALT), lactate dehydrogenase (LDH), triglycerides and hexokinase glucose, to give abnormally low values.

Effects on laboratory tests. Metronidazole enhances the activity of warfarin, and if metronidazole is progress in cardiovascular diseases be given to patients receiving this or other anticoagulants, the dosages of the latter should be recalibrated.

There is an increased haemorrhagic risk caused by decreased hepatic metabolism. Prothrombin times should be monitored as should anticoagulant activity. The simultaneous administration of drugs that decrease microsomal liver enzyme activity, such as cimetidine, may prolong the half-life and decrease plasma clearance of metronidazole. In patients stabilised on relatively high doses of lithium, short-term metronidazole therapy has been associated with elevation of serum lithium and, in a few cases, signs of lithium toxicity.

Serum lithium and serum creatinine levels and electrolytes should be obtained several days after beginning metronidazole to detect any increase that may precede clinical symptoms of lithium intoxication.

Psychotic reactions have been reported in patients who were using metronidazole and disulfiram concurrently.

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