{"id":127,"date":"2019-09-22T17:54:56","date_gmt":"2019-09-22T17:54:56","guid":{"rendered":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/chapter\/3-17-antiprotozoals\/"},"modified":"2025-01-16T22:25:13","modified_gmt":"2025-01-16T22:25:13","slug":"3-17-antiprotozoals","status":"publish","type":"chapter","link":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/chapter\/3-17-antiprotozoals\/","title":{"raw":"3.17 Antiprotozoals","rendered":"3.17 Antiprotozoals"},"content":{"raw":"Antiprotozoal drugs target infectious protozoans such as <em>Giardia<\/em>, an intestinal protozoan parasite that infects humans and other mammals, causing severe diarrhea (see Figure 3.12 for a microscopic image of giardia).<sup>[footnote] \u201c<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Giardia_lamblia_SEM_8698_lores.jpg\" target=\"_blank\" rel=\"noopener noreferrer\">Giardia lamblia SEM 8698 lores.jpg<\/a>\u201d by CDC\/ Janice Haney Carr is licensed under <a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/cc0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC0<\/a>[\/footnote]<\/sup>\n\n[caption id=\"\" align=\"aligncenter\" width=\"323\"]<img title=\"&quot;Giardia lamblia SEM 8698 lores.jpg&quot; by CDC\/ Janice Haney Carr is licensed under CC0\" src=\"https:\/\/pressbooks.ccconline.org\/accdigitalmarketing\/wp-content\/uploads\/sites\/219\/2019\/09\/image16.png\" alt=\"Microphoto showing Giardia lamblia\" width=\"323\" height=\"327\"> Figure 3.12 Giardia Lamblia[\/caption]\n\n<strong>Mechanism of Action:<\/strong> Many antiprotozoal agents work to inhibit protozoan folic acid synthesis, subsequently impairing the protozoal cell.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/cnx.org\/contents\/5CvTdmJL@7.1:rFziotaH@5\/Introduction\" target=\"_blank\" rel=\"noopener noreferrer\">Microbiology<\/a> by <a href=\"https:\/\/openstax.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">OpenStax<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>. Access for free at <a href=\"https:\/\/openstax.org\/books\/microbiology\/pages\/1-introduction\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/openstax.org\/books\/microbiology\/pages\/1-introduction<\/a>[\/footnote]<\/sup>\n\n<strong>Indications:<\/strong> 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 <em>Clostridium difficile<\/em> (C-diff).\n\n<strong>Nursing Considerations:<\/strong> It can be administered PO, parenterally, or topically. Orally is the preferred route for GI infections. The nurse should monitor the client carefully for side effects and adverse effects. Psychotic reactions have been reported with clients with alcohol substance disorder taking disulfiram.\n\n<strong>Side Effects\/Adverse Effects: <\/strong>Side effects include dizziness and dry mouth. Adverse effects include seizures, peripheral neuropathy, psychotic reactions, and hepatotoxicity.\n\n<strong>Health Teaching &amp; Health Promotion: <\/strong>Clients taking antiprotozoal medications should receive health teaching regarding the need for medication compliance and prevention of reinfection. They should be advised that the medication may cause dizziness and dry mouth. Additionally, the medication may cause darkening of the urine. They should also avoid alcoholic beverages during medication therapy to prevent a disulfiram-like reaction. If clients are being treated for protozoal infections such as trichomoniasis, they should be advised that sexual partners might be sources of reinfection even if asymptomatic. Partners should also receive treatment.<sup>[footnote]uCentral from Unbound Medicine. <a href=\"https:\/\/www.unboundmedicine.com\/ucentral\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.unboundmedicine.com\/ucentral<\/a>[\/footnote] <\/sup>Client 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.<sup>[footnote]This work is a derivative of\u00a0<a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/\" target=\"_blank\" rel=\"noopener\">DailyMed<\/a>\u00a0by\u00a0<a href=\"https:\/\/www.nlm.nih.gov\/\" target=\"_blank\" rel=\"noopener\">U.S. National Library of Medicine<\/a>\u00a0in the\u00a0<a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/\" target=\"_blank\" rel=\"noopener\">Public Domain.<\/a>[\/footnote]<\/sup>\n\nTable 3.17 Metronidazole Medication Grid\n<table class=\"grid\">\n<tbody>\n<tr>\n<th class=\"shaded\" scope=\"col\"><strong>Class\/Subclass<\/strong><\/th>\n<th class=\"shaded\" scope=\"col\"><strong>Prototype\/Generic<\/strong><\/th>\n<th class=\"shaded\" scope=\"col\"><strong>Nursing \u00a0Considerations<\/strong><\/th>\n<th class=\"shaded\" scope=\"col\"><strong>Therapeutic Effects<\/strong><\/th>\n<th class=\"shaded\" scope=\"col\"><strong>Side\/Adverse Effects<\/strong><\/th>\n<\/tr>\n<tr>\n<td scope=\"row\"><strong>Antiprotozoal-Antibacterial<\/strong><\/td>\n<td><a class=\"arrow\" href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/index.cfm\" target=\"_blank\" rel=\"noopener noreferrer\">metrogel<\/a>\n\n<a class=\"arrow\" href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=d2112f37-5080-4a19-bcc3-6386b49abe1d\" target=\"_blank\" rel=\"noopener noreferrer\">metronidazole IV<\/a><\/td>\n<td>Check 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, or use of alcohol or disulfiram during therapy\n\nUse cautiously with hepatic impairment, blood dyscrasias, or CNS diseases<\/td>\n<td>Improvement of symptoms<\/td>\n<td>Seizures\n\nPeripheral neuropathy\n\nPsychotic reactions\n\nHepatotoxicity<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<div class=\"textbox textbox--examples\"><header class=\"textbox__header\">\n<h2>Critical Thinking Activity 3.17<img class=\"alignright size-thumbnail wp-image-67\" src=\"https:\/\/pressbooks.ccconline.org\/accdigitalmarketing\/wp-content\/uploads\/sites\/219\/2019\/10\/ORN-Icons_internet-copy_internet-copy-300x300-1-150x150.png\" alt=\"Image of a circle containing a speech bubble with a question mark in it.\" width=\"150\" height=\"150\"><\/h2>\n<\/header>\n<div class=\"textbox__content\" style=\"text-align: left;\">\n\n<strong>Using the above grid information, consider the following clinical scenario question:<\/strong>\n\nA client develops C-diff after taking multiple antibiotics for a nonhealing 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 \u201c<a href=\"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/chapter\/chapter-3\/\" target=\"_blank\" rel=\"noopener\">Answer Key<\/a>\u201d section at the end of the book.\n\n<\/div>\n<\/div>","rendered":"<p>Antiprotozoal drugs target infectious protozoans such as <em>Giardia<\/em>, an intestinal protozoan parasite that infects humans and other mammals, causing severe diarrhea (see Figure 3.12 for a microscopic image of giardia).<sup><a class=\"footnote\" title=\"\u201cGiardia lamblia SEM 8698 lores.jpg\u201d by CDC\/ Janice Haney Carr is licensed under CC0\" id=\"return-footnote-127-1\" href=\"#footnote-127-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a><\/sup><\/p>\n<figure style=\"width: 323px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" title=\"&quot;Giardia lamblia SEM 8698 lores.jpg&quot; by CDC\/ Janice Haney Carr is licensed under CC0\" src=\"https:\/\/pressbooks.ccconline.org\/accdigitalmarketing\/wp-content\/uploads\/sites\/219\/2019\/09\/image16.png\" alt=\"Microphoto showing Giardia lamblia\" width=\"323\" height=\"327\" \/><figcaption class=\"wp-caption-text\">Figure 3.12 Giardia Lamblia<\/figcaption><\/figure>\n<p><strong>Mechanism of Action:<\/strong> Many antiprotozoal agents work to inhibit protozoan folic acid synthesis, subsequently impairing the protozoal cell.<sup><a class=\"footnote\" title=\"This work is a derivative of Microbiology by OpenStax licensed under CC BY 4.0. Access for free at https:\/\/openstax.org\/books\/microbiology\/pages\/1-introduction\" id=\"return-footnote-127-2\" href=\"#footnote-127-2\" aria-label=\"Footnote 2\"><sup class=\"footnote\">[2]<\/sup><\/a><\/sup><\/p>\n<p><strong>Indications:<\/strong> 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 <em>Clostridium difficile<\/em> (C-diff).<\/p>\n<p><strong>Nursing Considerations:<\/strong> It can be administered PO, parenterally, or topically. Orally is the preferred route for GI infections. The nurse should monitor the client carefully for side effects and adverse effects. Psychotic reactions have been reported with clients with alcohol substance disorder taking disulfiram.<\/p>\n<p><strong>Side Effects\/Adverse Effects: <\/strong>Side effects include dizziness and dry mouth. Adverse effects include seizures, peripheral neuropathy, psychotic reactions, and hepatotoxicity.<\/p>\n<p><strong>Health Teaching &amp; Health Promotion: <\/strong>Clients taking antiprotozoal medications should receive health teaching regarding the need for medication compliance and prevention of reinfection. They should be advised that the medication may cause dizziness and dry mouth. Additionally, the medication may cause darkening of the urine. They should also avoid alcoholic beverages during medication therapy to prevent a disulfiram-like reaction. If clients are being treated for protozoal infections such as trichomoniasis, they should be advised that sexual partners might be sources of reinfection even if asymptomatic. Partners should also receive treatment.<sup><a class=\"footnote\" title=\"uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral\" id=\"return-footnote-127-3\" href=\"#footnote-127-3\" aria-label=\"Footnote 3\"><sup class=\"footnote\">[3]<\/sup><\/a> <\/sup>Client teaching should include the avoidance of alcohol during therapy.<\/p>\n<p>Now let&#8217;s take a closer look at the medication grid in Table 3.17.<sup><a class=\"footnote\" title=\"This work is a derivative of\u00a0DailyMed\u00a0by\u00a0U.S. National Library of Medicine\u00a0in the\u00a0Public Domain.\" id=\"return-footnote-127-4\" href=\"#footnote-127-4\" aria-label=\"Footnote 4\"><sup class=\"footnote\">[4]<\/sup><\/a><\/sup><\/p>\n<p>Table 3.17 Metronidazole Medication Grid<\/p>\n<table class=\"grid\">\n<tbody>\n<tr>\n<th class=\"shaded\" scope=\"col\"><strong>Class\/Subclass<\/strong><\/th>\n<th class=\"shaded\" scope=\"col\"><strong>Prototype\/Generic<\/strong><\/th>\n<th class=\"shaded\" scope=\"col\"><strong>Nursing \u00a0Considerations<\/strong><\/th>\n<th class=\"shaded\" scope=\"col\"><strong>Therapeutic Effects<\/strong><\/th>\n<th class=\"shaded\" scope=\"col\"><strong>Side\/Adverse Effects<\/strong><\/th>\n<\/tr>\n<tr>\n<td scope=\"row\"><strong>Antiprotozoal-Antibacterial<\/strong><\/td>\n<td><a class=\"arrow\" href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/index.cfm\" target=\"_blank\" rel=\"noopener noreferrer\">metrogel<\/a><\/p>\n<p><a class=\"arrow\" href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=d2112f37-5080-4a19-bcc3-6386b49abe1d\" target=\"_blank\" rel=\"noopener noreferrer\">metronidazole IV<\/a><\/td>\n<td>Check for allergies<\/p>\n<p>Topical, vaginal, PO, or IV<\/p>\n<p>Don&#8217;t give by IV push. Infuse over 30 to 60 minutes<\/p>\n<p>Contraindications: Pregnancy, hypersensitivity, or use of alcohol or disulfiram during therapy<\/p>\n<p>Use cautiously with hepatic impairment, blood dyscrasias, or CNS diseases<\/td>\n<td>Improvement of symptoms<\/td>\n<td>Seizures<\/p>\n<p>Peripheral neuropathy<\/p>\n<p>Psychotic reactions<\/p>\n<p>Hepatotoxicity<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h2>Critical Thinking Activity 3.17<img loading=\"lazy\" decoding=\"async\" class=\"alignright size-thumbnail wp-image-67\" src=\"https:\/\/pressbooks.ccconline.org\/accdigitalmarketing\/wp-content\/uploads\/sites\/219\/2019\/10\/ORN-Icons_internet-copy_internet-copy-300x300-1-150x150.png\" alt=\"Image of a circle containing a speech bubble with a question mark in it.\" width=\"150\" height=\"150\" srcset=\"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-content\/uploads\/sites\/219\/2019\/10\/ORN-Icons_internet-copy_internet-copy-300x300-1-150x150.png 150w, https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-content\/uploads\/sites\/219\/2019\/10\/ORN-Icons_internet-copy_internet-copy-300x300-1-65x65.png 65w, https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-content\/uploads\/sites\/219\/2019\/10\/ORN-Icons_internet-copy_internet-copy-300x300-1-225x225.png 225w, https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-content\/uploads\/sites\/219\/2019\/10\/ORN-Icons_internet-copy_internet-copy-300x300-1.png 300w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/h2>\n<\/header>\n<div class=\"textbox__content\" style=\"text-align: left;\">\n<p><strong>Using the above grid information, consider the following clinical scenario question:<\/strong><\/p>\n<p>A client develops C-diff after taking multiple antibiotics for a nonhealing wound. What medication is commonly used to treat C-diff, and what route is used?<\/p>\n<p>Note: Answers to the Critical Thinking activities can be found in the \u201c<a href=\"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/chapter\/chapter-3\/\" target=\"_blank\" rel=\"noopener\">Answer Key<\/a>\u201d section at the end of the book.<\/p>\n<\/div>\n<\/div>\n<hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-127-1\"> \u201c<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Giardia_lamblia_SEM_8698_lores.jpg\" target=\"_blank\" rel=\"noopener noreferrer\">Giardia lamblia SEM 8698 lores.jpg<\/a>\u201d by CDC\/ Janice Haney Carr is licensed under <a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/cc0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC0<\/a> <a href=\"#return-footnote-127-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><li id=\"footnote-127-2\">This work is a derivative of <a href=\"https:\/\/cnx.org\/contents\/5CvTdmJL@7.1:rFziotaH@5\/Introduction\" target=\"_blank\" rel=\"noopener noreferrer\">Microbiology<\/a> by <a href=\"https:\/\/openstax.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">OpenStax<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>. Access for free at <a href=\"https:\/\/openstax.org\/books\/microbiology\/pages\/1-introduction\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/openstax.org\/books\/microbiology\/pages\/1-introduction<\/a> <a href=\"#return-footnote-127-2\" class=\"return-footnote\" aria-label=\"Return to footnote 2\">&crarr;<\/a><\/li><li id=\"footnote-127-3\">uCentral from Unbound Medicine. <a href=\"https:\/\/www.unboundmedicine.com\/ucentral\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.unboundmedicine.com\/ucentral<\/a> <a href=\"#return-footnote-127-3\" class=\"return-footnote\" aria-label=\"Return to footnote 3\">&crarr;<\/a><\/li><li id=\"footnote-127-4\">This work is a derivative of\u00a0<a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/\" target=\"_blank\" rel=\"noopener\">DailyMed<\/a>\u00a0by\u00a0<a href=\"https:\/\/www.nlm.nih.gov\/\" target=\"_blank\" rel=\"noopener\">U.S. National Library of Medicine<\/a>\u00a0in the\u00a0<a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/\" target=\"_blank\" rel=\"noopener\">Public Domain.<\/a> <a href=\"#return-footnote-127-4\" class=\"return-footnote\" aria-label=\"Return to footnote 4\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":83,"menu_order":16,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[48],"contributor":[],"license":[],"class_list":["post-127","chapter","type-chapter","status-publish","hentry","chapter-type-numberless"],"part":82,"_links":{"self":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/127","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/users\/83"}],"version-history":[{"count":1,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/127\/revisions"}],"predecessor-version":[{"id":128,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/127\/revisions\/128"}],"part":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/parts\/82"}],"metadata":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/127\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/media?parent=127"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapter-type?post=127"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/contributor?post=127"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/license?post=127"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}