Abdominal pain metronidazole

Counsel women taking metronidazole regarding potential for nausea, vomiting, and abdominal pain. Counsel patients to avoid alcohol or alcohol-containing substances during therapy with metronidazole owing to the risk of disulfuram-like reactions. 

In the hospital, he receives fluids and metronidazole 500 mg every 8 hours intravenously. Stool was sent for C. difficile toxin assay, which came back positive. The patient continues to have abdominal pain but no bowel movement. On day 3 of hospitalization, his abdomen is distended with diffuse pain. His white blood cell count remains elevated. A CT scan of the abdomen showed colonic dilatation to greater than 6 cm. The patient became febrile and hypotensive, requiring multiple pharmacologic support for hypotension. 

Lopinavir/ritonavir PI/PI2 400 mg/100 mg bid or 800 mg/200 mg daily. May need dose adjustment in hepatic insufficiency Take with food. Separate dosing from ddl by 1 h. Store capsules and solution in refrigerator Diarrhea, abdominal pain, nausea, hypertriglyceridemia, headache, t liver enzymes, See footnote 4 for contraindicated medications. Also avoid fosamprenavir. Avoid disulfiram and metronidazole with oral solution... 

Anorexia, nausea, vomiting, abdominal pain, and diarrhea have all been reported in patients taking metronidazole (14). The use of a large single dose most commonly leads to these complaints. A metallic taste also seems to be quite common (14), as is the occurrence of a black tongue (SEDA-13, 832) (15). 

Metronidazole is reduced xmder anaerobic conditions to a compound that prevents DNA synthesis. Adverse effects associated with metronidazole include nausea, diarrhoea, weight loss, abdominal pain, vomiting, headache, dizziness and metallic taste in the moutii. 

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