Metronidazol

Estrutura química de Metronidazol
Metronidazol
Aviso médico
Nome IUPAC (sistemática)
2-(2-methyl-5-nitro-1H-imidazol-1-yl)ethanol
Identificadores
CAS 443-48-1
ATC J01XD01
PubChem 4173
DrugBank APRD00631
Informação química
Fórmula molecular C6H9N3O3 
Massa molar 171.15 g/mol
Dados físicos
Ponto de fusão 160 °C
Solubilidade em água < 0,1 g/100 mL mg/mL (20 °C)
Farmacocinética
Biodisponibilidade 100% (oral)
59–94% (retal)
Metabolismo hepático
Meia-vida 6–7 horas
Excreção Renal (60-80%), biliar (6–15%)
Considerações terapêuticas
Administração Oral, tópico, retal, IV, vaginal
DL50 ?

O metronidazol é um derivado nitroimidazol com atividade antiprotozoária. Este composto também possui actividade antibacteriana contra bacilos gram-negativos anaeróbios, contra bacilos gram-positivos esporulados e contra todos os cocos anaeróbios.[1][2]

Está indicado no tratamento de giardíase, amebíase, tricomoníase, vaginites por Gardnerella vaginalis e infecções causadas por bactérias anaeróbias como Bacteroides fragilis e outros bacteróides, Fusobacterium sp, Clostridium sp, Eubacterium sp e cocos anaeróbios. Outra indicação seria no tratamento de pacientes portadores de periodontite crônica refratária, doença esta que apresenta na sua constituição microbiológica bacterias anaeróbias presentes na cavidade oral.

Mecanismo de ação

O mecanismo de ação do fármaco consiste na inibição da síntese de ácido desoxirribonucleico e na degradação do DNA.

Em geral, o metronidazol é administrado por via oral e é completamente absorvido. Preparações retais e intravenosas também estão disponíveis. É rapidamente distribuído pelos tecidos, atingindo concentrações elevadas nos líquidos corporais, incluindo o líquido cerebroespinhal. Uma parte é metabolizada, porém a maior parte é eliminada na urina.[3]

Efeitos adversos

Os efeitos adversos do metronidazol são geralmente brandos, mas cefaleias e sintomas gastrointestinais são comuns. As reações mais graves compreendem estomatite, leucopenia, neurite periférica e ataxia.

A ingestão com álcool pode provocar dores abdominais, vômito, enrubescimento e cefaleia. O metronidazol não deve ser usado em pacientes com alergia anterior ao metronidazol ou outro derivado.

Interações medicamentosas

O metronidazol pode interagir com outros medicamentos, entre os principais a cimetidina, a fenitoína, o fenobarbital, a varfarina, o lítio e o dissulfiram.

Contra-indicações e Precauções

  • Deve ser evitado no caso de problemas hepáticos, renais ou diálise
  • As mulheres grávidas ou a amamentar não devem seguir o tratamento com o metronidazol
  • Porfíria
  • Deve ser evitado no caso de alergia a este ou outros antibióticos

Referências

  1. ↑ «Metronidazol comprimidos: o que é, para que serve e como usar». Tua Saúde. Consultado em 1 de abril de 2021 
  2. ↑ «Metronidazol: o que é, para que serve e os cuidados». Veja Saúde. Consultado em 1 de abril de 2021 
  3. ↑ RANG, DALE (2016). Farmacologia. Rio de Janeiro: Elsevier. p. 1547 

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