d. Cautions and Warnings.
Metronidazole is inactive against Candida albicans infections.
(2) A total decrease in leukocytes has been reported with therapy. Total
and differential white blood cell counts should be made, especially if the client needs to
undergo a second course of therapy.
(3) Clients should be warned not to consume alcohol while receiving
metronidazole; it may lead to a reaction characterized by flushing, nausea and vomiting,
and a feeling of impending doom.
(4) It is well tolerated in pregnancy, but should be used with caution during
the first trimester.
e. Supply. Metronidazole is supplied as 250-mg tablets.
6-38. GAMMA BENZENE HEXACHLORIDE (LINDANE)
Gamma benzene hexachloride (Kwell, lindane) is very effective in the treatment
of both scabies ("itch" mite) and pediculosis (lice and "crabs"). When used to treat
scabies, a thin layer of the cream is rubbed into the skin from the neck to the soles of
the feet (15- to 25-grams for an adult). The cream is to be left on the client for a full 24
hours before being removed. No water is to be used on the client during this time. After
this 24-hour period, the client should bathe and put on clean clothing. Pruritis (itching)
is usually relieved after 24 hours, and there is rarely a need for a second application.
However, if necessary, a second and third application may be made at weekly intervals.
Gamma benzene hexachloride is both effective and safe to use where there is
secondary infection of the skin. However, subsequent treatment with a bactericide may
be needed to clear up the infection. When used in the treatment of pediculosis, the
cream is applied to the area that is infected with the lice (head, body, or pubic region)
and is washed off the following day. A single application is usually sufficient. The drug
is supplied as a 1 percent cream packaged in 60-gram containers.