A nurse is reviewing the medication history of a client who has a bacterial gastrointestinal infection and a prescription for metronidazole (Flagyl).
The nurse should identify that which of the following medications can interact with metronidazole?

Choice A is correct because azithromycin can cause liver toxicity and hepatitis, so the nurse should monitor the client’s liver function tests.

Choice B is wrong because azithromycin can be taken with or without food.

Choice C is wrong because azithromycin does not interact with dairy products.

Choice D is correct because azithromycin can increase the risk of sunburn and photosensitivity, so the nurse should advise the client to use sunscreen and avoid excessive sun exposure.

Choice E is correct because azithromycin is a bacteriostatic antibiotic that requires the client to complete the full course of therapy to prevent bacterial resistance and recurrence of infection.

Warfarin (Coumadin) can interact with metronidazole (Flagyl) and increase the risk of bleeding.This is because metronidazole may inhibit the enzyme that metabolizes warfarin, leading to higher warfarin levels and enhanced anticoagulant effect.If a patient is taking warfarin and metronidazole, they may need a dose adjustment and frequent monitoring of their INR.They should also watch for any signs of bleeding or bruising and report them to their doctor.

Choice B is wrong because levothyroxine (Synthroid) does not have a significant interaction with metronidazole.

Choice C is wrong because lisinopril (Prinivil) does not have a significant interaction with metronidazole.

Choice D is wrong because omeprazole (Prilosec) does not have a significant interaction with metronidazole.