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?

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.

Ceftriaxone (Rocephin) is athird-generation cephalosporin antibioticthat works byinterfering with the formation of bacterial cell walls.It is effective againstgram-negative bacteria, such asNeisseria gonorrhoeaeandHaemophilus species, which are common causes of bacterial meningitis.

Choice A is wrong because ceftriaxone is less active againstgram-positive bacteria, such asStaphylococcusandStreptococcusspecies.

Choice C is wrong because ceftriaxone is not effective againstanaerobic bacteria, which are bacteria that do not require oxygen to grow.Anaerobic bacteria are usually treated withmetronidazoleorclindamycin.

Choice D is wrong because ceftriaxone can treat bothaerobicandanaerobicgram-negative bacteria, but not all aerobic bacteria are gram-negative.

Aerobic bacteria are bacteria that require oxygen to grow.Some examples of aerobic gram-positive bacteria areListeria monocytogenesandBacillus anthracis, which are resistant to ceftriaxone.