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The Sound of Evolution
Metronidazole
甲硝唑
Mechanism of action:
Metronidazole 是一種 5-硝基咪唑（5-nitroimidazole）衍生物。Metronidazole 本身為前驅型分子，進入厭氧菌或原蟲細胞後，其硝基（-NO₂）基團會被微生物內的低氧還原酵素，如丙酮酸-鐵氧還蛋白氧化還原酶系統（pyruvate-ferredoxin oxidoreductase）還原，生成高度反應性的硝基自由基中間體。這些活化後的自由基會與 DNA 結合，造成 DNA 斷裂，干擾 DNA 複製與轉錄，最終導致細胞凋亡。
Reference(s):
1. Shennan A et al. (2006). A randomised controlled trial of metronidazole for the prevention of preterm birth in women positive for cervicovaginal fetal fibronectin: the PREMET Study. BJOG.
2. Williams CS et al. (2000). Do ethanol and metronidazole interact to produce a disulfiram-like reaction? Ann Pharmacother.
3. Visapaa JP et al. (2002). Lack of disulfiram-like reaction with metronidazole and ethanol. Ann Pharmacother.
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