Amebicidal, anti-trypanomiasis, anti-leshmaniasis

    Cards (55)

    • Amebiasis is an infestation with E. hystolytica
    • Principal site of infestation is the intestine
    • Other tissues affected include the liver, leading to liver abscesses
    • Symptoms of amebiasis include diarrhea and abdominal pain
    • Asymptomatic intestinal infection in nonendemic areas is treated by luminal amebicides
    • Luminal amebicides include Diloxanide furoate, Iodoquinol, and Paramomycin
    • Therapy with a luminal amebicide is required in the treatment of all other forms of amebiasis
    • Amebic colitis is treated with Metronidazole plus a luminal amebicide
    • TTC and erythromycin are alternatives for moderate colitis
    • Dehydroemetine or emetine can also be used, but they are toxic
    • Extraintestinal infections are treated with metronidazole plus a luminal amebicide
    • For unusual cases where initial therapy with metronidazole fails, aspiration of abscess (liver) is done along with chloroquine and repeat metronidazole
    • Dihydroemetine or emetine are toxic alternative drugs for extraintestinal infections
    • Luminal amebicides: Diloxanide, Idoquinol, Paramomycin
    • Tissue amebicides for both intestinal and extraintestinal infections: Metronidazole, tinidazole, Emetine, Dihydroemetine
    • Chloroquine is used for extraintestinal infections only
    • Metronidazole is a 5-nitroimidazole derivative
    • Therapeutic uses include amebiasis, gardiasis, trichomoniasis, and severe infections due to anaerobic bacteria
    • In patients with peptic ulcer infected with H. pylori, combination therapy includes PPI, amoxicillin, clarithromycin, and metronidazole
    • Adverse effects of metronidazole include headache, nausea, metallic taste, dizziness, and a disulfiram-like effect
    • Disulfiram-like effect includes copious vomiting, flushing, palpitation, and headache
    • Metronidazole interacts with alcohol causing a disulfiram-like effect
    • Drug interactions include inhibition of oral anticoagulant inactivation, enhanced metabolism with phenobarbitone, and reduced metabolism with cimetidine
    • Tinidazole is similar to metronidazole but has a better toxicity profile and higher half-life
    • Diloxanide furoate is useful in the treatment of asymptomatic passers of cysts and in conjunction with metronidazole for intestinal and systemic amebiasis
    • Emetine and dehydroemetine inhibit protein synthesis by blocking chain elongation
    • Adverse effects include pain at the site of injection, transient nausea and vomiting, and cardiotoxicity
    • Trypanosomiasis refers to chronic diseases caused by Trypanosoma species
    • African sleeping sickness is caused by Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense
    • Suramine, pentamidine, enflornithine, and melarsoprol are used in the treatment of trypanosomiasis
    • Chaga's disease is caused by Trypanosoma cruzi and can lead to cardiomyopathy and megacolon
    • Therapy includes Nifurtimox and Benznidazole
    • Suramine is the first-line therapy for early hemolymphatic African trypanosomiasis
    • Adverse effects include immediate reactions like fatigue, nausea, and late reactions like fever and renal abnormalities
    • Pentamidine disrupts the synthesis of DNA, RNA, phospholipids, and proteins
    • Therapeutic uses include PCP/PJP, African sleeping sickness, and an alternative for leishmaniasis
    • Adverse effects include hypotension, hypoglycemia, pain at the injection site, rash, metallic taste, fever, and cardiac arrhythmias
    • Eflornithine irreversibly inhibits both mammalian and trypanosomal ornithine decarboxylase
    • Therapeutic uses include the treatment of T. brucei gambiense
    • Adverse effects include anemia, leukopenia, thrombocytopenia, alopecia, vomiting, and abdominal pain