antiprotozoal- amoebiasis Flashcards Preview

pharmacology > antiprotozoal- amoebiasis > Flashcards

Flashcards in antiprotozoal- amoebiasis Deck (19):
1

Which protozoa are included?

includes entamoeba histolytica, trichomonas vaginalis and giardia lamblia

2

drugs against tissue amoebas
6 drugs

metronidazol,
tinidazol
ornidazol.
emetine.
dehydroemetine.
chloroquine

3

drugs against amoebas in the intestine.

diloxanide
idoquinol
paromomycine.

4

Iodoquinol
mechanism
kinetics.
adverse
clinical indications: 2

Mechanism of action: not fully understood

Pharmacokinetics: poor absorbtion given orally

Adverse: GI

Clinical indications:
1) in monotherapy for the treatment of intestinal asymptomatic amebiasis
2) in combination for the treatment of intestinal or
extraintestinal amebiasis

5

Diloxanid furoat
Mechanism:
Kinetics
Adverse
indication

Mechanism of action: not clear

Pharmacokinetics: its metabolite the diloxanid is absorbed

Adverse effects: GI

Clinical indications: alternative compound in asymptomatic amebiasisban

6

Nitroimidazoles- Metronidazole, tinidazole
Mechanism
CLinical indication

Mechanism of action: reactive reduction products have cytotoxic effect

Clinical indications: in combination for intestinal and extraintestinal infections

7

Paromomycin (aminoglycoside)

Mechanism of action: inhibits protein synthesis
Clinical indications: second line drug in intestinal and extraintestinal infections

8

Treatment of giardiasis:
two options for treatment:

First line drugs
1) Nitroimidazoles: metronidazole, tinidazole.

2) Nitazoxanid: broad spectrum antiprotozoal drug, not clear mechanism of action, few side effects.

Second line drugs
1) Paromomycin (aminoglycoside): poor absorbtion given orally.

2) Furazolidon: nitrofuran, oral drug with mainly GI adverse effects
3) Quinacrin: broad spectrum antiprotozoal drug, well absorbed orally,
long elimination half life (5 days), mainly GI adverse effects

9

Treatment of trichomoniasis

Nitroimidazoles: metronidazole, tinidazole

10

Treatment of toxoplasma gondii infection:
3 options

first choice –
1) Spiramycin (in pregnancy), Sulfamethoxazole +Trimethoprim
2) Pyrimethamine + Clindamycin + folinic acid
3) alternative compounds: - Pyrimethamine + Sulfadiazine + folinic acid

11

Treatment of pneumocystis jiroveci infection.

first choice – Sulfamethoxazole +Trimethoprim
alternative compounds:
- Pentamidine or Clindamycin + Primaquine
or Atovaquon

12

Treatment of african trypanosomiasis (gambienese and rhodesience--> acute form):
- Eflornithin
mechanism:
Given- 2 forms.
adverse effects- 3
indicated for- "

mechanism: inhibits ornithin decarboxylase
- given mainly i.v., orally.
- severe adverse effects (GI, seizures, bone marrow
suppression) causes diarrhoea.
- indicated for advanced (CNS) cases

13

Treatment of african trypanosomiasis (gambienese and rhodesience--> acute form):
- Melarsoprol -
Mechanism:
Given- 1
Adverse: 4.

Mechanism: arsenic containing compound, enzyme inhibitory effect.
- given in slow infusion,
- adverse effects: GI, hepatotoxicity, arrhythmia,
encephalopathy.
- indicated in advanced (CNS) cases.

14

Treatment of african trypanosomiasis (gambienese and rhodesience--> acute form):
Pentamidine
Mechanism:
Indicated- 3
given- 3
kinetics- 2
adverse- 5

Mechanism: effective against several protozoals
- unknown mechanism of action.
Given: IV, IM, aerosol.
Kinetics: half life is about 12 days, no CNS entry.

adverse effects: Pancreatic toxicity (hypoglycemia for some weeks then hyperglycemia), nephrotoxic, hallucination, arrhythmias, hypotension and more.

Indication:
1) it is used in early phase before the CNS involvement
2) other indication is the antimonial resistant leishmaniasis.
3) Pneumocystic jivoecii (usually used prophylatic).
4) it has fungicid effect as well.

15

Treatment of african trypanosomiasis (gambienese and rhodesience--> acute form):
Suramin
Mechanism:
admin
adverse effects: 3
indicated:

- mechanism: – not fully undertsood mechanism of action (inhibits protein synthesis but enzymes as well)

administered i.v., long half life (40-50 days)

- adverse effects: kidney impairment, dermatitis, neuropathy.
- indicated in the early phase, before CNS involvement

16

Treatment of american trypanosomiasis
1) Nifurtimox:
Mechanism:
indicated:
admin:
Adverse:

2) Benznidazol:
mechanism
Route
Adverse:

- Nifurtimox - might act by radical metabolites
- effective mainly in the acute phase
- administrated orally
- adverse effects: GI, neuropathy, seizures
- Benznidazol – inhibits protein synthesis and RNA synthesis
- administrated orally
- adverse effects: GI, neuropathy, psychosi

17

Treatment of leishmaniasis:
Mention 4 drugs and which one do you use for which!
Leishmania donovani-> visceral and kala-azar disease.
leishmania tropia-> cutaneous leishmania.
L. Braziliensis-> mucocutaneous form.

Drugs used for the treatment:
1) Amphotericin B – mainly in the visceral leishmaniasis
2) Miltefosine – orally given in the visceral form

3) pentavalent antimonials:
A) sodium stibogluconate
B) meglumin antimoniat
intravenously administrated drugs for different
leishmania forms with few side effects.
First choice drugs in mucocutaneous

18

Pentamidine (Drugs used in leishamania)
mechanism
adminstration
adverse effects: 4
reserved for?

- not fully understood mechanism of action (inhibits protein synthesis,
inhibits DHFR?)
- parenteral administration
- severe adverse effects: arrhythmias, liver and kidney disturbances, Stevens-Johnson syndrome
- reserve compound in resistant cases

19

sodium stibogluconate
admin- 2
mecha- 1
adverse: 4

administered IV or IM
mechanism unknown
adverse: GI myalgia, headache, QT prolongation.