Metronidazole MoA
- Electron acceptor that reduces cytotoxic compounds that bind to proteins and DNA
- Disrupts DNA, inhibiting nucleic acid synthesis
- Bactericidal
- Need anaerobic environment to reduce in order to be active
Metronidazole Spectrum
Oral and GI anaerobes
-Protozoa (Giardia, amoeba, Trichomonas
Metronidazole Clin Use
DOC: C diff, anaerobic infections above the neck and below the diaphragm, BV, giardiasis, trichamonaisis, amebiasis, endovascular infection due to Bacteroides species
Metronidazole Interacts
Contraindicated: BCG live vaccine, busulfan, disulfiram, lopinavir, ritonavir, tipranavir
Metronidazole ADRs
Nausea, vomiting with alcohol consumption!, epigastric distress, abdominal cramps
-Metallic taste
Chloroquine MoA
Binds hemazoin in parasitized RBCs causing cell lysis
Chloroquine Spectrum
Plasmodium species, extraintestinal amoebas
-Off label: lupus erythematosus, rheumatoid arthritis
Chloroquine Clin Use
Malaria tx and prophylaxis
Tx liver abscesses and intestinal wall infections caused by amebas
Chloroquine Interacts
Contraindicated: Dronedarone, eliglustat, pimozide, toremifene
Chloroquine ADRs
N/V/D, anorexia, abd pain, blurred vision, HA, photosensitivity, tinnitus, muscle weakness
Mebendazole MoA
Binds to and interferes with the assembly of the parasites’ microtubules and decreases glucose uptake
Mebendazole Spectrum
Drug of choice for whipworm, pinworm, hookworm, and roundworm infections
Mebendazole Clin Use
-Must be taken with a high fat meal or else little is absorbed
Mebendazole Interacts
Contraindicated: Carbamazepine, cimetidine, phenytoin
Mebendazole ADRs
May have abd pain and diarrhea
- Tolerated very well
- Contraindicated in pregnancy (category C)
Pyrantel pamoate MoA
Depolarizing, neuromuscular-blocking agent
-Paralyzes the worms and they are expelled from intestinal tract
Pyrantel pamoate Spectrum
Roundworm, pinworm, and hookworm infections
Pyrantel pamoate Clin Use
Medication is used in animals to de-worm as well as humans
-primarily used to treat pinworm infection in humans
Pyrantel pamoate Interacts
None
Pyrantel pamoate ADRs
Mild
-N/V/D
Lindane MoA
Directly absorbed into parasites and ova
Lindane Spectrum
Lice and scabies
Lindane Clin Use
Tx for head lice, pubic lice, and scabies
-Lotion (scabies) or shampoo (lice)
Lindane Interacts
Monitor electrolytes w/ magnesium citrate may increase risk of seizures
Lindane ADRs
Itching, burning skin, dry skin, rash
Permethrin MoA
Causes paralysis and death of the pest
Permethrin Spectrum
Lice and scabies
Permethrin Clin Use
Tx for head lice, pubic lice, and scabies
-Lotion or cream
Permethrin Interacts
None
Permethrin ADRs
Skin irritation
