Non-malaria antiprotozoal drugs

Question 1

Metronidazole

Answer 1

drug of choice for extraintestinal entamoeba histolytica, giardiasis, and trichomoniasis

• kills trophozoites (replicative active) but not cysts
• treatment usually followed by luminal drug to eliminate asymptomatic infection

Question 2

Metronidazole side effects

Answer 2

blocks acetaldehyde dehydrogenase

Question 3

Ioquinol

Answer 3

• Kills parasites that are still in lumen (paired with Metronidazole)
• low bioavailability (not well absorbed)
• kills trophozoites

Question 4

Pentamidine

Answer 4

• highly toxic
• treats west african trypanosomiasis
• also vscieral leishmania pneumocystosis

Question 5

Nifurtimox

Answer 5

T. Cruzi

• might involve generation ROS
• reduce severity of acute phase, but doesn’t eliminate all parasites
• does not prevent progression
• orally available
• 3-4 month treatment course
• toxicity issues-> hypersensitive and GI complications

Question 6

Miltefosine

Answer 6

visceral leishmania (in india)

• 28 daily dose
• avoid during pregnancy (b/c teratogenic)

Question 7

Nitazoxanide

Answer 7

giardia and cryptosporidium

Question 8

Nifurtimox and Benznidazole

Answer 8

Trypanosoma- Chaga’s disease

Question 9

Drug for sleeping sickness-Trypanosoma brusei

Answer 9

West Afrian: early stage->Pentamidine
late stage-> Eflornithine
East Afrian: Early stage-> suramin
Late stage-> melarsoprol