anti-protoza_part 6 malaria_and_antiamoebic_flashcards
What is the treatment for all plasmodial infections except chloroquine-resistant P. falciparum?
Treatment of clinical attacks: Oral chloroquine. Chemoprophylaxis: Oral chloroquine or Primaquine (for terminal prophylaxis of P. vivax and P. ovale).
What is the treatment for infections with chloroquine-resistant P. falciparum?
Treatment of clinical attacks: Mefloquine, Oral quinine + Fansidar or doxycycline, Oral halofantrine, Malarone. Chemoprophylaxis: Oral mefloquine, Chloroquine + Doxycycline.
What are tissue amoebicidal drugs?
Act primarily in the bowel wall and liver but not the intestinal lumen. 1) For intestinal and extra-intestinal infections: Nitroimidazoles (Metronidazole, Tinidazole, Ornidazole), Alkaloids (Emetine, Dehydroemetine). 2) For extra-intestinal only: Chloroquine.
What are luminal amoebicidal drugs?
1) Chloroacetamide: Diloxanide furoate. 2) 8-Halogenated hydroxyquinolines: Iodoquinol. 3) Antibiotics: Paramomycin, Erythromycin, Tetracycline.
What is the pharmacokinetics (P.K.) of Metronidazole?
Well absorbed and widely distributed. Metabolized in the liver by oxidation and glucuronide conjugation. Excreted through the kidneys. Half-life: 8 hours.
What is the mechanism of action of Metronidazole?
The nitro group is converted into a cytotoxic product by ferredoxine oxido-reductase. Causes multiple DNA breaks and inhibits transcription and replication.
What are the clinical uses of Metronidazole?
1) Amoebiasis (intestinal or liver abscess). 2) Giardiasis. 3) Trichomonas vaginalis. 4) Anaerobic infections (with gentamicin or cephalosporin). 5) Ulcerative gingivitis.
What are the adverse effects of Metronidazole?
Anorexia, nausea, dry mouth, cramps. Metallic taste. Headache, insomnia, weakness, dizziness. Stomatitis, rash, vertigo. Sensory neuropathy. Disulfiram-like reaction.
