Antiprotozoan therapy Flashcards
Patient has toxoplasmosis, what is treatment of choice?
Pyrimethamine + sulfadiazine
Patient has Trypanosmoa brucei, what is treatment of choice?
suramin (blood) and melarsoprol (cns)
Patient has T. cruzi, what is treatment of choice?
nifurtimox or benznidazole
Chloroquine mech
Block detoxification of heme into hemozoin. Heme accumulates and is toxic to plasmodia
Chloroquine is used to treat all plasmodium species except which one? why? how?
P. falciparum; frequency of resistance too high; membrane pump that decreases intracellular concentration of drug.
What is the treatment of P. Falciparum?
artemether/lumefantrine OR atovaquone/proguanil.
Treatment for giardiasis?
Tinidazole or metronidazole
Treatment for giardiasis?
Tinidazol
Treatment for entamoeba histolytica
Metronidazole, iodoquinol for asymptomatic cyst passers
Treatment for cryptosporidium
Prevention by filtering city water supplies. Nitazoxanide in immunocompetent hosts
Treatment for naegleria fowleri
Amphotercin B
Leishmania donovani
Amphotericin B, sodium stibogluconate
Babesia
Atovaquone + azithromycin
Plasmodium treatment
1) Begin with chloroquine, which blocks plasmodium heme polymerase 2) if resistant use mefloquine or atovaquone/proguanil 3) if life threatening use IV quinidine (test for G6PD deficiency) 4) for P vivax/ovale: add primaquine for hypnozoite (test for G6PD deficiency)