Non-malarial Antiprotozoal Drugs

Question 1

Metronidazole (or tinidazole) is used to treat …?

Answer 1

Entamoeba histolytica
Giardia
Trichomonas

(These are all anaerobes)

Question 2

How does metronidazole work?

i.e. 1. what does it kill? 2. what is its mech?

Answer 2

1. kills trophozoites (the actively dividing form) but not cysts
2. not definitively known - may target parasite DNA

Question 3

Treatment with metronidazole is usually followed by ….

Answer 3

luminal drugs to eliminate asymptomatic infection

Question 4

Metronidazole and alcohol

Answer 4

Antabuse effect

Acetaldehyde accumulates and cause

• hypotension
• nausea
• vomiting
• discomfort

Question 5

IODOQUINOL

• what kind of amebicide?
• kills what form?
• combine this with —- for —-

Answer 5

luminal amebicide

kills trophozoites

combine with metronidazole for amebic dysentery

Question 6

Pentamidine is the first line of defense for?

Answer 6

West African trypanosomiasis

Question 7

Nifurtimox

• mechanism?
• it reduces the severity of ?

Answer 7

mechanism unknown

• may involve reduction followed by oxidation
• generates ROS

reduces the severity of the acute phase (does not prevent progression)

Question 8

Miltefosine

• approved for use against?
• avoid its use when?

Answer 8

visceral leishmaniasis

avoid use during pregnancy (teratogenic)

Question 9

What do we treat giardia and cryptosporidium with?

Answer 9

Nitazoxanide

Question 10

What do we treat Chagas disease (trypanosome cruzi) with?

Answer 10

Nifurtimox

Benznidazole

Question 11

What do we treat Sleeping Sickness (trypanosoma brusei) with?

Answer 11

West Africa

• early: pentamidine
• late: eflornithine

East Africa

• early: suramin
• late: melarsoprol