Antiprotozoal and Anthelmintic Drugs Overview
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Questions and Answers

Which of the following are protozoal infections?

  • Leishmaniasis (correct)
  • Amoebiasis (correct)
  • Giardiasis (correct)
  • Trypanosomiasis (correct)
  • Malaria (correct)
  • Trichomoniasis (correct)
  • Toxoplasmosis (correct)

    • What causes amebiasis?

    Entamoeba Histolytica

    What are the possible outcomes of Entamoeba Histolytica infection?

  • Severe intestinal infections (dysentery) (correct)
  • Liver abscess (correct)
  • Mild to moderate colitis (correct)
  • Ameboma (correct)
  • Other extraintestinal infections (correct)
  • Asymptomatic infection (correct)

    • Amebiasis treatment is only aimed at acutely ill patients.

    <p>False</p> Signup and view all the answers

    Which of the following are luminal amebicides commonly used in treating asymptomatic amebiasis carriers?

    <p>Iodoquinol</p> Signup and view all the answers

    What is the treatment of choice for amebic colitis and dysentery?

    <p>Metronidazole plus a luminal amebicide</p> Signup and view all the answers

    What is the primary mode of action of metronidazole?

    <p>It interferes with the parasite's metabolic pathways.</p> Signup and view all the answers

    Metronidazole is effective against all forms of Entamoeba Histolytica infections.

    <p>False</p> Signup and view all the answers

    What are the common adverse effects of metronidazole?

    <p>Metallic taste</p> Signup and view all the answers

    What is the clinical indication for diloxanide furoate?

    <p>Treatment of asymptomatic passers of Entamoeba Histolytica cysts</p> Signup and view all the answers

    What is the primary adverse effect of diloxanide furoate?

    <p>Pruritus</p> Signup and view all the answers

    Paromomycin is a systemic amebicide.

    <p>False</p> Signup and view all the answers

    What is the mechanism of action of paromomycin?

    <p>It disrupts cell membranes, causing leakage</p> Signup and view all the answers

    What are the common adverse effects of paromomycin?

    <p>Abdominal distress</p> Signup and view all the answers

    What type of drug is iodoquinol?

    <p>A halogenated hydroxyquinoline</p> Signup and view all the answers

    Iodoquinol is effective against trophozoites in the intestinal wall.

    <p>False</p> Signup and view all the answers

    What are the common adverse effects of iodoquinol?

    <p>Gastrointestinal symptoms, headache, rash, and pruritus</p> Signup and view all the answers

    Chloroquine is used in combination with diloxanide furoate and metronidazole to treat and prevent liver abscesses.

    <p>True</p> Signup and view all the answers

    What are the rare adverse effects of chloroquine?

    <p>Hemolysis</p> Signup and view all the answers

    Chloroquine is contraindicated in patients with psoriasis or porphyria.

    <p>True</p> Signup and view all the answers

    What is the origin of emetine?

    <p>An alkaloid derived from ipecac</p> Signup and view all the answers

    Dehydroemetine is a synthetic analog of emetine.

    <p>True</p> Signup and view all the answers

    What is the primary reason for limited use of emetine and dehydroemetine?

    <p>Major toxicity concerns</p> Signup and view all the answers

    What are the serious toxicities associated with emetine and dehydroemetine?

    <p>Cardiac arrhythmias, heart failure, and hypotension</p> Signup and view all the answers

    What is the primary target of pentamidine's activity?

    <p>Trypanosomatid protozoans</p> Signup and view all the answers

    Pentamidine is only used orally.

    <p>False</p> Signup and view all the answers

    What are the clinical uses of pentamidine?

    <p>Pneumocystosis</p> Signup and view all the answers

    Pentamidine is known for being a relatively safe drug.

    <p>False</p> Signup and view all the answers

    What are the common adverse effects of pentamidine?

    <p>Dyspnea</p> Signup and view all the answers

    Sodium stibogluconate is a first-line agent for cutaneous and visceral leishmaniasis.

    <p>True</p> Signup and view all the answers

    How does the toxicity of sodium stibogluconate change during treatment?

    <p>Toxicity increases over the course of therapy</p> Signup and view all the answers

    What are the most common adverse effects of sodium stibogluconate?

    <p>Gastrointestinal symptoms</p> Signup and view all the answers

    What is the indication for nitazoxamide?

    <p>Treatment of Giardia lamblia infection</p> Signup and view all the answers

    Nitazoxamide has demonstrated activity against metronidazole-resistant protozoal strains.

    <p>True</p> Signup and view all the answers

    What is the role of suramin in treating trypanosomiasis?

    <p>First-line therapy for early hemolymphatic east African trypanosomiasis</p> Signup and view all the answers

    Adverse effects are rare with suramin.

    <p>False</p> Signup and view all the answers

    What adverse effects can occur immediately after suramin administration?

    <p>GIS symptoms</p> Signup and view all the answers

    What is the primary indication for melarso-prol?

    <p>M</p> Signup and view all the answers

    M

    <p>False</p> Signup and view all the answers

    What is the primary mode of action of melarso-prol?

    <p>Disruption of trypanosomes in the CNS</p> Signup and view all the answers

    Eflornitin is a first-line drug for advanced west African trypanosomiasis.

    <p>True</p> Signup and view all the answers

    What adverse effects are associated with eflornitin?

    <p>GIS symptoms</p> Signup and view all the answers

    What is the primary indication for nifurtimox?

    <p>Treatment of American trypanosomiasis (Chaga's disease)</p> Signup and view all the answers

    Benznidazole is an intravenously administered drug.

    <p>False</p> Signup and view all the answers

    What is the indication for benznidazole?

    <p>Treatment of Chaga's disease</p> Signup and view all the answers

    Amphotericin is an anti-parasitic drug.

    <p>False</p> Signup and view all the answers

    What is the primary indication for amphotericin?

    <p>Treatment of visceral leishmaniasis</p> Signup and view all the answers

    Miltefosine is the first effective oral drug for visceral leishmaniasis.

    <p>True</p> Signup and view all the answers

    What type of drug is paromomycin sulfate?

    <p>An aminoglycoside antibiotic</p> Signup and view all the answers

    What is the primary indication for paromomycin sulfate?

    <p>Treatment of visceral leishmaniasis</p> Signup and view all the answers

    Helminths are single-celled organisms.

    <p>False</p> Signup and view all the answers

    Albendazole is a broad-spectrum oral antihelminthic drug.

    <p>True</p> Signup and view all the answers

    What is the mechanism of action of benzimidazoles?

    <p>Inhibition of microtubule synthesis</p> Signup and view all the answers

    Albendazole should be administered with a fatty meal when used against intraluminal parasites.

    <p>False</p> Signup and view all the answers

    What are the common clinical uses of albendazole?

    <p>Hookworm infections</p> Signup and view all the answers

    Albendazole's adverse effects are typically severe and long-lasting.

    <p>False</p> Signup and view all the answers

    What is the alternative treatment for fascioliasis mentioned?

    <p>Bithionol</p> Signup and view all the answers

    Bithionol's adverse effects are typically mild and transient.

    <p>True</p> Signup and view all the answers

    What type of drug is diethylcarbamazine citrate?

    <p>A synthetic piperazine derivative</p> Signup and view all the answers

    What are the clinical uses of diethylcarbamazine citrate?

    <p>Wuchereria bancrofti</p> Signup and view all the answers

    Diethylcarbamazine citrate's adverse effects are severe and long-lasting.

    <p>False</p> Signup and view all the answers

    What is the primary mode of action of doxycycline?

    <p>It's a tetracycline antibiotic</p> Signup and view all the answers

    Doxycycline is a highly effective antihelminthic drug.

    <p>False</p> Signup and view all the answers

    Doxycycline is commonly used to treat strongyloidiasis.

    <p>False</p> Signup and view all the answers

    What is the primary effect of ivermectin on nematodes and arthropods?

    <p>It paralyzes them</p> Signup and view all the answers

    What are the primary clinical indications for ivermectin?

    <p>Onchocerciasis</p> Signup and view all the answers

    Ivermectin has shown to be highly effective against tapeworm infections.

    <p>False</p> Signup and view all the answers

    What is the mechanism of action of mebendazole?

    <p>It inhibits microtubule synthesis</p> Signup and view all the answers

    Mebendazole's adverse effects are often severe and long-lasting.

    <p>False</p> Signup and view all the answers

    What is the primary indication for metrifonate?

    <p>Treatment of Schistosoma haematobium infections</p> Signup and view all the answers

    Metrifonate's mechanism of action is related to inhibiting cholinesterase.

    <p>True</p> Signup and view all the answers

    What are the common adverse effects of metrifonate?

    <p>Diarrhea</p> Signup and view all the answers

    Niclosamide is a first-line drug for tapeworm infections.

    <p>False</p> Signup and view all the answers

    What are the primary indications for niclosamide?

    <p>Treatment of Taenia saginata and Taenia solium infections</p> Signup and view all the answers

    Niclosamide's adverse effects are typically severe and long-lasting.

    <p>False</p> Signup and view all the answers

    What is the alternative to praziquantel for treating Schistosoma mansoni infections?

    <p>Oxamniquine</p> Signup and view all the answers

    Oxamniquine's adverse effects are predominantly respiratory.

    <p>False</p> Signup and view all the answers

    What is the role of piperazine in treating ascariasis?

    <p>It's an alternative treatment</p> Signup and view all the answers

    Piperazine's mode of action involves blocking acetylcholine at the neuromuscular junction.

    <p>True</p> Signup and view all the answers

    Piperazine's adverse effects are typically severe and frequent.

    <p>False</p> Signup and view all the answers

    What is the primary clinical indication for praziquantel?

    <p>Treatment of schistosome infections of all species</p> Signup and view all the answers

    Praziquantel's mechanism of action involves inhibiting microtubule synthesis.

    <p>False</p> Signup and view all the answers

    What are the common adverse effects of praziquantel?

    <p>Dizziness</p> Signup and view all the answers

    What is the primary indication for pyrantel pamoate?

    <p>Treatment of pinworm and ascaris infections</p> Signup and view all the answers

    Pyrantel pamoate primarily targets parasitic worms.

    <p>True</p> Signup and view all the answers

    Pyrantel pamoate's adverse effects are common and severe.

    <p>False</p> Signup and view all the answers

    What is the primary indication for thiabendazole?

    <p>Treatment of strongyloidiasis and cutaneous larva migrans</p> Signup and view all the answers

    Thiabendazole is typically the first-line treatment for strongyloidiasis.

    <p>False</p> Signup and view all the answers

    Thiabendazole is contraindicated in patients with liver disease.

    <p>True</p> Signup and view all the answers

    Study Notes

    Antiprotozoal and Anthelmintic Drugs

    • Protozoal infections can include amoebiasis, trichomoniasis, giardiasis, leishmaniasis, trypanosomiasis, malaria, and toxoplasmosis.
    • Amebiasis is an infection of the intestinal tract caused by Entamoeba Histolytica.
    • This organism can cause asymptomatic infection, mild to moderate colitis, severe intestinal infections (dysentery), ameboma, liver abscess, and other extraintestinal infections.
    • Amebiasis can range from acute to long-term, varying in severity from no symptoms to fulminating dysentery.
    • Therapy is aimed at acutely ill patients and carriers.
    • Asymptomatic intestinal infection is treated with a luminal amebicide, including diloxanide furoate, iodoquinol, and paromomycin.
    • Each drug eradicates carriage in about 80-90% of patients with a single course of treatment.
    • Amebic colitis is treated with metronidazole plus a luminal amebicide.
    • Emetine and dehydroemetine can also be used.
    • Extraintestinal infections are treated with metronidazole plus a luminal amebicide.
    • Common chemotherapy drugs for amebiasis include: metronidazole, emetine, dehydroemetine, chloroquine, iodoquinol, antibiotics, and diloxanide furoate.
    • Metronidazole is a selectively toxic drug for anaerobic organisms, including amebas and bacteria. Its nitro group serves as an electron acceptor, creating cytotoxic compounds that disrupt proteins and DNA causing cell death.
    • Metronidazole is used to treat infections with E. histolytica in tissues, but not luminal parasites, so it's administered with a luminal amebicide for complete eradication.
    • Metronidazole is the treatment choice for giardiasis and trichomoniasis.
    • Metronidazole adverse effects can include nausea, headache, dry mouth, metallic taste, pancreatitis, severe CNS toxicity (rare), disulfiram-like effect with alcohol, seizures, and peripheral neuropathy.
    • Metronidazole can potentiate the effects of coumarin-type anticoagulants and lithium toxicity can occur when used with the drug.
    • Diloxanide furoate is useful in treating asymptomatic carriers of E. histolytica cysts.
    • It is absorbed at a rate of about 90% in the intestinal mucosa after hydrolysis.
    • Adverse effects include flatulance, dry mouth, pruritus, and urticaria.
    • Paromomycin, an aminoglycoside antibiotic, is not significantly absorbed from the gastrointestinal tract.
    • It is hydrolysed in the intestinal mucosa, absorbing about 90%.
    • Its amebicidal action is likely due to its effects on cell membranes causing leakage.
    • Adverse effects include abdominal distress and diarrhea.
    • Iodoquinol is a halogenated hydroxyquinoline, an effective luminal amebicide.
    • Used with metronidazole to treat amebic infections in the bowel lumen, it's not effective against trophozoites in the intestinal wall or extraintestinal tissues.
    • Frequent adverse effects include gastrointestinal symptoms, headache, rash, and pruritis.
    • The drug is discontinued if persistent diarrhea or signs of iodine toxicity (dermatitis, urticaria, pruritis, fever) develop.
    • Chloroquine is used, combined with metronidazole and diloxanide furoate to treat and prevent liver abscesses.
    • It reaches high liver concentrations and can be used for amebic abscesses that fail initial therapy with metronidazole.
    • Rare side effects include hemolysis in glucose-6-phosphate dehydrogenase (G6PD) deficient persons, impaired hearing, confusion, and psychosis.
    • Large intramuscular (IM) or rapid intravenous (IV) injections of chloroquine can cause severe hypotension, cardiac, and respiratory arrest.
    • It is contraindicated in people with psoriasis or porphyria.
    • Emetine and dehydroemetine are alkaloids derived from ipecac, effectively targeting tissue trophozoites of E. histolytica.
    • Significant toxicity concerns limit their use.
    • Serious side effects include cardiac arrhythmias, heart failure, and hypotension.
    • Pentamidine has activity against trypanosomatid protozoans but significant toxicity.
    • It's only used parenterally.
    • Clinical uses include pneumocystosis, African trypanosomiasis, and leishmaniasis.
    • Adverse effects include significant toxicity with rapid IV administration potentially leading to hypotension, tachycardia, dizziness, dyspnea, and pancreatic toxicity.
    • Sodium stibogluconate is a pentavalent antimonial used as a first-line agent for cutaneous and visceral leishmaniasis.
    • Toxicity increases over the course of treatment, with the most common side effects being gastrointestinal (GIS) symptoms.
    • Other rare but serious side effects include hemolytic anemia, serious liver, and renal and cardiac effects.
    • Nitazoxanide is approved to treat Giardia Lamblia. Its mechanism of action is unknown, but it appears to work against metronidazole-resistant protozoal strains.
    • Suramin is a first-line therapy for early hemolymphatic east African trypanosomiasis. Common adverse effects include immediate reactions such as gastrointestinal symptoms, seizures and death; and potential late reactions of fever, rush, paresthesias, and agranulocytosis.
    • Melarsoprol is a trivalent arsenical, a first-line therapy for advanced central nervous system (CNS) East African trypanosomiasis.
    • It's extremely toxic and the most important adverse effect is reactive encephalopathy, possibly due to disruption of trypanosomes in the CNS.
    • Eflornithine is an ornithine decarboxylase inhibitor that is a first-line drug for advanced West African trypanosomiasis.
    • Adverse effects can include gastrointestinal (GIS) symptoms, anemia, thrombocytopenia, leukopenia, and seizures.
    • Nifurtimox is a nitrofuran used for American trypanosomiasis (Chagas' disease).
    • Benznidazole is an oral nitroimidazole, also used in Chagas' disease treatment.
    • Amphotericin is an antifungal drug, and an alternative for visceral leishmaniasis treatment.
    • Miltefosine is the first effective oral drug for visceral leishmaniasis, and is highly efficacious.
    • Paromomycin sulfate is an aminoglycoside antibiotic approved for visceral leishmaniasis.
    • Albendazole is a broad-spectrum, benzimidazole carbamate anthelmintic inhibiting microtubule synthesis for nematodes.
    • Administered on an empty stomach for intraluminal parasites, but with a fatty meal for tissue parasites.
    • Clinical uses include ascariasis, trichuriasis, hookworm, pinworm infections, hydatid disease, and neurocysticercosis.
    • Adverse effects with 1-3 days of use are mild and transient, including gastrointestinal (GIS) symptoms, dizziness, and insomnia.
    • Long-term use may require monitoring of blood counts and liver function.
    • Bithionol is an alternative treatment for fascioliasis (sheep liver fluke) with mild and transient adverse effects including diarrhea, nausea, vomiting, dizziness, and headache.
    • Diethylcarbamazine citrate is a synthetic piperazine derivative used to treat Wuchereria bancrofti, Brugia malayi, Brugia timori, and loa loa.
    • Adverse reactions are mild and transient, including headache, malaise, anorexia, and dizziness.
    • Doxycycline is a tetracycline antibiotic with significant macrofilaricidal activity against Wucheria bancrofti.
    • Ivermectin paralyzes nematodes and arthropods by intensifying GABA-mediated transmission in peripheral nerves, used for onchocerciasis and strongyloidiasis.
    • Some patients may develop corneal opacities.
    • Mebendazole is a synthetic benzimidazole with a wide spectrum of antihelminthic activity, inhibiting microtubule synthesis.
    • It is used to treat ascariasis, trichuriasis, hookworm, and pinworm infections.
    • Mild gastrointestinal (GIS) symptoms are common adverse effects.
    • Metronidazole, along with other medications can be used in combination with metronidazole and diloxanide furoate to treat and prevent liver abscesses.
    • Metrifonate is a low-cost, second-line alternative for treating Schistosoma haematobium.
    • Its action is related to cholinesterase inhibition.
    • Adverse effects include mild and transient cholinergic symptoms such as nausea, vomiting, diarrhea, bronchospasm, fatigue, and vertigo.
    • Niclosamide is a second-line drug for most tapeworm infections, including T. saginata and T. solium.
    • Mild gastrointestinal symptoms may occur as a side effect.
    • Oxamniquine is an alternative to praziquantel for treating Schistosoma mansoni.
    • Common adverse effects are central nervous system (CNS) symptoms such as dizziness, headache, and drowsiness.
    • Piperazine is an alternative for treating ascariasis, causing parasite paralysis by blocking acetylcholine at the myoneural junction.
    • Occasional mild gastrointestinal (GIS) side effects occur. - Praziquantel is effective against various schistosome species infections.
    • Increasing permeability of the cell membranes to calcium results in death.
    • It's also used for taeniasis, neurocysticercosis, and hydatid disease. - Mild and transient adverse events are common.
    • Pyrantel pamoate is a broad-spectrum antihelminthic drug for pinworm and ascariasis infections.
    • It has a neuromuscular blocking effect resulting in worm paralysis.
    • Minor gastrointestinal (GIS) adverse effects are common.
    • Thiabendazole is an alternative to ivermectin or albendazole for treating strongyloidiasis and cutaneous larva migrans.

    Helminthic Drugs

    • Helminths (worms) are multicellular organisms infecting many humans, causing various diseases.
    • Albendazole, a broad-spectrum benzimidazole carbamate, acts by inhibiting microtubule synthesis in nematodes.
    • Administered on an empty stomach for intraluminal parasites, but with a fatty meal for tissue parasites.
    • Albendazole adverse reactions
    • include mild, transient adverse reactions such as gastrointestinal (GIS) symptoms (dizziness, insomnia) in the first few days of use, long term use can involve liver or blood count monitoring.
    • Bithionol is an alternative treatment for fascioliasis (sheep liver fluke) with mild, transient adverse effects including diarrhea, nausea, vomiting, dizziness, and headache.
    • Diethylcarbamazine citrate (DEC) is a synthetic piperazine derivative used for Wuchereria bancrofti, Brugia malayi, Brugia timori, and loa loa. Mild and transient adverse effects include headache, malaise, anorexia, and dizziness.
    • Doxycycline and other similar antibiotics are used for specific helminthic infections, often with macrofilaricidal activity against Wucheria bancrofti.
    • Ivermectin paralyzes nematodes and arthropods, indicated for onchocerciasis and strongyloidiasis. Possible side effect is corneal opacities in some patients.
    • Mebendazole is a synthetic benzimidazole with a wide spectrum of antihelminthic activity, inhibiting microtubule synthesis. Mebendazole adverse reactions can include mild GI symptoms as adverse effects.
    • Metrifonate is a low-cost, second-line alternative for treating Schistosoma haematobium. Adverse effects include mild and transient cholinergic symptoms (nausea, vomiting, diarrhea, bronchospasms, and fatigue).
    • Niclosamide is a second-line drug for T. saginata and T. solium tapeworm infections with possible mild gastrointestinal symptoms.
    • Oxamniquine is an alternative to praziquantel for treating Schistosoma mansoni, with common side effects including dizziness, headache, and drowsiness.
    • Piperazine is an alternative for ascariasis causing parasite paralysis that blocks acetylcholine at the myoneural junction. Mild gastrointestinal effects are possible.
    • Praziquantel is effective against various schistosome species, increasing permeability of membranes to calcium, resulting in death.
    • Pyrantel pamoate is a broad spectrum anthelminthic against pinworms and ascariasis. It has a neuromuscular-blocking effect that causes paralysis of worms. Mild gastrointestinal (GI) adverse effects are most common.
    • Thiabendazole is an alternative to ivermectin or albendazole for treating strongyloidiasis and cutaneous larva migrans.

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    This quiz focuses on antiprotozoal and anthelmintic drugs, exploring their uses in treating infections like amoebiasis and malaria. Understand the mechanisms behind these medications, including specific treatments for various stages of infection. Test your knowledge on therapeutic strategies for managing protozoal infections and their clinical significance.

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