Anti Amoebic Drugs PDF

CLASSIFICATION ANTIAMOEBIC DRUGS ANTI- AMOEBIC DRUGS Tissue amoebicides Luminal...

CLASSIFICATION ANTIAMOEBIC DRUGS ANTI- AMOEBIC DRUGS Tissue amoebicides Luminal amoebicides Nitroimidazole For extra- intestinal Amides Antibiotics For intestinal + extra amoebiasis only Diloxanide furoate Tetracycline intestinal amoebiasis Paromomycin Chloroquine Nitazoxanide 8- hydroxyquinolines Quiniodochlor Nitroimidazoles Alkaloid Metronidazole Diiodohydroxyquin Tinidazole Emetine Iodoquinol: A luminal amoebicide. In large doses, it can lead to Secnidazole Ornidazole Dehydroemetine Satranidazole thyroid enlargement and peripheral neuropathy. There are two classifications of drugs for amoebiasis: Diloxanide Furoate Tissue (extra-intestinal) amoebicides only: effective against amoebas It is the drug of choice for asymptomatic intestinal amoebiasis and in tissues outside the intestines (e.g., liver, lungs) is used with tissue amoebicides for extra-intestinal infections. It is also the drug of choice for carriers. It can cause flatulence as Example: chloroquine adverse effect. Both intestinal (luminal) and extra-intestinal amoebicides: effective Quiniodochlor: Another luminal amoebicide. against amoebas in both the intestines and tissues High doses can cause eye defects (Subacute Myelo Optic Neuropathy Examples: or SMON). Nitromidazole (metronidazole, tinidazole, secnidazole, Metronidazole Paromomycin: An aminoglycoside that can be used as a luminal ornidazole) Indications: amoebicide. Emetine and dehydroemetine Primary focus: Treats infections caused by anaerobic It also has some activity against cryptosporidiosis in AIDS patients bacteria, including: and has been approved for the treatment of kala- azar. Luminal amoebicides only: effective against amoebas in the intestines Bacteroides spp. Nitazoxanide: A prodrug converted to tizoxanide. Examples: Clostridium spp. Tizoxanide inhibits the enzyme pyruvate ferrodoxin oxidoreductase Diloxanide furoate Trichomoniasis (vaginal or urethral infection) (PFOR), which is essential for energy metabolism in anaerobic Paromomycin organisms. Giardiasis (intestinal parasite) Iodoquinol Pseudomembranous colitis (caused by C. difficile) It has good activity against cryptosporidium parvum and some Quiniodochlor Side Effects: activity against other parasites, but is only approved for treating Tetracyclines Nausea giardiasis and cryptosporidiosis. Tissue Amoebicides: Target amoebas in tissues only (not effective in Metallic taste in mouth Tinidazole: It is an equally efficacious congener of metronidazole, the intestines). Abdominal cramps similar to it in every way except:Metabolism is slower; t ⁄ is ~12 hr; Example: Chloroquine Drug Interactions: duration of action is longer; dosage schedules are simpler. Luminal and Tissue Amoebicides: Effective against amoebas in both Alcohol: Can cause a disulfiram-like reaction (nausea, Thus, it is more suited for single dose or once daily therapy. vomiting, flushing) if consumed with alcohol. Some comparative trials in amoebiasis have reported higher cure intestines and tissues. Anticoagulants (Coumarins): May increase the rates. Examples: Metronidazole, Tinidazole, Secnidazole, Ornidazole, It appears to be better tolerated; the incidence of side effects is Emetine, Dehydroemetine anticoagulant effect, potentially leading to bleeding. lower: metallic taste (2%), nausea (1%), rash (0.2%). Luminal Amoebicides Only: Target amoebas in the intestines only (not Emetine Emetine and dehydroemetine act by inhibiting protein Secnidazole: A congener of metronidazole with the same spectrum effective in tissues). of activity and potency. Absorption after oral administration is rapid synthesis and can be used parenterally in severe hepatic Examples: Diloxanide Furoate, Paromomycin, Iodoquinol, amoebiasis. and complete, but metabolism is slower resulting in a plasma t ⁄ of Quiniodochlor, Tetracyclines 17–29 hours. Toxicity of these drugs includes emesis, muscle weakness Satranidazole better tolerability no nausea, vomiting or metallic and cardiotoxicity (arrhythmias and congestive heart taste, absence of neurological and disulfiram- like reactions. failure). It is rarely used now.