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8/6/2019 Antiprotozoal and Antihelminthic Drugs_handout
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` Malaria
` Amoebiasis
` Trypanosomiasis
` Leishmaniasis
` Giardiasis
` Trichomoniasis
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` Caused by the plasmodium protozoa
` Four different plasmodium species
` Vector: female Anopheles mosquito
` Transmitted via blood transfusion, congenitally, or
via infected needles by drug abusers.
Life Cycle of the plasmodium:
Sexual ± in the mosquito
Asexual ± in human EXOERYTHROCYTIC PHASE ± ³outside´ RBC
ERYTHROCYTIC PHASE ± ³inside´ RBC
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` Erythrocytic: CHLOROQUINE, MEFLOQUINE, QUININE,
HYDROXYCHLOROQUINE
` Exoerythrocytic: PRIMAQUINE (prevents relapse)
` Chloroquine-resistant strains
QUININE SULFADOXINE+PYRIMETHAMINE (Fansidar)
` Multi-drug resistant strains Artemesin-lumerfrantine
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` CHLOROQUINE, MEFLOQUINE, QUININE,HYDROXYCHLOROQUINE 4-aminoquinoline derivatives
Bind to parasite nucleoproteins and interfere with protein
synthesis and alter pH of parasite Chloroquine ± prophylactic drug
Chloroquine & Hydroxychloroquine ± have
antiinflammatory effects
SIDE EFFECTS: N/V, D, anorexia, abd pain,
dizziness, headache
` Quinine: N/V, tinnitus, vertigo CINCHONISM SYNDROME
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ADVERSE EFFECTS:` Hepatotoxicity
` Dermatological changes (rashes, alopecia)
` Hemolytic anemia (chloroquine)
` Permanent eye damage/blindness (chloroquine)
` Nephrotoxicity (quinine)
` Steven Johnson Syndrome (Fansidar)
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1. Screen the client for any contraindications (liver
dysfunction, alcoholism, psoriasis, retinal
disease, pregnancy & lactation)
2. Arrange for appropriate culture and sensitivitytests before beginning therapy
3. Administer the complete course of the drug.
Mark a calendar for prophylactic doses.
4. Monitor hepatic function and ophthalmologicexamination before and periodically during
treatment
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5. Provide comfort and safety measures6. Maintain nutrition and address diarrheal
problems
7. Advise clients traveling to malaria-infested
countries to receive prophylactic doses of antimalarial drug before leaving, during visit and
upon return.
8. Instruct client to take oral antimalarial drugs with
food or at mealtime9. Warn client about consuming large quantities of
alochol
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` Amoebiasis` Leishmaniasis
Skin, mucuous membrane infection
` Trypanosomiasis
African sleeping sickness, Chaga¶s disease
` Trichomoniasis Vaginal infection
` Giardiasis Intestinal infection, traveler¶s diarrhea
` PCP/ Pneumocystis carinii pneumonia ARC (lung)
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` METRONID AZOLE (Flagyl) Bactericidal (H. pylori, anaerobic bacterial infection),
Trichonacidal (trichomoniasis) & Protozoacidal/Amoebicidal
(amoebiasis)
Prophylaxis in colorectal surgery Has METALLIC TASTE;
Side Effects/Adverse Effects:x N/V, D, headache, dizziness
x Neurotoxicity ± numbness, vertigo, ataxia
x Hepatotoxic
x DISULFIR AM-LIKE EFFECT
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` Assess for hepatic function and CNS disease` Instruct client to avoid alcohol-containing products
during & 48 hours after tx completion.
` Client should complete the course of medication even
if symptoms disappear
` Maintain nutrition & hydration
` Patient may take the medication with meals if GI upset
occurs; inform of the drug¶s metallic taste
` Inform patient that his/her urine may turn red-brown in
color (high doses)
` CNS effects/ safety precautions
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` Atovaquone PCP
` Pentamidine
Trypanosomiasis Leishmaniasis
PCP
` Yinodazole Trichomoniasis, Giardiasis &
amoebiasis
` Paramomycin Intestinal amoebiasis
` Pyrimethamine Toxoplasmosis
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` Nematodes Elongated round worms
`
Cestodes True tapeworms
` Trematodes Flukes, flat-shaped flatworms
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` Intestinal parasitism
` Tissue-invading worm
infections: TRICHINOSIS
FILARIASIS
SCHISTOSOMIASIS
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` Mebendazole (Antiox)
Drug of choice:
` Whipworm, Pinworm, Hookworm, Roundworm
Action: binds & interferes the synthesis of parasite¶s
microtublules and decreases glucose uptake
` Parasites are expelled in the feces
Side effects: Abd pain, diarrhea
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` Pyr antel pamoate (Combatr in)
` Uses: Pinworm, Hookworm, Roundworm
Action: paralyzes the worm by depolarizing
neuromucsular receptor of parasites
` Parasites are expelled in the feces
Side effects: N/V, D
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` Albendazole (Albenza) Dog tapeworm and pork tapeworm
TER ATOGENIC
` Thiabendazole (Minthezol)
Uses: strongyloidiasis, trichinosis
Action: microtubular aggregationSide effects: Steven-Johnson Syndrome
` Niclosamide
Use: Cestodes
` Pr aziquantel (Biltr icide) Use: Schistosomiasis
` Common side effects:
GI upset, dizziness,headache, drowsiness
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1. Collect stool specimen2. Obtain history of food intake & how the food was
prepared
3. Administer antihelminthics after meals or with food toreduce gastric upset
4. Explain the importance of handwashing and proper hygiene; daily change & laundering of underwear,towels and bed linens, disinfection of toilet facilities
5. Maintain nutrition
6. Emphasize importance of taking prescribed drug atdesignated times and keeping HCP appointments
7. Safety precautions