2. INTRODUCTION
• Amoebiasis, also known amoebic dysentery, is an infection caused by any of the amoebae of the
entamoeba group. Symptoms are most common during infection by entamoeba histolytica.
Amoebiasis can be present with no, mild, or severe symptoms. Symptoms may include abdominal
pain, diarrhea, or bloody diarrhea.
3. HISTORY
• Amoebiasis was first described by fedor A. Lösch in 1875, in northern russia. The most dramatic
incident in the US was the chicago world's fair outbreak in 1933, caused by contaminated
drinking water.
6. Classification of amebicidal drugs according to the site where the drug is effective, the
amebicidal drugs are classified as:
Luminal amebicides (act on parasite in the lumen of bowel)
systemic amebicides (against amebas in intestinal wall & liver)
Mixed amebicides ( against both the luminal and systemic form of diseases).
9. PHARMACOKINETICS
• PHARMACOKINETICS
• Absorption: metronidazole is usually given orally and it is rapidly and completely absorbed
achieving peak plasma concentration in 1-3 hours, with half life of about 7 hours.
• Distribution: it is distributed rapidly throughout the tissues, reaching high concentration in the
body fluids, including cerebrospinal fluid.
10. • Metabolism :
metabolism of metronidazole occurs in liver.
• Excretion :
the parent drug and its metabolites are excreted in the urine.
11. INDICATIONS
• Bacterial vaginosis.
• Pelvic inflammatory disease.
• To treat infected:
Insect bites.
Skin ulcers.
Bed sores.
Wounds.
• To treat and prevent bacterial and parasitic infections.
12. ADVERSE EFFECT
• Dizziness.
• Headache.
• Stomach upset.
• Nausea.
• Vomiting.
• Loss of appetite.
• Diarrhea.
• Constipation.
• Metallic taste in the mouth.
13. NURSES RESPONSIBILITY
• Before taking metronidazole, inform doctor about any allergies; or to other antibiotics (such as
tinidazole). This product may contain inactive ingredients, which can cause allergic reactions or
other problems.
• Before using this medication, inform doctor about medical history, especially of: liver disease,
kidney disease, certain blood disorders (low blood cell counts).
14. • Avoid alcoholic beverages and products containing propylene glycol while taking this medication
and for at least 3 days after finishing this medicine because severe stomach upset/cramps, nausea,
vomiting, headache, and flushing may occur.
• This drug may make the client dizzy. Alcohol or marijuana (cannabis) can make more dizzy. Do
not drive, use machinery, or do anything that needs alertness until client can do it safely. Inform to
doctor if client is using marijuana (cannabis).
15. • Metronidazole may cause live bacterial vaccines (such as typhoid vaccine) to not work as well. Do
not have any immunizations/vaccinations while using this medication unless doctor’s order.
• People with a rare genetic disorder (Cockayne syndrome) may be at risk for very serious liver
disease if they use metronidazole.
16. PAROMOMYCIN
• Aminoglycoside antibiotic.
• Not significantly absorbed from the git.
• Only as a luminal amoebicide and has no effect against extra intestinal amoebic infections.
• Inhibiting protein synthesis → kill trophozoites.
• Inhibiting symbiosis flora → indirectly inhibiting amoeba protozoa.
17. • Uses of paromomycin:
• for treating intestinal colonization with E. Histolytica.
• Giardiasis in pregnant women, especially during the first trimester, when metronidazole is
contraindicated and as an alternative agent for metronidazole-resistant isolates of g. Intestinalis.
• Dose - 500 mg orally three times daily for 10 days.
18. • CONTRAINDICATION:
• It should be avoided in patients with significant renal disease and cautiously used with GI
ulceration.
