medstudent2medstudent

1. Antiprotozoal
Drugs

2. Major Infections and drugs
Infection Drug of choice Comments
Amebiasis Metronidazole
Diloxanide for noninvasive
intestinal amebiasis
Giardiasis Metronidazole Diarrhea
Trichomoniasis Metronidazole Treat both partners
Toxoplasmosis
Pyrimethamine
Sulfadiazine
Leishmaniosis Stibogluconate
Trypanosomiasis
Nifurtimox (Chagas)
Arsenicals (African)

3. Metronidazole
▪ cytotoxic compounds bind to proteins and DNA cell
death
▪ PO administration
▪ Therapeutic levels in vaginal, seminal fluids, saliva, breast milk,
CSF
▪ Hepatic oxidation glucuronylation
▪ Eliminated by kidney
▪ SE : GIT distress, metallic taste, oral moniliasis, neurotoxilogic
problems
+phenobarbital
-cimetidine

4. AntiMalarial drugs

5. Antimalarial drugs
Gametocytic form Primaquine
Exoerythrocytic form Primaquine
Erythrocytic form Artemisinin, Chloroquine, Quinine,
Mefloquine, Pyrimethamine
Primaquine is a tissue schizonticide
Chloroquine is a blood schizonticide

6. Primaquine
MOA – oxidant responsible for
schizonticidal action, hemolysis
and methemoglobenemia
PK – PO administration, eliminated
by kidney
AE - drug induced anemia in G6PD
granulocytopenia, agranulocytosis
CI - pregnancy
Quinine, Quinidine
MOA – interfere with heme polymerization
leading to death of erythrocytic form of
plasmoidal parasite
PK – PO. Can reach fetus (fetotoxic). Alk
of urine decreases secretion
AE – Cinchonism NVTnVr
CI - +ve Coomb’s test for haemolytic anem
DI – antiacids, digoxin

7. Chloroquine side effects
▪ Seizures
▪ Hear reactions: deafness or tinnitus
▪ Gastrointestinal reactions: nausea, vomiting, diarrhea, abdominal
cramps, and anorexia
▪ Brain reactions: mild and transient headache
▪ Skin reactions: itchiness, skin color changes, hair loss, and skin
rashes
▪ Unpleasant metallic taste
▪ chloroquine retinopathy

8. •Antacids- may reduce absorption of chloroquine; take 4
hours apart
•Kaolin- may reduce absorption of chloroquine; take 4
hours apart
•Cimetidine- may inhibit metabolism of chloroquine;
increasing levels of chloroquine in the body
•Ampicillin- levels may be reduced by chloroquine; take 2
hours apart
•Cyclosporine- levels may be increased by chloroquine
•Mefloquine- may increase risk of convulsions
Drug interactions with Chloroquine

9. Sources:
Lippincott’s Pharmacology
Class Notes and Lectures
Done by
Carol Tafadzwa Dzorani