Drugs to be used in amoebic and protozoal infections.

1. Antiamoebic and
Other
Antiprotozoal
Drugs
__ Dr. Rajpushpa Labh

7. Amoebiasis
• Incidence & Prevalence
• Etiology : Anaerobic Protozoa Entamoeba
histolytica
• Spread by faecal contamination of food
and water
• Predisposing factors : poor environmental
sanitation & low socio-economic status
• Etiopathogenesis :

8. By Mariana Ruiz Villarreal LadyofHats - self-made based on the book "Parasitologia clinica" from craig and faust., Public Domain,
https://commons.wikimedia.org/w/index.php?curid=3694512

11. Metronidazole : prototype Nitroimidazole
Mechanism of action :

12. • Pharmacodynamics:
• Metronidazole produces concentration-dependent killing
• Pharmacokinetics:
• Half-life: 8h (mean); Renal clearance
• Bioavailability: Approximately 100% PO
• Antimicrobial Spectrum:
• Anaerobic Gram-negative bacilli: Bacteroides fragilis, Bacteroides
species, Fusobacterium spp., Porphyromonas spp.
• Anaerobic Gram-positive bacilli: Clostridium spp.
• Anaerobic cocci: Peptostreptococcus species
• Protozoa: Entamoeba histolytica, Giardia lamblia, Trichomonas
vaginalis

13. • Adverse Effects:
• Gastrointestinal: abdominal discomfort,
anorexia, nausea, vomiting, INJECTION SITE
REACTIONS metallic taste, glossitis, hepatitis
(rare), pancreatitis (rare)
• Neurologic:
• Hematologic: reversible leukopenia,
thrombocytopenia
• Hypersensitivity:
• Other: Metallic taste , DISULFIRAM LIKE
REACTION, LITHIUM, WARFARIN

14. • METRONODAZOLE USES : Amoebiasis, Giardiasis,
Trichomonas vaginitis, Psudomembranous enterocolitis, ANUG
(Trench Mouth), H pylori, Phophylactic use before surgery
• ?? TINIDAZOLE, SECNIDAZOLE, ORNIDAZOLE ??
• EMETINE V/S DIHYDROEMETINE (Inhibits protein
synthesis, only trophozoites, myocarditis)
• CHLOROQUINE
• DILOXANIDE FUROATE
• NITAZOXANIDE : Prodrug  TIZOXANIDE,PFOR,
cryptosporidium parvum

15. • Amoebic Liver abcess : Metronidazole/
Dihydroemetine
• GIARDIASIS : Metronidazole 400mg TDS for 7
days OR Tinidazole/Ornidazole/Secnidazole :
2gm single dose
• Nitaxoxanide : 500mg BD for 3 days
• TRICHOMONIASIS : Intravaginal pessaries of
Diiodohydroxyquin/ Quindochlor 200mg bed time
for 2 weeks

16. KALA -AZAR
• BIHAR
• SSG
• Meglumine Antimonate
• AMB : “reference drug”
• MILTEFOSINE : oral, 1st line in NVBDCP, 4 weeks therapy,
teratogenic, no pregnancy till 3 months after
• PAROMOMYCIN
• NVBDCP (Kala azar control programme) RDT, Splenic
aspirate
• Dermal Leishmaniasis (Oriental sore) : SSG, Paromomycin
ointment

17. • LUNCHTIME..! See you in tutorial… 