Protozoan Drugs

tsdownstate2018's version from 2015-04-22 22:26

Section 1

Question Answer
Treatment for A person with asymptomatic intestinal disease who is passing cysts in stool:Treat with luminals: Paromomycin (perferred) or Iodoquinol.
Treatment for a person with mild to severe intestinal intestinal infection (diarrhea or dysentary)treat with luminal and tissue amebicides. (Paromomycin or Iodoquinol) and (Metronidazole or Tinidazole)
Treatment for a person with extra-intestinal infection (hepatic abscess)treat with luminal (paromomycin or iodoquinol) and tissue amebicides (metronidazole or tinidazole) and if resistant chloroquine.
Treatment for a person with extra-intestinal infection non hepatic: treat with luminal (paromomycin or iodoquinol) and tissue amebicides (metronidazole or tinidazole).
Paromomycin and IodoquinolLuminal Amebicides
Paromomycin inhibits protein synthesis, Side effects mild: Diarrhea, nausea, contraindicated if there is bowel perforation: nephrotoxic, ototoxic
IodoquinolNot well absorbed in the intestine, unknown MOA, Contraindication in iodine intolerant patients
Metronidazole and TinidazoleTissue amebicides, Target intracellular targets like DNA
Systemic AmebicidesDehydroemetine, Tetracycline, and Chloroquine.
TetracyclineFor bowel wall only. MOA: acts by altering the GI flora needed for amebic proliferation, contraindicated in children and pregnant women.
ChloroquineUsed to treat amebic liver abscesses, if resistant to tissue amebicides
Dehydroemetine given IM not IV or orally, side effects cardiotoxic and hypotension

Section 2

Question Answer
Drugs to treat Giardia LambliaMetronidazole, Tinidazole, Furazolidine, Nitazoxanide
Drugs to treat Cryptosporidium ParvusNitazoxanide and Paromomycin
Alternative to metro for Giardia, MOA like metro, Side Effects: Disulfram like effects, Inhibits monoamine-oxidase (breaks down sympathetic neurotransmitters) can cause hypertensive crisis with sympathomimetics. Furazolidine
Nitazoxanide: Inhibits pyruvate:ferredoxin oxidoreductase (PFOR) which is necessary for anaerobic energy metabolism

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