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41 Cards in this Set
- Front
- Back
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What are the major Amebiasis infections?
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E. histolytica
E. Naegleria Acanthamoeba |
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What diseases do amebiasis cause?
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fulminating meningitis
granulomatious encephalitis |
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What are the symptoms of asymptomatic amebiasis?
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mild to moderate colitis
recurrent diarrhea, abdominal cramps mucus in stool Tenderness along colon |
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How does severe amebic colitis present?
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stools are semi-formed to liquid
streaked w/ blood and mucus fever, colicky pain in fulminant cases - peritonitis and hemorrhage |
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What is hepatic amebiasis?
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hepatic enlargement, pain, tenderness
amebas found in stolls and in aspirate from liver abscess serological test positive cough, pain in right shoulder |
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What is the MOA of metronidazole and tinidazole?
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reductive bioactivation to form a cytotoxic product which binds to protein and DNA --> kills
pyruvate:oxidoreductase |
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How is metronidazole and Tinidazole eliminated?
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through hepatic metabolism
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how is metronidazole and tinidazole administered?
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PO and pereteral
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When are metronidazole and tinidazole used?
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-severe amebiasis
-urogenital trichomonias - tx both partners -giardiasis -gardnerella vaginalis -anerobic infection -antibiotic assoc colitis -ulcerative colitis -cutaneious leishmaniasis |
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What are the adverse effects of metronidazole and tinidazole?
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urethral burning, metallic taste
seizures, ataxia, phlebitis, urinary discoloration GI irritation - nausea, vomiting, diarrhea dryness of mouth, insomnia, weakness, stomatitis |
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Is metronidazole and tinidazole safe in pregnancy?
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safety not established - teratogenic in animals
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What cautions should be taken into consideration w/ metronidazole and tinidazole use?
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disulfiram-like reaction w/ alcohol
potentiates anticoagulants |
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What is emetine?
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alkaloid that inhibits protein synthesis by blocking ribosomal movement
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How is emetine administered?
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intramuscular injections
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Where is emetine concentrated?
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liver, spleen, kidney, heart
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how is emetine eliminated?
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kidney
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when is emitine used?
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amebiasis
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What are the adverse effects of emitine on the heart?
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are protoplasmic poisons - effect heart --> cloudy swelling and necrosis
congestive heart failure, hypotension, arrhythmias, retrosternal pain, |
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What are the systemic adverse effects of emitine?
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abscess at site of injection, nausea, vomiting, diarrhea, muscular weakness, tenderness, pain
fatigue, headache, diziness urticaria, pruititic eruptions |
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How does diloxanide furotate work?
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hydrolyzed in gut lumen and converted to free base
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what is diloxanide furoate used for?
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aymptomatic carriers of amebiasis
moderate to severe intestinal amebiosis |
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What are the adverse effects of diloxanide furoate?
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nausea, vomiting, abdominal cramps, esophagitis
dry mouth pruritus, uticaria, proteinuria |
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what is iodoquinol?
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a halogenated hydroxyquinoline
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how is idoquinol administered?
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PO
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when in idoquinol administered?
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alternate for asymptomatic carriers and in patients w/ mild to severe intestinal amebiasis
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what are the adverse effects of idoquinol?
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usually mild
high doses can result in systemic absporption --> nephrotoxicity, optic atrophy, peripheral neuropathy, thyroid enlargment, agranulocytosis, nausea, vomiting |
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when is iodoqunol CI?
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thyroid and renal disease
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how does tetracycline act as an amebicide?
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kills intestinal flora which is ameba main food source
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when is tetracycline CI?
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pregnancy and children under 8
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what is the MOA of tetracycline?
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chelates Ca, Mg, Al into non-absorbable compounts
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how is tetracycline administered for amebiosis?
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w/ another amebicide - it is ineffective alone
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What is a tissue amebicidal drug?
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chloroquine
emetine metronidazol |
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what are luminal amebicidal agents?
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doloxanide furoate
iodoquinol paramomycin |
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what is the first choice of drug for amebiosis in a asymptomatic carrier?
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diloxanide furoate
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what is the second choice of drug for amebiosis in an asymptomatic carrier?
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paromycin or idoquinol
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what is the first choice of drug for amebiosis in mild to moderate disease?
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metronidazole+
diloxanide furoate or paromycin or idoqunol |
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what is the second choice of drug for amebiosis in mild to moderate disease?
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diloxanide furoate or iodoquinol or TC followed by chloroquine
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what is the first choice of drug for amebiosis in severe dysentry?
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metrondiazole IV until recovery followed by oral metronidazole +
diloxanide furoate |
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what is the second choice of drug for amebiosis in severe dysentry?
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TC + Diloxanide furoate followed by chlorquine
Emetiine + TC followed by DF iodoqunol + chloroqunol |
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what is the first choice of drug for amebiosis in hepatic involvement?
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metronidazole+ DF followed by chloroquine
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what is the second choice of drug for amebiosis in hepatic involvement?
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emetiine + chloroquine + DF
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