Antiprotozoal Agents

Antiprotozoal Agents

Causes of Protozoal Infections

  • Insect bites
    • Malaria
    • Trypanosomiasis
    • Leishmaniasis
  • Ingestion or contact with the causal organism
    • Amebiasis
    • Giardiasis
    • Trichomoniasis

Protozoal Parasites Identified as Causes of Malaria

  • Plasmodium falciparum
    • Considered the most dangerous type of protozoan
  • Plasmodium vivax
    • Milder form of the disease; seldom results in death
  • Plasmodium malariae
    • Endemic in tropical countries; mild symptoms
  • Plasmodium ovale
    • Rarely seen; in the process of being eradicated

Life Cycle of Plasmodium

Life Cycle of Plasmodium

Life Cycle of Plasmodium

Antimalarials

  • Chloroquine (Aralen)
    • Prevention and treatment of plasmodial malaria; treatment of extraintestinal amebiasis
  • Halofantrine (Halfan)
    • Treatment of plasmodial malaria in combination with other drugs
  • Hydroxychloroquine (Plaquenil)
    • Treatment of plasmodial malaria in combination with other drugs (particularly primaquine)
  • Mefloquine (Lariam)
    • Prevention and treatment of plasmodial malaria in combination with other drugs
  • Primaquine (generic)
    • Prevention of relapses of Plasmodium vivax and Plasmodium malariae infections
    • Radical cure of P. vivax malaria
  • Pyrimethamine (Daraprim)
    • Prevention of plasmodial malaria in combination with other agents to suppress transmission
    • Treatment of toxoplasmosis
  • Quinine (generic)
    • Treatment of chloroquine-resistant plasmodial infections

Antimalarials—Action

  • Interrupt plasmodial reproduction of protein synthesis
  • Agents that do not appear to affect the sporozoites are used for prophylaxis

Antimalarials—Contraindications

  • Known allergy
  • Liver disease
  • Alcoholism
  • Lactation
  • Cautions
    • Retinal disease or damage
    • Psoriasis

Antimalarials—Adverse Effects

  • Headache
  • Dizziness
  • Fever
  • Chills
  • Malaise
  • Nausea
  • Vomiting
  • Hepatic dysfunction

Antimalarials—Drug-to-Drug Interactions

  • Quinine derivatives and quinine create risk for cardiac toxicity
  • Antifolate drugs with pyrimethamine can increase risk of bone marrow suppression

Other Antiprotozoal Drugs

  • Actions
    • Inhibit DNA synthesis
  • Contraindications
    • Known allergy, pregnancy, CNS disease, and hepatic disease
  • Adverse reactions
    • Headache, dizziness, ataxia, nausea, vomiting, and diarrhea

Malaria

  • Signs and symptoms
    • Related to the destruction of red blood cells and toxicity to the liver
  • Treatment
    • Aims at attacking the parasite at the various stages of its development inside and outside the human body

Other Protozoal Infections

  • Amebiasis
  • Leishmaniasis
  • Trypanosomiasis
  • Trichomoniasis
  • Giardiasis
  • Pneumocystis carinii

Risk Factors for Protozoal Infections

  • Unsanitary conditions
  • Poor hygienic practices

Prototype Antiprotozoal Agent

Prototype Antiprotozoal Agent

Prototype Antiprotozoal Agent

Prototype Antifungal Agent

Prototype Antifungal Agent

Prototype Antifungal Agent

Use of Antifungals Across the Lifespan

Use of Antifungal Across the Lifespan

Use of Antifungal Across the Lifespan

Common Antiprotozoal Agents

  • Atovaquone (Mepron)
    • Especially active against PCP
  • Metronidazole (Flagyl, MetroGel, Noritate)
    • Treats amebiasis, trichomoniasis, and giardiasis
  • Pentamidine (Pentam 300, NebuPent)
    • Treats PCP, trypanosomiasis, and leishmaniasis
  • Tinidazole (Tindamax)
    • Treats trichomoniasis, giardiasis, and amebiasis

Nursing Considerations for Antimalarial Agents

  • Assessment (history and physical exam)
  • Nursing diagnosis
  • Implementation
  • Evaluation

Nursing Considerations for Antiprotozoal Agents

  • Assessment (history and physical exam)
  • Nursing diagnosis
  • Implementation
  • Evaluation
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