Professional Documents
Culture Documents
List the major group of antiamebiasis Choose the drug for asymptomatic, and
symptomatic amebiasis Identify the drugs useful in amebic liver abscess Identify side effects of antiamebiasis List the clinical aplication of metronidazole
case
A female patient complain lower abdominal
discomfort, flatulence, diarrhea. Patient is diagnosed as symptomatic amebiasis. E.histolytica is identified in her stool. The doctor prescribe an oral drug, which reduces her intestinal symptom. Later she got a severe dysentry, fever, weight loss and enlarge liver. Diagnosis now, amebic liver abscess. She has a history of disrrythmia. How do you manage this patient ?
Diloxanide Furoate
Useful in eradicating the bowel lumen dwelling
form 90% is rapidly absorbed and conyugated to form the glucuronide, promptly excreted in the urine Converted in the gut to diloxanide freebase The commonest adverse effect is flatulence
Iodoquinol
Diiodohydroxyquinoline & clioquinol 90% retained in the intestine Less effective than diloxanide Adverse effect:
g.i.symptom thyroid enlargement neurotoxic effect (SMON)
Tetracycline
Indirectly amebicide by modifying the
intestinal flora which necessary for ameba to survive
Paromomycine
Aminoglycoside antibiotic Direct amebicidal action
Chloroquine
Effective only in hepatic amebiasis (high
concentration in liver) Less effective than emetine Should be given in combination with emetine or metronidazole
tissue, eliminated slowly via kidney Toxic to the myocardium (arrhythmia and congestive heart failure) Should not be used in patient cardiac or renal disease, elderly, young children, pregnancy
Metronidazole
Has potent amebicidal activity Orally active Eradicate tissue infection The drug of first choice in tissue amebiasis Adverse effects:
g.i tract irritation disulfiram like reaction (with alcohol) coumarin effect increase dark coloration of urine
Summary
Two major group of antiamebiasis: luminal
amebicides, tissue amebicides For asymptomatis: diloxanide furoate For symptomatis: metronidazole Drugs useful in amebic liver abscess: metronidazole, emetin, chloroquine. Should be followed by lumen amebicide Clinical aplication of Metronidazole: intestinal and extraintestinal wall amebiasis, trichomonas, giardiasis, anaerobic bacteria