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Malaria Amoebiasis Trypanosomiasis Leishmaniasis Giardiasis Trichomoniasis

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Caused by the plasmodium protozoa Four different plasmodium species Vector: female Anopheles mosquito Transmitted via blood transfusion, congenitally, or via infected needles by drug abusers.

Life Cycle of the plasmodium: Sexual in the mosquito Asexual in human

EXOERYTHROCYTIC PHASE outside RBC ERYTHROCYTIC PHASE inside RBC

Erythrocytic:
CHLOROQUINE, MEFLOQUINE, QUININE, HYDROXYCHLOROQUINE

Exoerythrocytic:
PRIMAQUINE (prevents relapse)

Chloroquine-resistant strains
QUININE SULFADOXINE+PYRIMETHAMINE (Fansidar)

Multi-drug resistant strains

Artemesin-lumerfrantine

CHLOROQUINE, MEFLOQUINE, QUININE, HYDROXYCHLOROQUINE

4-aminoquinoline derivatives Bind to parasite nucleoproteins and interfere with protein synthesis and alter pH of parasite Chloroquine prophylactic drug Chloroquine & Hydroxychloroquine have antiinflammatory effects

SIDE EFFECTS: N/V, D, anorexia, abd pain, dizziness, headache ` Quinine: N/V, tinnitus, vertigo
CINCHONISM SYNDROME

ADVERSE EFFECTS: ` Hepatotoxicity ` Dermatological changes (rashes, alopecia) ` Hemolytic anemia (chloroquine) ` Permanent eye damage/blindness (chloroquine) ` Nephrotoxicity (quinine) ` Steven Johnson Syndrome (Fansidar)

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Screen the client for any contraindications (liver dysfunction, alcoholism, psoriasis, retinal disease, pregnancy & lactation) Arrange for appropriate culture and sensitivity tests before beginning therapy Administer the complete course of the drug. Mark a calendar for prophylactic doses. Monitor hepatic function and ophthalmologic examination before and periodically during treatment

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Provide comfort and safety measures Maintain nutrition and address diarrheal problems Advise clients traveling to malaria-infested countries to receive prophylactic doses of antimalarial drug before leaving, during visit and upon return. Instruct client to take oral antimalarial drugs with food or at mealtime Warn client about consuming large quantities of alochol

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Amoebiasis Leishmaniasis
Skin, mucuous membrane infection

Trypanosomiasis
African sleeping sickness, Chagas disease

Trichomoniasis
Vaginal infection

Giardiasis
Intestinal infection, travelers diarrhea

PCP/ Pneumocystis carinii pneumonia

ARC (lung)

METRONIDAZOLE (Flagyl)
Bactericidal (H. pylori, anaerobic bacterial infection), Trichonacidal (trichomoniasis) & Protozoacidal/Amoebicidal (amoebiasis) Prophylaxis in colorectal surgery Has METALLIC TASTE;

Side Effects/Adverse Effects:

x x x x N/V, D, headache, dizziness Neurotoxicity numbness, vertigo, ataxia Hepatotoxic DISULFIRAM-LIKE EFFECT

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Assess for hepatic function and CNS disease Instruct client to avoid alcohol-containing products during & 48 hours after tx completion. Client should complete the course of medication even if symptoms disappear Maintain nutrition & hydration Patient may take the medication with meals if GI upset occurs; inform of the drugs metallic taste Inform patient that his/her urine may turn red-brown in color (high doses) CNS effects/ safety precautions

Atovaquone
PCP
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Paramomycin
Intestinal amoebiasis

Pentamidine
Trypanosomiasis Leishmaniasis PCP
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Pyrimethamine
Toxoplasmosis

Yinodazole
Trichomoniasis, Giardiasis & amoebiasis

Nematodes
Elongated round worms

Cestodes
True tapeworms

Trematodes
Flukes, flat-shaped flatworms

Intestinal parasitism Tissue-invading worm infections:

TRICHINOSIS FILARIASIS SCHISTOSOMIASIS

Mebendazole (Antiox)

Drug of choice: ` Whipworm, Pinworm, Hookworm, Roundworm Action: binds & interferes the synthesis of parasites microtublules and decreases glucose uptake ` Parasites are expelled in the feces Side effects: Abd pain, diarrhea

Pyrantel pamoate (Combatrin) Uses: Pinworm, Hookworm, Roundworm

Action: paralyzes the worm by depolarizing neuromucsular receptor of parasites ` Parasites are expelled in the feces Side effects: N/V, D

Albendazole (Albenza)
Dog tapeworm and pork tapeworm TERATOGENIC

Thiabendazole (Minthezol)
Uses: strongyloidiasis, trichinosis Action: microtubular aggregation Side effects: Steven-Johnson Syndrome

Niclosamide
Use: Cestodes

Common side effects: GI upset, dizziness, headache, drowsiness

Praziquantel (Biltricide)
Use: Schistosomiasis

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Collect stool specimen Obtain history of food intake & how the food was prepared Administer antihelminthics after meals or with food to reduce gastric upset Explain the importance of handwashing and proper hygiene; daily change & laundering of underwear, towels and bed linens, disinfection of toilet facilities Maintain nutrition Emphasize importance of taking prescribed drug at designated times and keeping HCP appointments Safety precautions