PHARMACOLOGY ASSIGNMENT.pptx

Pharmacology clinical medicine

1. GROUP TWO PHARMACOLOGY BCM 219

2. CHEMOTHERAPY OF AMOEBIASIS,GIARDIASIS AND TRICHOMONIASIS CHEMOTHERAPY Treatment of systemic infections or malignancy Specific dugs are used Drugs have selective toxicity Toxicity is to the infecting organism Malignant cell also targeted L imited effect to host cell

3. AMOEBIASIS Amoebiasis is caused by Entamoeba histolytica Transmitted through contaminated water and food The symptoms are often quite mild include loose feces and stomach pain stomach cramping can also occur Incubation is 2 to 4 weeks

4. DIAGNOSIS Examination of fresh dysenteric fecal specimen Motile amoebae ( trophozoite stage) present F ormed or semi formed feces examined P resence of cysts indicate infection History taking serves as a basis Clinical presentations guides clinician

5. TREATMENT Drug choice depends on clinical presentation It is treated in non endemic areas Where endemic symptomatic cases are treated Here Diloxanide furoate is used Iodoquinole and paromomycin are also used Used as a single course treatment

6. TREATMENT – AMOEBIC COLITIS AND DYSENTRY Drug of choice is metranidazole Erythromycin and tetracyclins are alternatives These are used for moderate presentations Dehydroemetin and emetin can be used T hese are avoided due to toxicity Extraintestinal cases are handled different

7. TREATMENT- EXTRAINTESTINAL Where trophozoites spread to other organs The liver is primarily affected Drug of choice is metranidazole Liver abscess aspiration can be done This comes when medication fails Chloroquinole is added to initial prescription

8. TREATMENT – METRANIDAZOLE Oral 500 to 700 mg Given every 8 hours Prescribed for 7 to 10 days Followed with intraluminal agent Include iodoquinol , paromomycin and diloxanide furoate These are used to eradicate infection

9. TREATMENT PAROMOMYCIN 25-35 mg/kg/day orally Drug is given every 6 hours Given for for 5-10 days For Iodoquinol ; 650 mg orally Given 8 hourly for 20 days Not to exceed 2 g/day

10. GIARDIASIS Caused by Giardia lamblia Associated with poor hygienic conditions   Transmitted through faecal-oral route  C ontact with contaminated food and water E xhibits a variety of clinical presentation R anges from asymptomatic to severe presentations

11. GIARDIASIS SYMPTOMS Symptoms occurs after 1-2 weeks Gas and diarrhea Foul-smelling, greasy poop that can float. Stomach cramps or pain. Upset stomach or nausea. Dehydration.

12. GIARDIASIS DIAGNOSIS Stool is the sample of choice Multiple samples may be taken Sample is examined for Giardia parasites Stool antigen detection assays N ucleic acid amplification tests ( NAAT) Q uicker and more sensitive than microscopy

13. GIARDIASIS TREATMENT Majority of patients only need rehydration Done orally or IV in extremes Metronidazole is the first-line treatment  Typical dosing is 250 to 500 mg  3 times a day for 5 to 10 days Can be safely used in children

14. GIARDIASIS TREATMENT-CHILDREN   Given 30- 50 mg/kg per day D ivided into three doses P ossible regimens include tinidazole, nitazoxanide, mebendazole Albendazole and paromomycin are also used Paromomycin is poorly systemically absorbed  Thus considered in first trimester treatment

15. GIARDIASIS TREATMENT Tinidazole is given 2g orally G iven as a single dose Mebendazole is given 200mg 3 times Given daily for 3 days Albendazole is given 400mg/day This is for 5 days

16. TRICHOMONIASIS Trichomoniasis is a sexually transmitted infection Caused by Trichomonas vaginalis R esides in lumen of urogenital tract Women will often present with symptoms Men tend to be asymptomatic Occasionally they present with symptoms

17. TRICHOMONIASIS SYMPTOMS-WOMEN Itching, burning, redness of the genitals Discomfort when peeing Soreness of the genitals C lear , white, yellowish/greenish vaginal discharge Usually with a fishy smell. C an make intercourse feel unpleasant

18. TRICHOMONIASIS SYMPTOMS-MEN Men are usually asymptomatic When symptomatic the present with ; Itching or irritation inside the penis Burning after peeing or ejaculating Discharge from the penis. Discharge is usually purulent

19. TRICHOMONIASIS DIAGNOSIS Clinical examination and history are essential Discharge from both genders is used Microscopic identification of the motile protozoan Culture of the parasites from swabs I mmunonuorescence method is also used Polymerase chain reactions (PCR)

20. TRICHOMONIASIS TREATMENT Metronidazole is the main drug of choice 250 mg oral dosing Thrice a day for 7 days Alternative is 500 mg twice a day A lso given for 7 days Single 2g dose can be given

21. TRICHOMONIASIS TREATMENT Tinidazole is also an alternative Given 2g orally as single dose More expensive unlike metranidazole Infected persons advised to abstain Also advised to test for STIs Retesting is advised due to reinfection

22. METRANIDAZOLE –MODE OF ACTION  B elongs to nitroimidazole class of antibiotics It inhibits nucleic acid synthesis Does so by disrupting DNA Causes strand breakage Binds DNA and electron-transport proteins Binding of organism`s proteins hinders synthesis

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