Eukaryote (ex.

Prokaryote (Bacteria)
Protozoa) AMEBIASIS
True nucleus with Nucleoid; with loosely
multiple organized DNA • caused by Entamoeba histolytica
ANTIPROTOZOAL DRUGS chromosomes; lacking a nuclear o Tx: metronidazole + a luminal amebicidal
with nuclear membrane and drug, such as diloxanide furoate.
membrane and mitotic apparatus o This combination provides cure rates of
mitotic apparatus greater than 90%.
With organelles No organelles
(mitochondria and
lysosomes)
Larger (80s) Smaller (70s)
ribosomes ribosomes

Luminal amebicides

• Diloxanide furoate - for tx of • Chloroquine – to treat and prevent amebic

liver abscess, also malaria
asymptomatic passers of cysts; tx of
intestinal amebiasis • MOA – amebicide – unknown
- antimalarial – alter the properties of
• - CI: pregnant women and children DNA
under 2 y/o
• SE- visual disturbances, ototoxicity
• Paromomycin- an aminoglycoside
• Tetracycline

Mixed amebicide (luminal +

Systemic amebicides
• Emetine
• Dehydroemetine
– both emetine and dehydroemetine
inhibit protein synthesis & IM is the
preferred route
– S/E: pain at the site of injection,
transient nausea, cardiotoxicity (eg.,
arrhythmias, congestive heart failure),
neuromuscular weakness, dizziness,
and rashes
MALARIA
systemic)
• Metronidazole – selectively toxic not only • four species of the protozoal genus
for amebae but also for anaerobic plasmodium
organisms and for anoxic or hypoxic cells • anopheles mosquito
• - forms cytotoxic compounds that bind to
proteins and DNA to result in cell death
• - DOC for Amebiasis
• - GIT irritation, metallic taste; disulfiram-
like effect

Against exoerythrocytic form/ tissue

schizontocide
• Primaquine – MOA is not completely
understood; also gametocidal for all four
plasmodia species, transmission of the
disease can be interrupted.
 Against erythrocytic form/ blood
schizonticide
• Chloroquine –DOC in the treatment of
erythrocytic falciparum malaria, except in
resistant strains
• - less effective against vivax malaria
• - also has anti-inflammatory action (also
used in rheumatoid arthritis and discoid
lupus erythematosus)
• MOA: alters the properties of DNA
ANTHELMINTHIC DRUGS
Three major groups of helminthes (or
worms), the nematodes, trematodes and
cestodes
. antihelminthic drugs are aimed at
metabolic targets that are present in the
parasite
c. Pyrantelpamoate – poorly
absorbed orally, acts as a
depolarizing neuromuscular
blocking agent (paralyzes the
worm)
d. Thiabendazole
- MOA - unknown
CESTODES (tapeworms)
oNiclosamide – DOC for most
cestode infection; laxative is
administered prior to oral
administration of niclosamide;
alcohol should be avoided within
1 day of niclosamide
Against gametocytic form
• Quinine – for chloroquine-resistant organisms;
fetotoxic
• Mefloquine - effective single agent for Primaquine
multidrug-resistant forms of P. falciparum • MOA – unknown
• Pyrimethamine – blood schizonticide and • Administer drug with meals or with
sporontocide antacids
• - acts as a strong sporonticide in the
mosquito’s gut when the mosquito ingests it
with the blood of the human host
• - inhibits folate reduction
• - alone is effective against P. falciparum
• - in combination with a sulfonamide, it is also
used against P. malariae
NEMATODES (round worms)
b. Mebendazole
a. Ivermectin
• DOC for the treatment of onchocerciasis
• DOC: whipworm, pinworm,
(river blindness) hookworm and roundworm
• effective against scabies • binds to and interferes with the
• The killing of the microfilaria can result in synthesis of microtubules and
a Mazotti-like reaction (fever, headache, also by decreasing glucose
dizziness, somnolence, hypotension,
etc.) uptake.
• CI: pregnancy; meningitis • CI: pregnancy – embryotoxic
and teratogenic
TREMATODES (flukes)
o Praziquantel • SE: Nausea, abdominal pain,
• broad spectrum of activity against headache, malaise and dizziness
trematodes (flukes) and cestodes
(tapeworms) • CI: Hypersensitivity, ocular
• causes spastic paralysis of worms
cysticercosis
• higher doses - tegumental damage in
the worms, which activates host
defense mechanism