CHAPTER 12: ANTI-PROTOZOAL AGENTS o Indications- Prevent the acute malarial reaction

CAUSES OF PROTOZOAL INFECTIONS? in individuals who have been infected by the

o Insect Bites parasite, or work against tissue schizonts as
o Malaria prophylactic or antirelapse agents
o Trypanosomiasis o Actions- Enters human red blood cells and
o Leishmaniasis changes the metabolic pathways necessary for the
o Ingestion or Contact with the Causal reproduction of the Plasmodium
Organism o Pharmacokinetics- Readily absorbed from the
o Amebiasis GI tract, concentrated in the liver, spleen, kidney,
o Giardiasis and brain and is excreted very slowly in the urine
o Trichomoniasis o Contraindications- Known allergy, liver disease,
PROTOZOAL PARASITES IDENTIFIED AS alcoholism, pregnancy and lactation
CAUSES OF MALARIA o Adverse effects- CNS, GI, hepatic dysfunction
o Plasmodium falciparum and dermatological
o Considered the most dangerous type of o Drug-to-drug interactions- Patient who is
protozoan receiving combinations of quinine derivative and
o Plasmodium vivax quinine is at increased risk for toxicity and
o Milder form of the disease; seldom convulsions
o Prototype - Quinine (generic)
results in death
o Plasmodium malariae NURSING CONSIDERATIONS FOR
ANTIMALARIAL AGENTS
o Endemic in tropical countries; mild
o Assess:
symptoms
o History of allergy to any of the
o Plasmodium ovale
antimalarials
o Rarely seen; in the process of being
o Physical status
eradicated
o Ophthalmic and retinal examinations
MALARIA
o Signs and Symptoms and auditory screening
o Liver function, including liver function
o Related to the destruction of red blood
tests
cells and toxicity to the liver
o Blood culture to identify the causative,
o Treatment
Inspect the skin closely for color,
o Aims at attacking the parasite at the
temperature, texture, and evidence of
various stages of its development inside
lesions
and outside the human body
RISK FACTORS FOR PROTOZOAL INFECTIONS
ANTIMALARIALS
o Unsanitary Conditions
o Chloroquine (Aralen)
o Poor Hygienic Practices
o Prevention and treatment of plasmodial
OTHER PROTOZOAL INFECTIONS
malaria; treatment of extraintestinal
o Amebiasis
amebiasis
o Leishmaniasis
o Hydroxychloroquine (Plaquenil)
o Trypanosomiasis
o Treatment of plasmodial malaria in
o Trichomoniasis
combination with other drugs
(particularly primaquin) o Giardiasis
o Mefloquine (Lariam) o Pneumocystic carinii
o Prevention and treatment of plasmodial COMMON OTHER ANTIPROTOZOAL AGENTS
malaria in combination with other o Atovaquone (Mepron)
drugs o Especially active against PCP
o Primaquine (generic) o Metronidazole (Flagyl, MetroGel, Noritate)
o Prevention of relapses of Plasmodium o Treats amebiasis, trichomoniasis, and
vivax and Plasmodium malariae giardiasis
infections; radical cure of o Pentamidine (Pentam 300, NebuPent)
P. vivax malaria o Treats PCP, trypanosomiasis, and
o Pyrimethamine (Daraprim) leishmaniasis
o Prevention of plasmodial malaria in o Tinidazole (Tindamax)
combination with other agents to o Treats trichomoniasis, giardiasis, and
suppress transmission; treatment of amebiasis
toxoplasmosis Actions- Inhibit DNA synthesis in susceptible protozoa
o Quinine (generic) Pharmokokinetics- Readily absorbed and highly protein
o Treatment of chloroquine-resistant bound in circulation or metabolized in the liver and
plasmodial infections excreted in the urine and feces
Contraindications- Known allergy, pregnancy, CNS
disease, hepatic disease
Adverse Reactions- Headache, dizziness, ataxia, nausea,
vomiting, and diarrhea
Drug-to-drug interaction- Alcohol, anticoagulants,
disulfiram
NURSING CONSIDERATIONS FOR
ANTIPROTOZOAL AGENTS
 Assess:
o History of allergy to any of the
antiprotozoals
o Perform a physical assessment
o CNS to check reflexes and muscle
strength, skin and mucous membranes
to check for lesions, color, temperature,
and texture
o Evaluate liver function, including liver
function tests
o Obtain cultures

LIFE CYCLE OF PLASMODIUM