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Understanding Leishmaniasis Treatment Methods

Leishmaniasis is caused by parasitic protozoa transmitted by sand flies, leading to various diseases. Sodium stibogluconate is the main drug therapy, while pentamidine isethionate is an alternative option. Miltefosine and Amphotericin B can also be used. Learn about their mechanisms of action, pharmacokinetics, adverse effects, and more.

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Understanding Leishmaniasis Treatment Methods

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  1. LEISHMANIASIS Dr.Abdul latif Mahesar Dept.of medical pharmacology King Saud university

  2. Leishmaniasis is a parasitic disease caused by microsopcopic protozoans of genus leishmania • It was identified by a British medical officer Sir William Leishman. • It occurs in Mediterrarean region, Africa , central and south America.

  3. Leishmania is a parasitic protozoa • it is transmitted by flesh eating flies like sand fly. • It can be transmitted from animal to human and from human to human • it can cause visceral disease mainly enlargement of liver and spleen with fever, as well as cutaneous and mucocutaneous lesions.

  4. Sodium stibogluconate is a primary drug for all forms of the disease. • Cutaneous lesions can also be treated by fluconazole and metronidazole . • mucocutaneous disease can be treated by amphotericin B

  5. SODIUM STIBOGLUCONATE Pentavalent antimonials include: • Sodium stibogluconate • Meglumine antimonate

  6. Mechanism of action: • Specifically It is unknown • Evidence for inhibition of glycolysis in the parasite at the phosphofructokinase reaction is reported • Or effects on nucleic acid metabolism

  7. Pharmacokinetics • It does not get absorbed orally • It is administered parenterally in a dose of 20mg/kg /day IV /IM for 20 days for cutaneous leishmaniasis and 28 days for visceral and mucocutaneous disease. • It is distributed in extravascular compartment . • Drug is metabolized to minimum • It is excreted in urine

  8. It is potentially cardiotoxic drug

  9. ADVERSE EFFECTS: • Pain at the site of injection • Gastrointestinal upset • Cardiac arrhythmias • Myalgia • Fever • Headache • Arthralgia • Resistance • Renal and hepatic function should be monitored regularly

  10. PENTAMIDINE ISETHIONATE • It is used as an alternative to Na stibogluconate for the treatment of visceral leishmaniasis and sometimes used for cutaneous lesion , but not routinely. • mechanism of action is unkown but it may be similar to sodium stibogluconate • It is given in a dose of 2-4 mg/kg Im daily or every other day up to 15 days

  11. Pharmacokinetics • It is not absorbed orally. • It is administered parentrally • It is accumulated and eliminated very slowly in urine • It has a half life of 12 days

  12. Its mechanism of action is unknown

  13. Adverse effects • Pain at the site of injections • Hypotension due to peripheral vasodilatation • Respiratory stimulation followed by depression • Tachycardia • anemia , neutropenia • Hypoglycemia • Dizziness • Dyspnea • Hepatitis • Pancreatic toxicity hypoglycemia

  14. Reversible renal insufficiency • GIT disturbances • Cardiac arrhythmia • Abnormal liver function tests • it can also be used for the treatment of pneumocystosis and African trypanosomiasis

  15. MILTEFOSINE • It is alkylphosphocholine analog • It is used in the treatment of visceral leishmaniasis • It is taken orally 100 mg/daily for adults

  16. Adverse effects • Gastrointestinal disturbances • Elevation in liver transaminase • Teratogenic

  17. Amphotericin B it is an antifungal drug which can be used as an alternative therapy for visceral leishmaniasis. Aminosidine + Pentamidine

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