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LEISHMANIASIS

LEISHMANIASIS. TYPES. A) Cutaneous B) Mucocutaneous C) Visceral. Life Cycle. The parasite in blood stream. * Is transmitted from animals to humans by the bite of infected sand fly. * Diagnosed by the presence of parasite in biopsy from skin.

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LEISHMANIASIS

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  1. LEISHMANIASIS

  2. TYPES • A)Cutaneous • B) Mucocutaneous • C) Visceral

  3. Life Cycle

  4. The parasite in blood stream • * Is transmitted from animals to humans by the bite of infected sand fly. • * Diagnosed by the presence of parasite in biopsy from skin. • * Treatment is limited due to toxicities & failure of drugs.

  5. Sodium Stibogluconate • Pentavalent antimonial drug

  6. Pharmacokinetics • Not absorbed orally • Given IV/ IM for 20 days for cutaneous leishmaniasis & 28 days for visceral and mucocutaneous disease. • Distributed in extravascular compartement.

  7. Partially metabolized • Excreted in urine

  8. Mechanism Of Action • Unknown • Production of oxygen free radicals

  9. Adverse Effects • GIT upset • Fever, headache, arthralgia , rash. • IMI----( local pain & sterile abscess). • QT prolongation. • Hemolytic anaemia

  10. Pentamidine • Alternative to Na stibogluconate for the treatment of visceral leishmaniasis. • For cutaneous lesion

  11. Pharmacokinetics • Not absorbed orally • Given IV/ IM. • Accumulative drug & eliminated slowly in urine ( elimination half-life 12 days). • Not effectively cross blood brain barrier • Can be inhaled as a nebulized powder.

  12. Mechanism of Action • Unknown

  13. Clinical uses • Pneumocystosis • Prophylaxis against pneumocystosis in immunocompromised individuals. • African trypanosomiasis ( sleeping sickness). • Alternative to sodium stibogluconate for visceral leishmaniasis.

  14. Adverse Effects • Rapid IVI can lead to severe hypotension, tachycardia , dizziness, dyspnea ( should be given slowly over 2 hours). • IMI – pain & sterile abscess

  15. Pancreatic toxicity( acute pancreatitis) • Hypoglycemia • Hyperglycemia • Reversible renal insufficiency • Rash • Metallic taste

  16. Fever • Thrombocytopenia • Cardiac arrhythmias • GIT upset • Cough, dyspnea, bronchospasm ( with the inhaled drug ) • Headache, Arthralgia

  17. Miltefosine • An alkylphosphocholine analog • Used for the treatment of visceral leishmaniasis • Given orally

  18. Adverse Effects • Vomiting & diarrhea • Elevation in liver enzymes • Teratogenic

  19. Amphotericin B • Antifungal drug • Used as alternative therapy for visceral leishmaniasis.

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