LEISHMANIASIS

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LEISHMANIASIS
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TYPES

• A) Cutaneous
• B) Mucocutaneous
• C) Visceral

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Life Cycle
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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.

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Sodium Stibogluconate

• Pentavalent antimonial drug

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Pharmacokinetics

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

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• Partially metabolized
• Excreted in urine

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Mechanism Of Action

• Unknown
• Production of oxygen free radicals

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Adverse Effects

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

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Pentamidine

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

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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.

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Mechanism of Action

• Unknown

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Clinical uses

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

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Adverse Effects

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

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

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

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Miltefosine

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

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Adverse Effects

• Vomiting diarrhea
• Elevation in liver enzymes
• Teratogenic

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Amphotericin B

• Antifungal drug
• Used as alternative therapy for visceral
  leishmaniasis.