2. Antiprotozoal Agents
Chapter 12

3. Causes of Protozoal Infections
Insect Bites
Malaria
Trypanosomiasis
Leishmaniasis
Ingestion or Contact with the Causal Organism
Amebiasis
Giardiasis
Trichomoniasis

4. Protozoal Parasites Identified as Causes of Malaria
Plasmodium falciparum
Considered the most dangerous type of protozoan
Plasmodium vivax
Milder form of the disease; seldom results in death
Plasmodium malariae
Endemic in tropical countries; mild symptoms
Plasmodium ovale
Rarely seen; in the process of being eradicated

5. Life Cycle of Plasmodium

6. Antimalarials Chloroquine (Aralen)
Prevention and treatment of plasmodial malaria; treatment of extraintestinal amebiasis
Halofantrine (Halfan)
Treatment of plasmodial malaria in combination with other drugs
Hydroxychloroquine (Plaquenil)
Treatment of plasmodial malaria in combination with other drugs (particularly primaquine)

7. Antimalarials (cont.) Mefloquine (Lariam)
Prevention and treatment of plasmodial malaria in combination with other drugs
Primaquine (generic)
Prevention of relapses of Plasmodium vivax and Plasmodium malariae infections; radical cure of P. vivax malaria

8. Antimalarials (cont.) Pyrimethamine (Daraprim)
Prevention of plasmodial malaria in combination with other agents to suppress transmission; treatment of toxoplasmosis
Quinine (generic)
Treatment of chloroquine-resistant plasmodial infections

9. Question
Please answer the following statements as true or false. Halofantrine (Halfan) is an antimalarial drug used in the treatment of plasmodial malaria. It is typically used in combination with other drugs.

10. Answer
True Rationale: Halofantrine (Halfan): Treatment of plasmodial malaria; used in combination with other drugs

11. Antimalarials - Action
Interrupt plasmodial reproduction of protein synthesis
Agents which do not appear to affect the sporozoties are used for prophylaxis

12. Antimalarials - Contraindications
Known Allergy
Liver Disease
Alcoholism
Lactation
Caution:
Retinal disease of damage
Psoriasis

13. Antimalarials – Adverse Effects
Headache
Dizziness
Fever
Chills
Malaise
Nausea
Vomiting
Hepatic Dysfunction

14. Antimalarials – Drug-to-Drug Interaction
Quinine derivatives and quinine is at risk for cardiac toxicity.
Antifolate drugs with pyrimethamine can cause increase risk of bone marrow suppression.

15. Other Antiprotozoal Drugs
Actions
Inhibit DNA synthesis
Contraindications
Known allergy, pregnancy, CNS disease, hepatic disease
Adverse Reactions
Headache, dizziness, ataxia, nausea, vomiting, and diarrhea

16. Malaria Signs and Symptoms
Related to the destruction of red blood cells and toxicity to the liver
Treatment
Aims at attacking the parasite at the various stages of its development inside and outside the human body

17. Other Protozoal Infections
Amebiasis
Leishmaniasis
Trypanosomiasis
Trichomoniasis
Giardiasis
Pneumocystic carinii

18. Risk Factors for Protozoal Infections
Unsanitary Conditions
Poor Hygienic Practices

19. Question
When are antiprotozoal medications contraindicated? A. Renal disease B. Anemia C. CNS disease D. Cardiovascular disease

20. Answer
C. CNS disease
Rationale: Contraindications are known allergy, pregnancy, CNS disease, hepatic disease.

21. Prototype Antiprotozoal Agent

22. Prototype Antiprotozoal Agent

23. Use of Antiprotozoal Therapy Across the Life Span

24. Common Antiprotozoal Agents
Atovaquone (Mepron)
Especially active against PCP
Metronidazole (Flagyl, MetroGel, Noritate)
Treats amebiasis, trichomoniasis, and giardiasis
Pentamidine (Pentam 300, NebuPent)
Treats PCP, trypanosomiasis, and leishmaniasis
Tinidazole (Tindamax)
Treats trichomoniasis, giardiasis, and amebiasis

25. Nursing Considerations for Antimalarial Agents
Assessment: History and Physical Exam-any allergy to any of the antimalarial, CNS disease, liver function
Nursing Diagnosis-acute pain r/t GI/CNS effects of the drug; Imbalanced nutrition: less than body requirements r/t GI effects of the drug..
Implementation
Evaluation

26. Nursing Considerations for Antiprotozoal Agents
Assessment: History and Physical Exam
Nursing Diagnosis
Implementation
Evaluation

27. Question
The nurse is caring for a patient with Parkinson’s disease. When developing the care plan for this patient which of the following would be an appropriate nursing diagnosis? A. Constipation related to dopaminergic effects B. Diarrhea related to dopaminergic effects C. Risk for injury related to CVS effects and incidence of orthostatic hypotension D. Risk for injury related to CVS effects and incidence of PVD

28. Answer
A. Constipation related to dopaminergic effects Rationale: Nursing diagnoses related to drug therapy might include: Constipation related to dopaminergic effects; Risk for injury related to CNS effects and incidence of orthostatic hypertension