1. AFAMS Antiparasitic Products, Insecticides and Repellants EO 003.01 Part 27

2. AFAMS Overview of Lesson (Insert Dari) Antiprotozoals - What is a protozoa? -Agents that act against amoebiasis and other protozoal diseases. -Antimalarials -Agents against leishmaniasis and trypanosomiasis. Antihelmintics - What is a helminth? Insert Dari

3. AFAMS What I need to know as a pharmacy technician (Insert Dari) In this lecture we will cover the drugs listed in the ANA Formulary which are classified according to the ATC system under (P) Anti-parasitics, insecticides and repellants. For each of these medications/classes students must obtain an understanding of: (1) Mechanism of Action (2) Indications (Uses) (3) Efficacy (4) Side Effects Insert Dari

4. AFAMS What is parasitic disease? (Insert Dari) There are three types of organisms that cause parasitic disease: (1)Protazoa (2)Helminthes (3)Ectoparasites Parasitic diseases can affect practically all living organisms, including plants and mammals. Humans can get parasites from contaminated food or water, bug bites, or sexual contact. Insert Dari

5. AFAMS Giardia lambia a parasite that causes severe diarrhea (Insert Dari) Mosquito that carries the malaria causing parasite (Insert Dari)

6. AFAMS Antiprotazoals (Insert Dari)

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8. Amoebiasis (Insert Dari) Amoebiasis – a gastrointestinal tract infection caused by the amoeba: Entamoeba histolytica. Symptoms can range from mild diarrhea to dysentery with blood and mucus in the stool. Infection is passed via the fecal-oral route and is usually due to drinking contaminated water. Insert Dari

9. AFAMS Agents that act against amoebiasis and other protozoal diseases. (Insert Dari) Iodoquinol Mechanism of Action Exact mechanism is unknown. Indications (Use) Is used to treat amoebiasis Side Effects Upset stomach Diarrhea Insert Dari

10. AFAMS Agents that act against amoebiasis and other protozoal diseases. (Insert Dari) Metronidazole Mechanism of Action Interferes with protein synthesis within the cell = cell death. Indication (Uses) Used to treat anaerobic bacterial and protozoal infections to include: amoebiasis various intra-abdominal infections Insert Dari

11. AFAMS Agents that act against amoebiasis and other protozoal diseases. (Insert Dari) Side Effects Upset stomach Diarrhea Important Points Do not consume alcohol while taking this medication, it causes patients to become very ill (vomiting, nausea etc.) Insert Dari

12. AFAMS Agents that act against amoebiasis and other protozoal diseases. (Insert Dari) Tinidazole Mechanism of Action Prevents DNA synthesis = death. Indication (Use) Is used to treat amoebiasis giardiasis and trichomoniasis. Side Effects fatigue/weakness metallic taste upset stomach Insert Dari

13. AFAMS

14. What is Malaria? (Insert Dari) Malaria is a disease caused by an infection with a parasite. Mosquitoes carry the parasite and spread it to people by biting them. Malaria is common in many countries. Insert Dari

15. AFAMS What is Malaria? (Insert Dari) It can be mild or severe. Severe malaria can cause serious health problems and even death Insert Dari

16. AFAMS Chloroquine Quinine Primaquin Lumefantrine and Artemether Mechanism of Action Prevents growth and replication of the parasite. Indications (Use) To treat or to prevent malaria from occurring. Insert Dari Antimalarials (Insert Dari)

17. AFAMS Side Effects Vivid dreams Headache Dizziness Anemia Changes in mood Important Information Should be taken with food to minimize stomach upset. Very important for patients to take the medication as directed by the physician and for the amount of time prescribed for the medication to be effective. Insert Dari Antimalarials (Insert Dari)

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19. What is leishmaniasis? A protozoal infection spread by sand flies. The symptoms of leishmaniasis are skin sores which erupt weeks to months after the person affected is bitten by sand flies. Other consequences, which can occur anywhere from a few months to years after infection, include fever, damage to the spleen and liver, and anemia.

20. AFAMS (Insert Dari) Insert Dari

21. AFAMS Meglumine antimoniate (Insert Dari) Mechanism of Action Affect the metabolism of the cell = cell death. Indication (Use) Used to treat cutaneous and visceral leishmaniasis. Side Effects muscle and joint pain mild rash nausea and abdominal pain Important Points Must be administered by IV or IM injection. Insert Dari

22. AFAMS Anti-helmintics (Insert Dari)

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24. What is a helminth? (Insert Dari) A helminth is essentially a worm. Infection also occurs via the oral fecal route. Usually by unintentionally ingesting worm eggs or larvae. Through direct contact with other infected people, contaminated water or food. Insert Dari

25. AFAMS Mechanism of Action Interferes with metabolism = death of worm. Indications (Use) Used to treat infections that are caused by worms (helminths). Side Effects headache upset stomach Insert Dari Albendazole (Insert Dari)

26. AFAMS Praziquantel (Insert Dari) Mechanism of Action Paralyzes the worm (helminth). Indications Treatment of schistosomiasis Side Effects Dizziness Upset stomach Feeling tired or fatigued Insert Dari

27. AFAMS Shistosomiasis (Insert Dari) Most patients infected do not show symptoms. Clinical manifestations of acute infection include: Swimmer's itch - a localized dermatitis. Katayama fever – a hypersensitivity reaction marked by fever and cough. Insert Dari

28. AFAMS Pyrantel Pamoate (Insert Dari) Mechanism of Action Paralyzes the worm (helminth). Indication (Use) Treatment of pinworms (small white worm approx 1cm) that infect the GI tract. Characterized by anal itching Side Effects Dizziness Headaches Stomach upset Insert Dari

29. AFAMS Questions? (Insert Dari)

30. AFAMS In-class Assignment (Insert Dari) This assignment will consist of 5 questions which are to be completed individually. Once complete the instructor will review the answers with the class. Insert Dari

31. AFAMS 1. Amoebiasis is generally an infection of which organ system? (Insert Dari) A)Skin B)Respiratory Tract C)Gastrointestinal Tract D)Urinary Tract Insert Dari

32. AFAMS 1. Answer: Amoebiasis is generally an infection of which organ system? (Insert Dari) A)Skin B)Respiratory Tract C)Gastrointestinal Tract D)Urinary Tract Insert Dari

33. AFAMS 2. Which of the following is NOT used to treat amoebiasis? (Insert Dari) A)Iodoquinol B)Metronidazole C)Tinidazole D)Chloroquin Insert Dari

34. AFAMS 2. Answer: Which of the following is NOT used to treat amoebiasis? (Insert Dari) A)Iodoquinol B)Metronidazole C)Tinidazole D)Chloroquin Insert Dari

35. AFAMS 3. How do humans become infected with Malaria? (Insert Dari) A)Oral-fecal route B)Mosquito bites C)Contaminated water D)Contaminated food Insert Dari

36. AFAMS 3. Answer: How do humans become infected with Malaria? (Insert Dari) A)Oral-fecal route B)Mosquito bites C)Contaminated water D)Contaminated food Insert Dari

37. AFAMS 4. Which of the following is used to treat leishmaniasis? (Insert Dari) A)Meglumine antimoniate B)Metronidazole C)Quinine D)Albendazole Insert Dari

38. AFAMS 4. Answer: Which of the following is used to treat leishmaniasis? (Insert Dari) A)Meglumine antimoniate B)Metronidazole C)Quinine D)Albendazole Insert Dari

39. AFAMS 5. Match the following drugs with their mechanism of action: (Insert Dari) A)Pyrantel pamoate B)Metronidazole C)Chloroquin D)Meglumine antimoniate 1) Prevents growth and replication of parasite 2) Causes worm paralysis 3) Interferes with protein synthesis 4) Affects the metabolism of the cell Insert Dari

40. AFAMS 5. Answer: Match the following drugs with their mechanism of action: (Insert Dari) A)Pyrantel pamoate (2) Causes worm paralysis B)Metronidazole (3) Interferes with protein synthesis C)Chloroquin (1) Prevents growth and replication of parasite D)Meglumine antimoniate (4) Affects the metabolism of the cell Insert Dari