RT Book, Section
A1 Cota, Jason M.
A1 Anandan, JV
A2 DiPiro, Joseph T.
A2 Talbert, Robert L.
A2 Yee, Gary C.
A2 Matzke, Gary R.
A2 Wells, Barbara G.
A2 Posey, L. Michael
SR Print(0)
ID 1145222320
T1 Parasitic Diseases
T2 Pharmacotherapy: A Pathophysiologic Approach, 10e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9781259587481
LK accesspharmacy.mhmedical.com/content.aspx?aid=1145222320
RD 2022/05/16
AB KEY  CONCEPTS  Nitazoxanide  and  tinidazole  are  Food  and  Drug  Administration  (FDA)-approved  for  giardiasis  treatment.  While  the  FDA  has  not  approved  metronidazole  for  this  indication,  it  has  been  widely  accepted  as  the  mainstay  of  giardiasis  therapy  for  the  past  50  years.  Human  immunodeficiency  virus  (HIV)-infected  patients  with  cryptosporidiosis  must  receive  antiretroviral  therapy  as  the  mainstay  of  therapy  in  addition  to  antiparasitic  therapy.  Serologic  detection  assays  are  required  to  diagnose  Entamoeba  histolytica  infection  because  stool  sample  analysis  is  insensitive  and  does  not  distinguish  between  E.  histolytica  and  the  nonpathogenic  E.  dispar  or  E.  moshkovskii.  Metronidazole  and  tinidazole  are  tissue-acting  agents  against  amoeba;  whereas,  paromomycin,  iodoquinol,  and  diloxanide  furoate  are  luminal  amebicides.  The  drugs  that  have  been  used  to  treat  Trypanosoma  cruzi  infections  include  benznidazole  and  nifurtimox,  but  are  not  currently  approved  by  the  FDA.  Both  are  available  from  the  Centers  for  Disease  Control  and  Prevention  (CDC)  under  an  Investigational  New  Drug  program.  Chloroquine  has  been  the  recommended  drug  for  malaria  chemoprophylaxis,  but  clinicians  have  increasingly  prescribed  alternative  antimalarial  drugs  such  as  atovaquone-proguanil,  doxycycline,  primaquine,  and  mefloquine  because  these  regimens  retain  effectiveness  in  areas  where  chloroquine-resistant  Plasmodium  falciparum  exposure  is  likely.  Administration  of  corticosteroids  or  other  immunosuppressive  drugs  to  an  infected  individual  can  result  in  hyperinfections  and  disseminated  strongyloidiasis.  Antihelminthic  therapy  destroys  parasites  and  may  cause  increased  inflammation  and  worsening  of  neurocysticercosis  symptoms.  For  head  lice,  the  American  Academy  of  Pediatrics  recommends  either  nonprescription  1%  permethrin  or  pyrethrins  plus  piperonyl  butoxide  topical  preparations  as  agents  of  choice  unless  local  resistance  to  these  agents  is  documented.  A  single  application  of  5%  permethrin  results  in  cure  rates  in  more  than  90%  of  subjects  with  scabies  at  14  and  28  days,  but  a  second  dose  should  be  applied  1  week  later  because  its  ovicidal  efficacy  remains  unclear.