Leishmaniasis
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Meglumine antimoniate and sodium stibogluconate, which are pentavalent antimonials, are commonly used to treat leishmaniasis. Pentamidine, amphotericin B, and miltefosine are also options. Meglumine antimoniate is given via injection for visceral, mucocutaneous, and cutaneous leishmaniasis. Sodium stibogluconate is also injected and sold under the brand name Pentostam. Pentamidine can be injected or inhaled to treat leishmaniasis. Amphotericin B is administered via intravenous injection. Side effects are common with these medications. Surgery may also be
Leishmaniasis
- 2. Treatment • meglumine antimonate. • sodium stibogluconate. Antimony-containing compounds : • Pentamidine: CL • amphotericin Other drugs : • Plastic surgery (ML). • Splenectomy in drug- resistant (VL). Surgery
- 3. Meglumine antimoniate • Meglumine antimoniate is a medicine used to leishmaniasis. This include visceral, mucocutaneous, and cutaneous leishmaniasis. It is given by injection into a muscle or into the area infected.Side effects include loss of appetite, nausea, abdominal pain, cough, feeling tired, muscle pains, irregular heartbeat, and kidney problems. It should not be used in people with significant heart, liver, or kidney problems. It is not recommended during breastfeeding. It belongs to a group of medications known as the pentavalent antimonials.
- 4. Sodium stibogluconate • sold under the brand name Pentostam among others, is a medication used to treat leishmaniasis. This includes leishmaniasis of the cutaneous, visceral, and mucosal types. • Some combination of miltefosine, paramycin and liposomal amphotericin B; however, may be recommended due to issues with resistance. • It is given by injection.Side effects are common and include loss of appetite, nausea, muscle pains, headache, and feeling tired.Serious side effect may include an irregular heartbeat or pancreatitis.Sodium stibogluconate is less safe than some other options during pregnancy. It is not believed to result in any problems if used during breastfeeding.Sodium stibogluconate is in the pentavalent antimonials class of medication.
- 5. Pentamidine • is an antimicrobial medication used to treat African trypanosomiasis, leishmaniasis, babesiosis, and to prevent and treat pneumocystis pneumonia (PCP) in people with poor immune function. It is an option for both visceral leishmaniasis and cutaneous leishmaniasis. Pentamidine can be given by injection into a vein or muscle or by inhalation. • Common side effects of the injectable form include low blood sugar, pain at the site of injection, nausea, vomiting, low blood pressure, and kidney problems. Common side effects of the inhaled form include wheezing, cough, and nausea. It is unclear if doses should be changed in those with kidney or liver problems. Pentamidine is not recommended in early pregnancy but may be used in later pregnancy.Its safety during breastfeeding is unclear.While how the medication works is not entirely clear, it is believed to involve decreasing the making of DNA, RNA, and protein.
- 6. Amphotericin • B is an antifungal medication used for serious fungal infections and leishmaniasis. It is typically given by injection into a vein • Common side effects include a reaction with fever, chills, and headaches soon after the medication is give, as well as kidney problems. Allergic symptoms including anaphylaxis may occur. • Other serious side effects include low blood potassium and inflammation of the heart.It appears to be relatively safe in pregnancy. There is a lipid formulation that has a lower risk of side effects.It is in the polyene class of medications and works in part by interfering with the cell membrane of the fungus
- 7. Treatment Cutaneous and Mucocutaneous • Antimony (Pentostam®, Sodium stibogluconate) is the drug of choice • Given under an experimental protocol at Walter Reed Army Medical Center (WRAMC) • 20 days of intravenous therapy • Available at WRAMC for all branches of the military • Requires patient to come to WRAMC • Fluconazole may decrease healing time in L. major infection • Biopsy and culture to determine species is required • Six weeks of therapy is needed
- 8. Treatment Visceral Leishmaniasis • Liposomal amphotericin-B (AmBisome®) is the drug of choice • 3 mg/kg per day on days 1-5, day 14 and day 21 • Pentostam® is an alternative therapy • 28 days of therapy is required • Although AmBisome® is widely available, the difficulty of accurate diagnosis and the potential severity of visceral infection suggest possible patients be referred to the Leishmania Treatment Center at WRAMC for maximal diagnostic efficiency
- 9. •Thanx