Jump to navigation. What is the aim of this review? This Cochrane Review aims to determine the effectiveness and safety of drugs used to treat people with amoebic colitis, which is an infection of the large intestines caused by the parasite, Entamoeba histolytica. Cochrane researchers searched for all relevant studies to answer this question and included 41 relevant studies in this review.
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Get started right now by watching this FREE video presentation. Shilpa Verma. Vikram Singh Thakur. Show More. No Downloads. Views Total views. Actions Shares. Embeds 0 No embeds. No notes for slide. Antiamoebic drugs 1. The disease can be acute or chronic, with the patients showing varying degrees of illness, from no symptoms to mild diarrhea to fulminating dysentery Dysentery in which the symptoms are intensely acute, leading to prostration, collapse, and often death.
The diagnosis is established by isolating E. Therapy is aimed not only at the acutely ill patients but also at those who are asymptomatic carriers, because dormant E. Protozoal infections are common among the people in underdeveloped topical and subtropical countries, where sanitary conditions, hygienic practices and control of vectors of transmission are inadequate.
Life cycle of Entamoeba histolytica Entamoeba histolytica exists in two forms: 1. Cysts form That can survive out side the body. Life cycle Life cycle consists of following steps: 6. Ingestion of cysts Cysts are ingested through feces, contaminated food or water. Formation of trophozoites Cysts are passed into the lumen of intestine, where the trophozoites are liberated. Penetration and multiplication of trophozoites Trophozoites are penetrated in intestinal wall and multiply within colon wall.
They either invade and ulcerate the mucosa of large intestine or simply feed on intestinal bacteria. Systemic invasion Large numbers of trophozoites within the colon wall can also lead to systemic invasion and caused liver abscess.
Cysts discarded The trophozoites within the intestine are slowly carried toward the rectum, where they return to cyst form and are excreted in feces. Mechanism of action of Metronidazole Metronidazole is a prodrug. It requires reductive activation of nitro group by susceptible organism. Its selective toxicity towards anaerobic and microaerophilic pathogens such as E.
These organisms contain electron transport components such as ferridoxin, small Fe-S proteins that have sufficiently negative redox potential to donate electrons to metronidazole. The single electron transfer forms a highly reactive nitro radical anion that kills susceptible organisms by radical-mediated mechanisms that target DNA, resulting in cell death. Mechanism of action of Metronidazole Pharmacokinetics Absorption Metronidazole is usually given orally and it is rapidly and completely absorbed achieving peak plasma concentration in hours, with half life of about 7 hours.
Distribution It is distributed rapidly throughout the tissues, reaching high concentration in the body fluids, including cerebrospinal fluid. Metabolism Metabolism of metronidazole occurs in liver. Excretion The parent drug and its metabolites are excreted in the urine.
Contraindication: Phenobarbital is the inducer of this enzymatic system so it enhances the rate of metabolism when used concomitantly. Cimetidine inhibit this system so it prolongs the plasma half life of metronidazole. Adverse effects: An unpleasant metallic taste is often experienced.
The most common adverse effects are those associated with the gastrointestinal tract, including nausea, vomiting, epigastric distress, and abdominal cramps. Tinidazole: Tinidazole is a second-generation nitroimidazole that is similar to metronidazole in spectrum of activity, absorption, adverse effects and drug interactions.
It was approved by the U. Food and Drug Administration in for the treatment of amebiasis, amebic liver abcess, Tinidazole is as effective as metronidazole, with a shorter course of treatment, yet is more expensive than generic metronidazole. Long term use of drug should be avoided. It eliminates trophozoites in liver abscesses. Emetine and Dehydroemetine: Used as alternative agents for the treatment of amebiasis. You just clipped your first slide!
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Recent Progress on the Discovery of Antiamoebic Agents
E-mail: mush. Diseases caused by protozoal organisms are responsible for significant mortality and morbidity worldwide. Amoebiasis caused by Entamoeba histolytica is an example of such diseases. In the quest for safe and effective antiamoebic agents, several heterocyclic moieties have been reported, out of which members of the azole family dioxazole, pyrazoline, tetrazole, triazole and thiazolidinone derivatives have attracted wide attention. This class of heterocyclic compounds have emerged as potential chemotherapeutic agents exhibiting promising antiamoebic activity with a non-cytotoxic nature. In the present article, some important breakthroughs in this area have been discussed. To get an insight at the supra-molecular level, computational studies like Lipinski's and DFT studies were carried out.
Antiamoebic drugs for treating amoebic colitis