Pharmacology · MU Sofia

82. Antiprotozoal drugs.

Covers antiprotozoal drugs grouped by the disease they treat, from amoebiasis and malaria to trypanosomiasis, leishmaniasis and giardiasis. It then sets out each group's mechanism of action, a pharmacokinetics table for metronidazole, tinidazole, nitazoxanide and quinidine, common and serious side effects, selected drug interactions, therapeutic uses and pregnancy considerations, ending with recap questions.

Inside: 9 sections · 4 labelled pictures · 1 table · 10 flashcards · 2 min

Topic 81 of 93 in the MU Sofia syllabus for Pharmacology (Medicine, Year 3). The free AceMed note covers it in 9 sections, about 234 words (2 min of reading), with 10 flashcards.

In this note

  1. Antiprotozoal Drugs
  2. Classification
  3. Pharmacodynamics
  4. Pharmacokinetics
  5. Side Effects
  6. Drug Interactions
  7. Therapeutic Uses
  8. Pregnancy & Breastfeeding
  9. Recap Questions

Antiprotozoal Drugs

Antiprotozoal drugs are used to treat infections caused by protozoa—single-celled parasites responsible for diseases like malaria, amebiasis, and leishmaniasis.

Classification

  1. 1. Amebiasis: Chloroquine, Metronidazole, Tinidazole
  2. 2. Malaria: Mefloquine, Quinidine
  3. 3. Trypanosomiasis: Benznidazole, Suramin
  4. 4. Leishmaniasis: Miltefosine
  5. 5. Giardiasis: Nitazoxanide

Pharmacodynamics

  • Chloroquine, Metronidazole, Tinidazole (Amebiasis): Disrupt protozoal DNA synthesis → cell death
  • Mefloquine, Quinidine (Malaria): Inhibit heme polymerase → accumulation of toxic heme → parasite death
  • Benznidazole, Suramin (Trypanosomiasis): Generate reactive oxygen species / inhibit energy metabolism
  • Miltefosine (Leishmaniasis): Disrupts cell membrane integrity → induces protozoal apoptosis
  • Nitazoxanide (Giardiasis): Inhibits pyruvate-ferredoxin oxidoreductase → energy metabolism failure

Side Effects

  • Common: Nausea, vomiting, diarrhea, headache, dizziness
  • Serious/Rare:
  • Allergic reactions – e.g. Stevens-Johnson syndrome
  • Hepatotoxicity
  • Neurotoxicity – especially with quinidine
  • Hematologic – anemia, leukopenia

Drug Interactions

  • Metronidazole: Potentiates warfarin → ↑ bleeding risk
  • Tinidazole: Causes disulfiram-like reaction with alcohol
  • Nitazoxanide: ↑ levels of highly protein-bound drugs
  • Suramin: Nephrotoxicity ↑ with other nephrotoxic agents
  • Quinidine: Inhibits digoxin metabolism → ↑ digoxin toxicity

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