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Kala Azar and Filariasis: Treatment and Mechanisms
Classification of Drugs Used in Kala Azar
1. Antimonials (Sodium Stibogluconate)
- Mechanism of Action: Inhibits parasite metabolism by interfering with energy production.
- Adverse Effects: Hepatotoxicity, nephrotoxicity, ECG changes.
- Contraindications: Liver or kidney dysfunction.
2. Amphotericin B
- Mechanism of Action: Binds to ergosterol in the parasite's membrane.
- Adverse Effects: Nephrotoxicity, fever, chills, electrolyte imbalance.
- Contraindications: Renal failure, nephrotoxic drugs.
3. Miltefosine
- Mechanism of Action: Inhibits phospholipid metabolism.
- Adverse Effects: Nausea, vomiting, liver dysfunction, teratogenicity.
- Contraindications: Pregnancy and breastfeeding.
4. Paromomycin
- Mechanism of Action: Inhibits protein synthesis by binding to the ribosome.
- Adverse Effects: Hearing loss, nephrotoxicity, allergic reactions.
- Contraindications: Hearing loss, renal dysfunction.
Classification of Drugs Used in Filariasis
1. Diethylcarbamazine (DEC)
- Mechanism of Action: Targets microfilariae and adult worms.
- Adverse Effects: Fever, rashes, dizziness.
- Contraindications: Strongyloidiasis.
2. Albendazole
- Mechanism of Action: Inhibits microtubule formation.
- Adverse Effects: Gastrointestinal upset, hepatotoxicity.
- Contraindications: Pregnancy (especially first trimester).
3. Ivermectin
- Mechanism of Action: Paralyzes the parasite through chloride channel binding.
- Adverse Effects: Fever, pruritus, lymphadenopathy.
- Contraindications: Pregnancy, children under 5 years.
Treatment of Kala Azar
- First-line treatment: Sodium Stibogluconate or Meglumine antimoniate (20-day regimen).
- Alternative treatments: Amphotericin B (liposomal), Miltefosine, Paromomycin.
Treatment of Filariasis
- Microfilarial treatment: Diethylcarbamazine (DEC), Albendazole, or Ivermectin.
- Adult worm treatment: Combination of DEC with Albendazole or Ivermectin.
- Lymphatic damage management: Antibiotics for secondary infections, hygiene practices.