抗寄生虫药Antiparasitedrugs-方三华

FangSanhuaAnti-parasitedrugs

1.Humanparasite2.

Antimalarialdrugs3.Themalarialparasite,Plasmodium,isaverysmall,single-cellorganism.Itlivesasaparasiteinotherorganisms,namelymanandmosquito.Theparasiteisthecauseofthetropicalorsubtropicaldiseasemalaria.Antimalarialdrugs-Malarialparasite4.5.Fourspeciesofplasmodiumcanproducethediseaseinitsvariousforms:Plasmodiumfalciparum（恶性疟原虫）Plasmodiumvivax（间日疟原虫）Plasmodiumovale（卵形疟原虫）Plasmodiummalaria（三日疟原虫）6.Antimalarialdrugs-ParasiteLifeCycle红细胞外期红细胞内期按蚊－有性繁殖人体－无性繁殖7.Nooneavailableagentcanreliablyeffectaradicalcure,ie,eliminatebothexo-erythrocyticanderythrocyticstages.Fewavailableagentsarecausalprophylacticdrugs,ie,capableofpreventingerythrocyticinfection.Antimalarialdrugs8.控制复发Primaquine（伯氨喹）迟发病因预防Pyrimethamine（乙胺嘧啶）速发控制症状Chloroquine（氯喹）Quinine（奎宁）Mefloquine（甲氟喹）Artemisinin（青蒿素）阻止传播Pyrimethamine（乙胺嘧啶）阻止传播Primaquine（伯氨喹）Chloroquine（氯喹）Quinine（奎宁）（恶性疟无效）红细胞外期红细胞内期按蚊－有性繁殖9.Antimalarialdrugs–Chloroquine（氯喹）Chloroquineisasynthetic4-aminoquinolinederivate控制症状Chloroquine氯喹Quinine奎宁Mefloquine甲氟喹Artemisinin青蒿素红细胞内期10.Pharmacologicaleffects1.AntimalarialeffectsRapidschizonticidalactivity（裂殖体杀灭剂）

againstallinfectionsofmalariaspecies

.Alsogametocytocidal（杀配子体）againstP.vivax,P.malariaeandP.ovale.Itisnotactiveagainstexo-erythrocyticform,andshouldthereforebeusedwithprimaquine（伯氨喹）toeffectradicalcureofP.vivax.Antimalarialdrugs-Chloroquine11.Antimalarialdrugs-Chloroquine12.Antimalarialdrugs-Chloroquine13.Antimalarialdrugs-Chloroquine14.Quinine（奎宁）Mefloquine（甲氟喹）Pyronaridine(咯萘啶)Artemisinin(青蒿素)Artemetherandartesunate(蒿甲醚和青蒿琥酯)

Otherangentskillerythrocyticparasites15.控制复发Primaquine(伯氨喹)迟发阻止传播Primaquine(伯氨喹)Chloroquine(氯喹)Quinine(奎宁)（恶性疟无效）红细胞外期红细胞内期按蚊－有性繁殖Antimalarialdrugs–Primaquine（伯氨喹）16.Antimalarialdrugs–Primaquine（伯氨喹）17.Antimalarialdrugs–Primaquine（伯氨喹）18.红细胞外期红细胞内期按蚊－有性繁殖Antimalarialdrugs–Pyrimethamine（乙胺嘧啶）病因预防Pyrimethamine(乙胺嘧啶)速发Pyrimethamine(乙胺嘧啶)19.Antimalarialdrugs–Pyrimethamine（乙胺嘧啶）20.symptom？21.复发？传播？控制症状Chloroquine（氯喹）Quinine（奎宁）Mefloquine（甲氟喹）Artemisinin（青蒿素）22.病因预防？控制复发Primaquine（伯氨喹）迟发阻止传播Primaquine（伯氨喹）Chloroquine（氯喹）Quinine（奎宁）（恶性疟无效）23.病因预防Pyrimethamine(乙胺嘧啶)速发阻止传播Pyrimethamine（乙胺嘧啶）24.25.

Antiamebiasisdrugs26.Antiamebiasisdrugs-Amebiasis27.AmebiasisisinfectionwithEntamoebahistolytica,Atiny,one-celledorganism.Antiamebiasisdrugs-Amebiasis28.FeaturesofAmebiasis29.MultiplicationandlifecycleofEhistolyticaAntiamebiasisdrugs-Amebiasis30.Antiamebiasisdrugs-Amebiasis31.Antiamebiasisdrugs-

Metronidazole甲硝唑PharmacologicaleffectsAntibioticeffectiveagainstanaerobicbacteria.Anti-giardialamblia（贾第氏鞭毛虫）effectAnti-amebaeffects（肠内、肠外）

ThetreatmentofalltissueinfectionswithEhistolytica4.Anti-infusorian（滴虫）effects32.MechanismofactionsThemethylgroupofmetronidazoleischemicallyreducedinanaerobicbacteriaandsensitiveprotozoans.（原生动物）Reactivereductionproductsappeartoberesponsibleforantimicrobialactivity.Rapidlyabsorbedandhasabioavailabilityofapproximately90%Antiamebiasisdrugs-

Metronidazole33.AdverseeffectsSerioussideeffectsofmetronidazolearerare;andincludeseizuresanddamageofnervesresultinginnumbnessandtinglingofextremities(peripheralneuropathy).

Minorsideeffectsincludenausea,headaches,lossofappetite,ametallictaste,andrarelyarash.Antiamebiasisdrugs-

Metronidazole34.Emetine依米丁&dehydroemetine去氢依米丁Amebicideeffects:sporadin(滋养体)Mechanismofactions:proteinsynthesisinhibitor.Clinicuses:

Amebicliverabscess,AcuteamebicdysenteryUsedincaseofresistancetometronidazole.

35.Emetine依米丁&dehydroemetine去氢依米丁AdverseeffectsNausea,vomitinganddiarrhoea.Palpitations,tachycardia,retrosternalpain,hypotension,dyspnoea,ECGchanges(STdepression,QTprolongation,T-waveinversion).Tremor,myastheniaandparalysisincludingrespiratoryparalysis.Antiamebiasisdrugs-

Otheramebicides36.Antiamebiasisdrugs-

Diloxanide二氯尼特37.MechanismofactionsLuminalamebicide.DestroysthetrophozoitesofE.histolyticathateventuallyformintocysts.(包囊)Thecystsarethenexcretedbypersonsinfectedwithasymptomaticamebiasis.(无症状的阿米巴病)Antiamebiasisdrugs-

Diloxanide38.AdverseeffectsNotcommonlyseenwiththismedicationunlessthepatientistakingespeciallyhighdoses.Minorsideeffectsincludenausea,headaches,andrarelyarash.Antiamebiasisdrugs-

Diloxanide39.Antiamebiasisdrugs-

Otheramebicides40.Antimalarialdrugs-Chloroquine41.

Anti-bilharziasis&filariasisDrug42.Bilharziasis急性发热过敏反应腹痛、腹泻肝脾肿大43.AnthelminticActionsSchistosomiasis(血吸虫病)Clonorchiasis,Opisthorchiasis(支睾吸虫病),andParagonimiasis(肺吸虫病)Taeniasis(绦虫病)、Diphyllobothriasis(裂头绦虫病）

HNana（缩小膜壳绦虫）Neurocysticercosis（脑囊虫病）HydatidDisease（包虫囊病）OtherParasites：fasciolopsiasis,metagonimiasis,andotherformsofheterophyiasis.fascioliasis,Praziquantel吡喹酮44.MechanismofactionsIncreasethepermeabilityofcellmembranestocalcium,resultinginparalysis,dislodgement,anddeath.Inschistosomeinfections,praziquanteliseffectiveagainstadultwormsandimmaturestagesProphylacticeffectagainstcercarial（尾蚴）infection.Praziquantel吡喹酮45.AdverseeffectsMostfrequentareheadache,dizziness,drowsiness,andlassitude;Othersincludenausea,vomiting,abdominalpain,pruritus,urticaria,arthralgia,myalgia,andlow-gradefever.MildandtransientelevationsofliverenzymesPraziquantel吡喹酮46.Filariasis淋巴管炎、淋巴结炎橡皮肿、乳糜尿47.Diethylcarbamazine乙胺嗪AnthelminticActionsDiethylcarbamazineimmobilizesmicrofilariae（微丝蚴）andalterstheirsurfacestructure,displacingthemfromtissuesandmakingthemmoresusceptibletodestructionbyhostdefensemechanisms.ClinicalUsesWuchereriaBancrofti,BrugiaMalayi,BrugiaTimori,andLoaLoaAdverseeffectsGenerallymildandtransientIncludeheadache,malaise,anorexia,weakness,nausea,vomiting,anddizziness.48.

AnthelminticDrugs

驱(蠕)虫药

49.AnthelminticDrugs

–Albendazole（阿苯达唑）50.PharmacologicaleffectsAbroad-spectrumoralanthelmintic,isthedrugofchoicefortreatmentofhydatiddisease（包虫病）andcysticercosis.（囊虫病）Alsousedforthetreatmentofpinworm（蛲虫）andhookworminfections,ascariasis（蛔虫病）,trichuriasis（鞭虫病）andstrongyloidiasis（类圆线虫病）AnthelminticDrugs

-Albendazole51.AdverseeffectsMildandtransient