Pentamidine antiprotozoal effects

IVABRADINE ANTIPROTOZOALS Risk of arrhythmias with pentamidine Additive effect Monitor ECG closely... 

PROPAFENONE I. ANTIARRHYTHMICS - disopyra-mide, procainamide 2. ANTIBIOTICS - macrolides (especially azithromycin, clarithromycin, parenteral erythromycin, telithromycin), quinolones (especially moxifloxacin), quinupristin/ dalfopristin 3. ANTICANCER AND IMMUNOMODULATING DRUGS -arsenic trioxide 4. ANTIDEPRESSANTS - TCAs, venlafaxine 5. ANTIEMETICS-dolasetron 6. ANTIFUNGALS-fluconazole, posaconazole, voriconazole 7. ANTIHISTAMINES - terfenadine, hydroxyzine, mizolastine 8. ANTI-M ALARIALS - artemether with lumefantrine, chloroquine, hydroxychloroquine, mefloquine, quinine 9. ANTIPROTOZOALS - pentamidine isetionate 10. ANTIPSYCHOTICS-atypicals, phenothiazines, pimozide II. BETA-BLOCKERS - sotalol 12. BRONCHODILATORS -parenteral bronchodilators 13. CNS STIMULANTS - atomoxetine Risk of ventricular arrhythmias, particularly torsades de pointes Additive effect these drugs prolong the Q-T interval. Also, amitriptyline, clomipramine and desipramine levels may be t by propafenone. Amitriptyline and clomipramine may t propafenone levels. Propafenone and these TCAs inhibit CYP2D6-mediated metabolism of each other Avoid co-administration... 

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS ANTIPROTOZOALS -PENTAMIDINE ISETIONATE t adverse effects with didanosine, tenofovir and zidovudine Additive toxicity Monitor FBC and renal function closely. Consider stopping didanosine while pentamidine is required for Pneumocystis jiroveci pneumonia... 

ADEFOVIR DIPIVOXIL 1. ANTIBIOTICS -aminoglycosides, vancomycin 2. ANTICANCER AND IMMUNOMODULATING DRUGS - cidosporin, tacrolimus 3. ANTIFUNGALS-amphotericin, 4. ANTIPROTOZOALS-pentamidine 5. ANTIVIRALS - cidofovir, foscarnet sodium, tenofovir Possible t efficacy and side-effects Competition for renal excretion Monitor renal function weekly... 

FOSCARNET SODIUM ANTIPROTOZOALS - PENTAMIDINE (INTRAVENOUS) Risk of hypocalcaemia Unclear possibly additive hypocalcaemic effects Use extreme caution with intravenous pentamidine monitor serum calcium (correct before the start of treatment), renal function and for signs of tetany closely. Stop one drug if necessary... 

Pentamidine is a diamidine compound developed more than five decades ago [128]. Initially, it was only used for its antiprotozoal properties against African trypanosomiasis [129], and visceral leishmaniasis [130]. Subsequently, its use was extended to the treatment and prophylaxis of PCP in immunosuppressed patients [131-133]. The use of pentamidine, which was rare in countries without tropical diseases, increased notably because of the high incidence of PCP observed in patients with AIDS [72, 97, 134-136]. Until 1984, pentamidine distribution in the USA was restricted indeed it was only available through the Center for Disease Control. Although TMP-SMZ is regarded as the preferred treatment for PCP [102, 103], pentamidine or less frequently used combinations (trime-trexate/leucovorin, clindamycin/ primaquine [137]) are reasonable alternatives when TMP-SMZ is not tolerated or is without effect [138]. 

Long chain hydrocarbons and fatty acids are best known as constitutents of waxes and lipophilic compounds. Some representatives of this natural product group show high antiprotozoal activity but mostly combined with a high levels of toxicity to mammalian cells. One example is traws-aconitic acid (2) that was used in combination with sodium stibogluconate, allopurinol, or pentamidine for experimental visceral leishmaniasis to determine synergistic effects [34]. When these three drugs (50, 15, 8 mM/kg/day, respectively) were used with trans-aconitic acid (5 mM/kg/day) the parasite load in BALB/c mice was inhibited by 100, 88, and 100%, respectively. At tested concentration trans-aconitic acid itself showed an inhibition of 59.2 %. 

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