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Entamoeba histolytica
Published in Peter D. Walzer, Robert M. Genta, Parasitic Infections in the Compromised Host, 2020
William A. Petri, Jonathan I. Ravdin
Treatment of invasive amebiasis requires a combination of a well-absorbed drug to treat disease in the wall of the intestine and extraintestinally and a luminal drug to eliminate carriage of the amebas. Systemically absorbed antiamebic drugs include metronidazole, tinidazole (unavailable in the United States), emetine, and dehydroemetine (administered intramuscularly only), and chloroquine. Chloroquine has not been shown to be effective at treating intestinal disease and is reserved for amebic liver abscess not responding to metronidazole. Emetine and dehydroemetine are ipecac alkaloids that are not tolerated when given orally, have frequent cardiovascular side effects, and are also second-line drugs. Metronidazole is the drug of choice for invasive infection with E.. histolytica. A poorly absorbed antiamebic agent should be added to therapy with metronidazole (especially if the course is less than 10 days) to eliminate luminal E. histolytica; amebic liver abscess has occurred 1-3 months after treatment of amebic colitis with metronidazole alone (249). It is not clear when other agents should be added to metronidazole; patients with amebic liver abscess who fail metronidazole will usually respond to emetines plus chloroquine or require drainage (248). Metronidazole has been shown to be potentially both mutagenic and carcinogenic (250,251), and while the benefits of this drug outweigh the risks in treating invasive amebiasis, the ideal drug to treat amebiasis has yet to be found.
Treatment and Prevention of Amebiasis
Published in Roberto R. Kretschmer, Amebiasis: Infection and Disease by Entamoeba histolytica, 2020
Contraindications — Emetine is contraindicated in patients with cardiac and kidney diseases. It is worth stressing that emetine, when used at the appropriate dosage, remains an excellent antiamebic drug, very effective in the treatment of amebic dysentery and liver abscess, and entailing only a few harmful side-effects.
Anti-infective drugs*
Published in Bev-Lorraine True, Robert H. Dreisbach, Dreisbach’s HANDBOOK of POISONING, 2001
Bev-Lorraine True, Robert H. Dreisbach
Ipecac is used as an emetic in the syrup form (see p. 90), never in the fluidextract form; the fluidextract is 14 times as concentrated as the syrup, and 10 ml is hazardous. Emetine, the alkaloid from ipecac (the roots and rhizomes of Cephaelis ipecacuanha), is used in the treatment of amebiasis.
The management of Babesia, amoeba and other zoonotic diseases provoked by protozoa
Published in Expert Opinion on Therapeutic Patents, 2023
Clemente Capasso, Claudiu T. Supuran
As for babesiosis treatment, animal models are applicable even for the pathogenesis of amoebiasis [54,55]. Intracecal inoculation of trophozoites leads to chronic infection and inflammation in certain strains of mice, such as CBA or C3H, which can be considered a model of intestinal amoebiasis [54,55]. For example, metronidazole and tinidazole work in mouse model CBA. AMIX and VPC16a1006, nitazoxanide-related compounds with enhanced solubility, showed equal performance in vitro but inferior efficacy in vivo due to their lower luminal concentrations and improved absorption [55]. Chloroquine was ineffective in vitro but exhibited good efficacy in vivo. Emetine shows moderate effectiveness both in vitro and in vivo. Iodoquinol, mainly used to prevent relapse, showed efficacy in the CBA mouse model [55].
Therapeutic options for COVID-19: a quick review
Published in Journal of Chemotherapy, 2020
Muhammad Sani Ismaila, Faruku Bande, Aminu Ishaka, Aminatu Abubakar Sani, Karla Georges
Among the literature analyzed in the present work are those focusing on the use of antiparasitic drugs like emetine and ivermectin to treat patients with COVID-19. Emetine, for example, is an isoquinoline, an alkaloid from ipecac. It has been extensively used as an antiparasitic drug reported to inhibit both ribosomal and mitochondrial protein synthesis as well as interfere with the integration and activities of DNA and RNA.80–82 Ivermectin is a broad-spectrum antiparasitic drug. The proposed anti-COVID-19 viral mechanism reported for ivermectin from the in-vitro study is by blocking importin heterodimer responsible for nuclear import. Ivermectin is originally an antiparasitic drug shown to bind with and destabilize the Impα/β1 heterodimer, thereby preventing it from binding to the viral protein and from entering the nucleus, this results in decreased inhibition of the antiviral responses, leading to more efficient antiviral response.29 In vitro experimentation in Vero/hSLAM cells infected with SARS-CoV-2 clinical isolate, Australia/VIC01/2020 (MOI = 0.1) resulted in a ∼5000-fold reduction in viral RNA at 48 h with no toxicity observed.29 But some controversy arose which made the FDA to issue a warning explaining that in vitro studies as reported in Antiviral Research (AVR) were commonly used in the early stages of drug development; thus, additional testing was needed to determine whether ivermectin might be safe or effective in preventing or treating coronavirus or COVID-19 (FDA:https://www.fda.gov/animal-veterinary/product-safety-information/fda-letter-stakeholders-do-not-use-ivermectin-intended-animals-treatment-covid-19-humans).