Page 176 - Learnwell EVS
P. 176
6. Parasitic diseases
Treatment
– Acute phase
nifurtimox P O (contra-ind icated in th e first trim ester of preg nancy, breast-feed ing or in
patients w ith h istory of m ental d isord ers or seizures):
P atient und er 4 0 kg : 1 0 to 1 2 m g / kg / d ay in 2 to 3 d iv id ed d oses for 3 0 to 6 0
d ays
P atient ov er 4 0 kg : 8 m g / kg / d ay in 2 to 3 d iv id ed d oses for 3 0 to 6 0 d ays
T h e ad v erse effects of nifurtim ox (anorexia, nausea, g astric pain, ag itation, sleeping
d isord ers, seizures) occur in less th an 2 0 % of cases and m ust not result in treatm ent
d iscontinuation. A v oid alcoh ol d uring treatm ent.
boernznidazole P O ( contra- ind icated in th e first trim ester of preg nancy and breast-
feed ing ):
P atient und er 4 0 kg : 7 .5 m g / kg / d ay in 2 to 3 d iv id ed d oses for 3 0 to 6 0 d ays
P atient ov er 4 0 kg : 5 m g / kg / d ay in 2 to 3 d iv id ed d oses for 3 0 to 6 0 d ays
T h e m inor ad v erse effects of benznid azole (nausea, skin rash ) occur in about 5 0 % of
patients. I n th e ev ent of purpura w ith fev er, paraesth esia or periph eral polyneuritis,
stop tream ent.
– Chronic phase in children under 12 years
benznidazole P O
C h ild ren und er 4 0 kg : 7 .5 m g / kg / d ay in 2 to 3 d iv id ed d oses for 3 0 to 6 0 d ay6s
C h ild ren ov er 4 0 kg : 5 m g / kg / d ay in 2 to 3 d iv id ed d oses for 3 0 to 6 0 d ays
– Chronic phase in children over 12 years and adults
D o not treat in th e ev ent of preg nancy, breast-feed ing , h epatic or renal failure, or a
nsiefuvrteimreoixntPerOcur:re8nttopa1th0 omloggy/. kg / d ay in 2 to 3 d iv id ed d oses for 6 0 to 9 0 d ays
boernznidazole P O : 5 m g / kg / d ay in 2 to 3 d iv id ed d oses for 6 0 d ays
– Symptomatic treatment
See seizures (pag e 2 3 ), pain (pag e 2 9 ) and h eart failure (pag e 2 9 4 ).
Prevention
– I m prov em ent of h ousing and v ector control: plastered w alls and cem ent floors,
corrug ated -iron roofs, insecticid e spraying .
– B lood transfusions: screening d onor blood for T. cruzi infection.
143
Treatment
– Acute phase
nifurtimox P O (contra-ind icated in th e first trim ester of preg nancy, breast-feed ing or in
patients w ith h istory of m ental d isord ers or seizures):
P atient und er 4 0 kg : 1 0 to 1 2 m g / kg / d ay in 2 to 3 d iv id ed d oses for 3 0 to 6 0
d ays
P atient ov er 4 0 kg : 8 m g / kg / d ay in 2 to 3 d iv id ed d oses for 3 0 to 6 0 d ays
T h e ad v erse effects of nifurtim ox (anorexia, nausea, g astric pain, ag itation, sleeping
d isord ers, seizures) occur in less th an 2 0 % of cases and m ust not result in treatm ent
d iscontinuation. A v oid alcoh ol d uring treatm ent.
boernznidazole P O ( contra- ind icated in th e first trim ester of preg nancy and breast-
feed ing ):
P atient und er 4 0 kg : 7 .5 m g / kg / d ay in 2 to 3 d iv id ed d oses for 3 0 to 6 0 d ays
P atient ov er 4 0 kg : 5 m g / kg / d ay in 2 to 3 d iv id ed d oses for 3 0 to 6 0 d ays
T h e m inor ad v erse effects of benznid azole (nausea, skin rash ) occur in about 5 0 % of
patients. I n th e ev ent of purpura w ith fev er, paraesth esia or periph eral polyneuritis,
stop tream ent.
– Chronic phase in children under 12 years
benznidazole P O
C h ild ren und er 4 0 kg : 7 .5 m g / kg / d ay in 2 to 3 d iv id ed d oses for 3 0 to 6 0 d ay6s
C h ild ren ov er 4 0 kg : 5 m g / kg / d ay in 2 to 3 d iv id ed d oses for 3 0 to 6 0 d ays
– Chronic phase in children over 12 years and adults
D o not treat in th e ev ent of preg nancy, breast-feed ing , h epatic or renal failure, or a
nsiefuvrteimreoixntPerOcur:re8nttopa1th0 omloggy/. kg / d ay in 2 to 3 d iv id ed d oses for 6 0 to 9 0 d ays
boernznidazole P O : 5 m g / kg / d ay in 2 to 3 d iv id ed d oses for 6 0 d ays
– Symptomatic treatment
See seizures (pag e 2 3 ), pain (pag e 2 9 ) and h eart failure (pag e 2 9 4 ).
Prevention
– I m prov em ent of h ousing and v ector control: plastered w alls and cem ent floors,
corrug ated -iron roofs, insecticid e spraying .
– B lood transfusions: screening d onor blood for T. cruzi infection.
143
