Antileishmanial drugs Sodium Stibogluconate, Pentamidine isetionate, Sodium Stibogluconate Is a pentavalent antimonial that acts by unknown mechanism and

is found to be effective against cutaneous as well as visceral leishmaniasis (kala-azar). It is rapidly absorbed after parenteral (i/m or i/v inj.) administration and exhibits two phase-elimination, i.e. with short (about 2 hours) and long (> 24 hours) halflife

Cautions: renal and hepatic impairment, pregnancy; protein-rich diet should be provided through out treatment period, iron and other nutritional deficiencies and intercurrent infections required to be corrected; monitoring of cardiac, renal and hepatic functions, dose reduction or withdrawal of therapy if any abnormality; i/v injections must be given slowly over 5 minutes (to reduce the risk of local thrombosis) and stopped if coughing or substernal pain; mucocutanous disease; heart disease (withdraw if conduction disturbance occurs)

Contra-indications: significant renal impairment; breast-feeding

Adverse effects: anorexia, nausea, vomiting, abdominal pain; ECG changes; headache, lethargy, myalgia; raised liver enzymes; coughing and substernal pain; rarely anaphylaxis; and also reported, fever, sweating, flashing, vertigo, bleeding from nose and gum, jaundice, rash; pain and thrombosis on i/v administration, intramuscular injection also painful

Pentamidine isetionate
The drug has activity against human visceral leishmaniasis, African trypanosomiasis especially against that caused by T.b. gambiense and kills nonreplicating forms of P. carinii. It is also capable of curing Babesia canis infection in puppies and L. donovani infections in hamsters. Recently it has undergone successful therapeutic trail for its fungicidal effect in systemic blastomycoses. It is fairly well absorbed from parenteral sites of administration and accumulates in tissues after repeated administration

Indications: leishmaniasis; African (sleeping sickness), pneumocystosis

trypanosomiasis

Adverse effects: nephrotoxicity; acute hypotension with dizziness, headache, breathlessness, tachycardia and syncope following rapid i/v injection; hypoglycemia may be followed by hyperglycemia and type 1 diabetes mellitus; pancreatitis; also hypocalcemia, gastrointestinal disturbances, confusion, hallucinations, arrhythmias; thrombocytopenia, leucopenia, abnormal liver function tests; anemia; hyperkalemia, rash, Stevens-Johnson syndrome, pain, local induration, sterile abscess and muscle necrosis at injection site