TRYPANOSOMIASIS

TRYPANOSOMIASIS-TREATMENTS

Similar to the malarial parasites these organisms are also included in the type of protozoa.

Trypanosomiasis is a collective name for a kind of disease affecting the vertebrates. It is caused by Trypanosoma cruzi-causing the American Sleeping Sickness (Chaga's Disease)

Trypanosoma brucei-causing the African Sleeping Sickness

African sickness is very common and more fatal. In African forests the bite of tsetse fly causes eruptions of red sores and within a few weeks the person will experience fever, swollen lymph glands, blood in urine, aching muscles and joints, headache, and irritability in the first phase.

Followed by the second phase which involves the brain system with severe nerve effects. personality changes, changes in circadian rhythm, slurred speech, and difficulty walking are the nervous effects. If left untreated the person will die.

Treatments

1)Melarsoprol
2)Pentamidine
3)Nifurtimox
4.Suramin
Melarsoprol
Melarsoprol inhibits the sulphydryl groups in the parasitic enzymes.
It can be given IV or oral
I can cross the blood-brain barrier and enter into the CNS and hence it can act on the organism at the second stage too.
It is rapidly metabolized by the liver into a non-toxic compound and rapidly excreted in the urine. It has a short half-life. 
This is the drug of choice to treat trypanosomiasis with CNS involvement.
Side effects
Encephalopathy
GI distress
Allergies
Hemolytic anemia in those who lack G-6-Phospho Diesterase 
Contraindicated in those who have influenza.
Pentamidine
It is thought the drug has a great affinity to the organism and bind with it. After binding it enters into the cell nucleus and modify DNA or inhibit glycolysis.
Can be given by oral or IM and as Aerosol
IV administration may cause serious hypotension, and arrhythmias.
Does not enter into CNS but can concentrate in liver and kidney
It is having longer half life like more than two weeks and excreted unchanged in the urine
Hence it is the drug of choice in the I-stage (hemolymphatic stage) of the disease and not for the CNS stage.
The aerosol form is used for prophylaxis.
Side effects
Reversible kidney damages
Respiratory stimulation followed by depression 
Pancreatic dysfunctions
Nifurtimox
This medicine forms toxic intracellular oxygen radicals and kills the organism. 
Given by oral
Short half-life. Rapidly metabolized and excreted in urine
Drug of choice for American sleeping sickness
But it is not a curative it is suppressive only
Side effects
1.Anaphylaxis
2.Dermatitis
3.GI distress
4.Peripheral neuropathy
5.CNS effects
6.Immunity suppression
Suramin
Acting by suppressing energy-producing enzymes
Given by IV only
As a prophylaxis and treatments of early stages of African sickness
Side effects
Albuminuria 
Rash
GI distress
Urticaria
Nerve complications
Shock.
The drug should be discontinued immediately if there are renal casts in the urine.