Antiprotozoal compounds are the drugs of choice in patients with visceral leishmaniasis.
The Drug of Choice used to treat Leishmaniasis is
- Sodium stibogluconate
| Sodium stibogluconate |
| Availability: injectable solution ,100mg Sb/mL |
| Indication & dosage: 1. Leishmaniasis (Orphan) 20 mg Sb/kg/day (maximum 850 mg) IV/IM for 20-28 days |
| 2. Acute Myeloid Leukemia (Orphan) Orphan designation for treatment of acute myeloid leukemia (AML) ØBioXcel Corporation; 780 East Main Street, Suite 2; Branford, Connecticut 06405 |
| Mechanism of Action: Reduction in the fructose diphosphate and an inhibition of glycolysis |
| Administration: Sodium stibogluconate is usually administered by intravenous or intramuscular injection daily at a dose of 20 mg/kg/day (maximum 850 mg) for 21–28 days. Intralesional injections may be used for a single lesion or a few small lesions of cutaneous leishmaniasis. |
| Metabolism & Elimination: Metabolism: unknown Excretion: unknown |
| Contra-indications: Hypersensitivity Significant renal impairment; breast-feeding |
Nursing follow up during treatment
Patients should be given their daily medicines and watched for possible complications. It is good to enquire the patient’s symptoms and observe during drug administration. Warning symptoms for possible drug related adverse events are:
SSG – abdominal pain, nausea, vomiting may show pancreatitis. Decrease in urine output is a sign of renal failure. Cardiotoxicity may lead to sudden cardiac arrest. ECG may show QT prolongation and should be done in patients suspected of cardiac problems and electrolyte abnormalities.
Ambisome – Back pain, chills and rigors during drug administration. Severe fatigue and muscular pain may be a sign for hypokalemia.
Paromomycin – decreased hearing
Miltefosine – nausea and vomiting
Taking vital signs (temperature, blood pressure, pulse rate and respiratory rate) should be frequently monitored
Side effects
- Gastrointestinal tract symptoms (nausea and diarrhoea)
- Musculoskeletal
- complaints (myalgia and arthralgia)
- Fatigue
- Pancreatitis
- Liver damage
- Rarely, damage to the kidney or heart
- Bone marrow suppression.
REFERENCES
- Robert Kizior, Keith Hodgson, Saunders Nursing Drug handbook,1st edition 2024, Elsevier Publications. ISBN-9780443116070
- McGraw Hill- Drug Handbook, Seventh Edition, 2013, McGraw Hill Education Publications,9780071799430.
- April Hazard, Cynthia Sanoski, Davi’s Drug Guide for Nurses -Sixteenth Edition 2019, FA Davis Company Publications,9780803669451.
- Jones and Bartlet, Pharmacology for Nurses, Second Edition, 2020, Jones and Bartlet Learning Publications, ISBN 9781284141986.
- Nursebro.com, Search – Nursebro
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