Trypanosomiasis

African trypanosomiasis is an illness caused by the Trypanosoma brucei parasite which is transmitted by the tsetse fly. African trypanosomiasis causes African Sleeping Sickness which can infect the central nervous system and cause lethargy, sleepiness, and eventually death.  

American trypanosomiasis is an illness caused by Trypanosoma cruzi parasite, which is transmitted by the Reduviid insect. American trypanosomiasis causes cardiomyopathy.   

Pentamidine has an unknown mechanism and adverse effects include renal dysfunction and pancreatitis.

Suramin also has an unknown mechanism. Adverse effects include paresthesias and photophobia.  

Melarsoprol likely disrupts parasitic metabolism by binding to pyruvate kinase. Melarsoprol administration can result in a reactive encephalopathy that can be fatal.  Hemolytic anemias are also possible.

Eflornithine inhibits ornithine decarboxylase irreversibly, which is important in cell division.  Seizures and hearing loss are possible adverse effects.

Nifurtimox and benznidazole both work by creating toxic free radicals.

Class Drugs

• Pentamidine

• Suramin

• Melarsoprol

• Eflornithine

• Nifurtimox

• Benznidazole

Class Mechanism of Action

See individual drugs

Class Applications

Trypanosomiasis

• Chagas disease

Trypanosoma cruzi

• Cardiomyopathy

• Endemic in Central America and South America

• African sleeping sickness

Trypanosoma brucei gambiense

• Trypanosoma brucei rhodesiense

• Eventually infects CNS causing lethargy, sleep, and eventually death if not treated

 

Class Adverse Effects

See individual drugs

Drug Table

Drug Name	Application	Comments	Image
Pentamidine	1st stage of African trypanosomiasis (hemolymphatic stage) due to T. brucei gambiense; Leishmaniasis; Pneumocystis jirovecii pneumonia	Mechanism; Unknown; Adverse Effects; Renal dysfunction; Pancreatitis; Diabetes/hyperglycemia	"Pen" "Tamping Tool" "Diner"
Suramin	1st stage of African trypanosomiasis (hemolymphatic stage) due to T. brucei gambiense	Adverse Effects; Loss of consciousness; Paresthesias, photophobia, increased sensitivities	"Sir" "Ramen"
Melarsoprol	2nd stage of African trypanosomiasis (CNS stage) due to T. brucei gambiense or Trypanosoma gambiense	Mechanism; Likely Irreversibly binds to pyruvate kinase in parasite; Adverse Effects; Reactive encephalopathy, can be fatal; Hypersensitivity; Hemolytic anemia	"Miller Lite" "Soap"
Eflornithine	2nd stage of African trypanosomiasis (CNS stage) due to Trypanosoma gambiense; Prophylaxis and treatment	Mechanism; Inhibits ornithine decarboxylase irreversibly, which is important in cell division; Adverse Effects; Seizures; Hearing loss	"Elf" "Horn"
Nifurtimox	Chagas disease (T. cruzi); 2nd stage T. gambiense (CNS stage)	Mechanism; Creates toxic oxygen free radicals; Adverse Effects; Peripheral neuropathy; Hypersensitivity	"Nitrogen" "Fur"
Benznidazole	Chagas disease	Mechanism; Creates toxic oxygen free radicals	"Mercedes Benz" "Ore-Ida"