Orally administered anti kala-azar drug is?
ANSWER: (B) MiltefosineREF: Harrison's 18th ed ch: 212Drugs for lieshmeniasis and their route of administration:DrugDose and routeRemarksPentavalent Antimonial CompoundsTwo pentavalent antmonial (Sb) preparations are available: sodium stibogluconate (100 mg of SbVmL) and meglumine antimonate (85 mg of Sb/mL).The daily dose is 20 mg/kg by rapid IV infusion or IM injection, and therapy continues for 28-30 daysAdverse reactions to Sb treatment are common and include arthralgia, myalgia, and elevated serum levels of aminotransferases. Electrocardiographic changes are common. Concave ST segment elevation is not significant, but prolongation of QT to >0.5 s may herald ventricular arrhythmia and sudden death. Chemical pancreatitis is common but usually does not require discontinuation of treatment; severe clinical pancreatitis occurs in im- munosuppressed patients.Conventional Amphotericin B deoxycholate0.75-1.0 mg/kg on alternate days for a total of 15 infusions.Fever with chills is an almost universal adverse reaction to AmB infusions. Nausea and vomiting are also common, as is thrombophlebitis in the infused veins. AmB can cause renal dysfunction and hypokalemia and in rare instances elicits hypersensitivity reactions, bone marrow suppression, and myocarditis, all of which can be fatal.The several lipid formulations of AmB3 mg/kg daily on days 1-5,14, and 21 (total dose, 21 mg/kg). However, the total dose requirement for different regions of the world varies widely. In a study in India, a single dose of 10 mg,'leg cured infection in 96% of patients.Adverse effects of liposomal AmB are usually mild and include infusion reactions, backache, and occasional reversible nephrotoxicity.Because very little free drug is available to cause toxicity, a large amount of drug can be delivered over a short period.Paromomycin (aminosi- dine)IM dose of 11 mg of base/kg daily for 21 daysParomomycin is a relatively safe drug, but some patients develop hepatotoxicity, reversible ototoxicity, and (in rare instances) nephrotoxicity' and tetany.MiitefosineFirst oral compound approved for the treatment of leishmaniasis.Daily dose of 50 mg for 28 days for patients weighing <25 kg, a twice-daily dose of 50 mg for 28 days for patients weighing >25 kg, and 2.5 mg/kg for 28 days for children 2-11 years of age.Its adverse effects include mild to moderate vomiting and diarrhea in 40% and 20% of patients, respectively; these reactions usually clear spontaneously after a few days. Rare cases of severe allergic dermatitis, hepatotoxicity, and nephrotoxicity have been reported.best administered as directly observed therapy to ensure completion of treatment and to minimize the risk of resistance induction c/I in pregnancy
Paromomycin
Miltefosine
Amphotericin
Sodium stibogluconate
D.O.C