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TM: American Trypanosomiasis (Chagas disease) (iii) Tx (Of chronic disease…
TM: American Trypanosomiasis (Chagas disease) (iii) Tx
Benznidazole
1st line
5-10mg/kg QD for 1-2 months
anti parasitic
SEs: dermatological, photosensitivity, neuropathy, BM depression
Nifurtimox
10 mg/kg divided TID for 1-3 months
SEs: anorexia, weight loss, haemolytic anaemia, neuropathy, psychosis
more toxic than benznidazole
Challenge of availability
expensive
lengthly + potentially toxic
effective if given early
Of chronic disease
management of complications
for CM
digitalis
pacemaker (increased survival)
AICD
antiarryhmics (amiodarone increases survival)
partial left ventriculectomy
anticoagulation if prothrombotic
transplant - excellent outcomes reported
aneurysm repair urgently, as rupture has poor outcomes
for megaoesophagus
surgical repair of dilation of lower oesophagus
for megacolon
cholinergic drugs
laxatives
fibre
rectosigmoidectomy
tx unlikely to stop GI disease progression - just symptomatic tx