Metronidazole interferes with the metabolism of warfarin and may po- Antimicrobial Spectrum tentiate its anticoagulant activity cheap trimox 500mg fast delivery. The drug is not gate anaerobic gram-positive and gram-negative bacte- recommended for use during pregnancy buy trimox 250 mg mastercard. Drug resistance is Iodoquinol infrequent; the mechanism of resistance is not under- Iodoquinol (diiodohydroxyquin discount trimox 500mg on line, Yodoxin, Moebiquin) stood. Tinidazole, a 5-nitroimidazole closely related to is a halogenated 8-hydroxyquinoline derivative whose metronidazole, is effective against vaginal trichomonia- precise mechanism of action is not known but is thought sis resistant to metronidazole. The drug is tract and is excreted in the urine as glucuronide and sul- distributed in body ﬂuids and has a half-life of about 8 fate conjugates. Metronidazole is metabolized by oxidation Iodoquinol is the drug of choice in the treatment of and glucuronide formation in the liver and is primarily asymptomatic amebiasis and D. It is 53 Antiprotozoal Drugs 609 also used in combination with other drugs in the treat- may act by inhibiting dihydrofolate reductase and inter- ment of other forms of amebiasis and as an alternative fering with polyamine metabolism. Chronic use of clioquinol, a closely related agent, ticularly the kidney, and is slowly excreted, mostly as the has been linked to a myelitislike illness and to optic at- unmodiﬁed drug. Pentamidine is active against Pneumocystis carinii, Diloxanide Furoate trypanosomes, and leishmaniasis unresponsive to pen- Diloxanide furoate (Furamide) is an amebicide that is tavalent antimonials. Although it is more mild or asymptomatic infections, cures of 83 to 95% toxic than trimethoprim–sulfamethoxazole, it has been have been achieved; in patients with dysentery, cure widely used in patients with acquired immunodeﬁ- rates may be less impressive. It Pentamidine is an alternative drug for visceral leish- is remarkably free of side effects, but occasionally ﬂatu- maniasis, especially when sodium stibogluconate has lence, abdominal distention, anorexia, nausea, vomiting, failed or is contraindicated. Diloxanide is ex- serve agent for the treatment of trypanosomiasis before creted in the urine, largely as the glucuronide. Rapid drug in- fusion may produce tachycardia, vomiting, shortness of Antibiotics breath, headache, and a fall in blood pressure. Changes Several antibiotics have been used to treat intestinal in blood sugar (hypoglycemia or hyperglycemia) neces- protozoal infections.
Religious involvement buy trimox 500 mg with mastercard, spirituality and medicine 227 Other studies of physical health Studies have shown that religious involvement is associated with health-promoting 55–57 55 buy trimox 500mg without prescription,56 55 behaviors such as more exercise 250 mg trimox otc, proper nutrition, more seat belt use, smoking 57 27 cessation and greater use of preventive services. In addition, religious involvement 58 predicted greater functioning among disabled persons. Finally, religious involvement 59 was associated with fewer hospitalizations and shorter hospital stays. Only a few inconclusive studies have been carried out on the relationship between religious 51 involvement and spirituality, and cancer risk and mortality. End-oflife care addresses not only physical symptoms but also psychosocial and spiritual concerns. Terminally ill patients derive 61,62 strength and hope from spiritual and religious beliefs. Indeed, terminally ill adults 63 64 report significantly greater religiousness and depth of spiritual perspective compared with healthy adults. Greater depth of spiritual perspective is associated with greater sense 64 61,65 of well-being. Studies also suggest that religiously involved persons at the end of life are more accepting of death, unrelated to belief in an afterlife. Finally, intrinsic 66,67 68 religiosity and religious involvement are associated with less death anxiety. RELIGIOUS INVOLVEMENT, SPIRITUALITY AND MENTAL HEALTH A majority of the nearly 850 studies of mental health that have used religious and spiritual variables have found that religious involvement and spirituality are associated 25 with better mental health outcomes. Depression Depression is a common illness; 6–10% of the population experience significant 69 depression during their lifetime. Recent longitudinal studies have examined the 70 relationship between religious involvement and spirituality and depression.