IODOQUINOL

IODOQUINOL
(eye-oh-do-kwin'ole)
Diiodohydroxyquin, Yodoxin
Classifications: amebicide; antiprotozoal;
Therapeutic: antiprotozoal
; amebicide
Prototype: Emetine
Pregnancy Category: C

Availability

210 mg, 650 mg tablets

Action

Direct-acting (contact) amebicide.

Therapeutic Effect

Effective against both trophozoites and cyst forms of Entamoeba histolytica in intestinal lumen. Not useful for extraintestinal amebiasis.

Uses

Intestinal amebiasis and for asymptomatic passers of cysts. Commonly used either concurrently or in alternating courses with another intestinal amebicide.

Unlabeled Uses

Balantidiasis and Acrodermatitis enteropathica; traveler's diarrhea; shampoo preparation (Sebaquin) used for control of seborrheic dermatitis of scalp.

Contraindications

Hypersensitivity to any 8-hydroxyquinoline or to iodine-containing preparations or foods; hepatic or renal damage; pregnancy (category C).

Cautious Use

Severe thyroid disease; minor self-limiting problems; prolonged high-dosage therapy; preexisting optic neuropathy; lactation.

Route & Dosage

Intestinal Amebiasis
Adult: PO 650 mg t.i.d. for 20 d (max: 2 g/d); may repeat after a 2–3 wk drug-free interval
Child: PO 30–40 mg/kg/d in 2–3 divided doses for 20 d (max: 1.95 g/d); may repeat after a 2–3 wk drug-free interval

Administration

Oral
  • Give drug after meals. If patient has difficulty swallowing tablet, crush and mix with applesauce.

Adverse Effects (≥1%)

Body as a Whole: Hypersensitivity (urticaria, pruritus). CNS: Headache, agitation, retrograde amnesia, vertigo, ataxia, peripheral neuropathy (especially in children); muscle pain, weakness usually below T12 vertebrae, dysesthesias especially of lower limbs, paresthesias, increased sense of warmth. Special Senses: Blurred vision, optic atrophy, optic neuritis, permanent loss of vision. GI: Nausea, vomiting, anorexia, abdominal cramps, diarrhea, constipation, rectal irritation and itching. Skin: Discoloration of hair and nails, acne, hair loss, urticaria, various forms of skin eruptions. Hematologic: Agranulocytosis (rare). Endocrine: Thyroid hypertrophy, iodism [generalized furunculosis (iodine toxiderma), skin eruptions, fever, chills, weakness].

Diagnostic Test Interference

Iodoquinol can cause elevations of PBI and decrease of I-131 uptake (effects may last for several weeks to 6 mo even after discontinuation of therapy). Ferric chloride test for PKU (phenylketonuria) may yield false-positive results if iodoquinol is present in urine.

Pharmacokinetics

Absorption: Small amount from GI tract. Elimination: In feces.

Nursing Implications

Assessment & Drug Effects

  • Monitor I&O ratio. Record characteristics of stools: color, consistency, frequency, presence of blood, mucus, or other material.
  • Note: ophthalmologic examinations are recommended at regular intervals during prolonged therapy.
  • Monitor and report immediately the onset of blurred or decreased vision or eye pain. Also report symptoms of peripheral neuropathy: pain, numbness, tingling, or weakness of extremities.

Patient & Family Education

  • Report skin rash and symptoms of agranulocytosis (see Appendix F).
  • Complete full course of treatment. Stool needs be examined again 1, 3, and 6 mo after termination of treatment.
  • Note: Intestinal amebiasis is spread mainly by contaminated water, raw fruits or vegetables, flies, roaches, and hand-to-mouth transfer of infected feces. It is very important to wash hands after defecation and before eating.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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