Central nervous system disturbances and peripheral neuropathy may also occur.Most common side effects
anorexia
weight loss
nausea
vomiting
headache
dizziness
amnesiaLess common effects
rash
depression
anxiety
confusion
fever
sore throat
chills
seizures
impotence
tremors
muscle weakness
numbness of hands or feet

Contraindications
Nifurtimox is contraindicated in people with severe liver or kidney disease, as well as people with a background of neurological or psychiatric disorders. Mechanism of action
Nifurtimox forms a nitro-anion radical metabolite that reacts with nucleic acids of the parasite causing significant breakdown of DNA. Its mechanism is similar to that proposed for the antibacterial action of metronidazole. Nifurtimox undergoes reduction and creates oxygen radicals such as superoxide. These radicals are toxic to T. cruzi. Mammalian cells are protected by presence of catalase, glutathione, peroxidases, and superoxide dismutase. Accumulation of hydrogen peroxide to cytotoxic levels results in parasite death. Society and culture
Legal status
Nifurtimox is only licensed for use in Argentina, the United States, and Germany. It was approved for medical use in the United States in August 2020. Names
Research
Nifurtimox is in a phase-II clinical trial for the treatment of pediatric neuroblastoma and medulloblastoma. References
External links
"Nifurtimox". Drug Information Portal. U.S. National Library of Medicine.
It is not for long term definitive treatment/cure, only as an adjunct (surgery is the aim for cure in most causes of Cushings syndrome). Metyrapone hence acts by inhibiting adrenal steroidogenesis. One side effect is hirsutism (in women) because of the excess androgen precursors created. The other commonly used agent for medical treatment of Cushings is ketoconazole (an anti-fungal agent). This does not exhibit the side effect of hirsutism. Pharmacology
Pharmacodynamics
Metyrapone blocks cortisol steroidogenesis by acting as a reversible inhibitor of 11β-hydroxylase. This stimulates adrenocorticotropic hormone (ACTH) secretion, which in turn increases plasma 11-deoxycortisol levels. Chemistry
Analogues of metyrapone include aminoglutethimide, amphenone B, and mitotane. Research
Metyrapone has been found in early human trials to reduce recollection of emotional memories in normal volunteers. The volunteers showed significant impairment in ability to retrieve memories with negative emotional content while not impairing memories with neutral content. This has significant implication in the study of the process of emotional healing in post traumatic stress disorder.Due to the permissive action of cortisol on glucagon, partial blockade of cortisol may reduce
the effects of circulating glucagon in chronically increasing blood glucose in metabolic syndrome (syndrome X) and type 2 diabetes. See also
ACTH stimulation test


== References ==