1. Anti-parasitic Drugs - Antiprotozoals Part 1 Flashcards
Anti-malarial Agents (3)
Chloroquine
Mefloquine
Primaquine
Anti-amebic (2)
Metronidazole
Iodoquinol
Drugs for Trichimoniasis
Metronidazole
Drugs for Giardiasis
Metronidazole
Drugs for Pneumocystosis
Trimethoprime + Sulfamethoxazole
Drugs for Leishmaniasis (3)
Sodium stibogluconate
Meltifosine
Amphotericin B
Drugs for Trypanosomiasis (3)
Nifurtimox - Chaga’s Disease
Suramin - Hemolymphatic stage
Melasoprol - CNS and mucocutaneous
Drugs for Toxoplasmosis
Pyrimethamine + Sulfadiazine
Malarial Drugs: Plasmodium Falciparum and Side Effects (2)
Chloroquine
- Severe fever
- Parasitized RBC occlude capillaries in brain, kidneys, lungs
Malarial Drugs: Plasmodium Malariae
Chloroquine
Malarial Drugs: Plasmodium Vivax
Chloroquine + Primaquine
Malarial Drugs: Plasmodium Ovale and Side effects
Chloroquine + Primaquine
Fever, chills, headache, splenomegaly, anemia
Malarial Drugs: Prophylaxis (3)
Chloroquine
Mefloquine
Doxycycline
Malarial Drugs: Treatment
Chloroquine
Mefloquine
Primaquine
Malarial Drugs for Travel: Areas without resistant P falciparum
Cholorquine
Malarial Drugs for Travel: Areas with chloroquine-resistant P falciparum (2)
Malarone
Mefloquine
Malarial Drugs for Travel: Areas with multidrug resistant P falciparum
Doxycycline
Malarial Drugs for Travel: Alternative for primary prevention (2)
Primaquine
Terminal prophylaxis of P vivax and P ovale
Malarial Drugs: Chloroquine MOA (2)
Prevents the biocrystallization
of hemoglobin to hemozoin
Inhibits parasite’s ability to digest hemoglobin
Malarial Drugs: Chloroquine Uses (2)
Malaria (kills active erythrocytic phase of all species)
Amebic liver abscess
Malarial Drugs: Chloroquine C/I
Psoriasis and porphyria
Malarial Drugs: Chloroquine Adverse Effets
Pruritis
Blurring of vision
Nausea
Vomiting
Long Term Use: Irreversible otoxicity Retinopathy Myopathy Peripheral neuropathy Hemolysis (G6PD deficiency)
Malarial Drugs: Artemether MOA
Inhibition of parasite calcium ATP
Malarial Drugs: Artemether Uses
Complicated M. falciparum
Malarial Drugs: Artemether Adverse Effects (5)
NVD
Dizziness
Neutropenia
Elevate liver enzmyes and allergic reactions
Malarial Drugs: Quinine and Quinidine MOA
Complexes with DNA to prevent strand separation, blockade of DNA replication and transcription to RNA
Malarial Drugs: Quinine and Quinidine Uses (2)
Severe M. falciparum
Babesiosis
Malarial Drugs: Quinine and Quinidine Adverse Effects (4)
Cinchonism- tinnitus, headache, nausea, dizziness, flushing and visual disturbances.
Hypersensitivity
Hemolysis (G6PD deficient)
Blackwater fever
Malarial Drugs: Quinine and Quinidine C/I (3)
Visual, auditory, and cardiac problems
Malarial Drugs: Mefloquine Uses (2)
Chloroquine resistant malaria
Prophylaxis and treatment
Malarial Drugs: Mefloquine Adverse Effects (5)
Neuropsychiatric toxicity
Depression
Psychosis
Seizures
Cardiac problems
Malarial Drugs: Primaquine MOA
Acts as cellular oxidants
Malarial Drugs: Primaquine Uses
Eradication of dormant liver forms of
P. Vivax
P. Ovale
Pneumocystis jiroveci
Malarial Drugs: Primaquine Adverse Effects
Hemolysis & methemoglobinemia in G6PD defeciency.
Malarial Drugs: Atovaquone/proguanil MOA
Disrupting mitochondrial electron transport parasite
Malarial Drugs: Atovaquone/proguanil Uses
Prophylaxis and treatment of malaria falciparum and P jiroveci
Malarial Drugs: Atovaquone/proguanil Adverse Effects (3)
GI distress
Elevate liver enzymes
Flue like symptoms
Malarial Drugs: Doxycycline MOA
Inhibits protein synthesis
Malarial Drugs: Doxycycline Uses (3)
Multidrug resistant malaria
P Falciparum
Filariasis
Malarial Drugs: Primaquine C/I (3)
Granulocytopenia
Methemoglobinemia
Pregnancy
Amebiasis (amebic dysentery)
Entamoeba hystolytica
Cysts ingested form water, tropozoites travel to colon
Amebiasis (amebic dysentery) Symptoms (5)
Asymptomatic intestinal infection
Mild to moderate colitis
Severe intestinal infection (dysentery)
Ameboma
Liver abscess and other extraintestinal infections (anchovy sauce).
Amebiasis (amebic dysentery): Drugs for Asymptomatic Intestinal Infection (1)
Iodoquinol
Amebiasis (amebic dysentery): Drugs for amebic colitis
Metronidazole + Iodoquinol
Amebiasis (amebic dysentery): Extraintestinal infection
Metronidazole/Chloroquine + Iodoquinol
Giardiasis: Parasite, Side Effects, and Drug (3)
Giardia lamblia
Bloating, flatulence, foul-smelling, fatty diarrhea (often seen in campers/hikers) – transmission cysts in water
Rx: Metronidazole
Trichomonas vaginalis: Defined and Drug
Vaginitis: foul smelling, greenish discharge: itching & burning – transmission – sexual
Rx: Metronidazole, and treat partner
Metronidazole and Tinidazole MOA
Forms reactive cytotoxic products kills parasite
Metronidazole and Tinidazole Uses (2)
Intestinal wall and hepatic abscess,
Other extra intestinal amebiasis, Trichomoniasis, Giadiasis, H.pylori, B.fragilis
Metronidazole and Tinidazole Adverse Effects (5)
Metallic taste
Disulfiram like reaction
Headache
Paresthesias
Dark discoloration of urine
Nitazoxanide MOA
Inhibits the pyruvate-ferredoxin oxidoreductase pathway
Nitazoxanide Uses
Metronidazole resistant protozoas and helminthic infection, Amebiasis, H.pylori
Iodoquinol Uses
Luminal amebicide
Iodoquinol Adverse Effects (3)
Iodine toxicity
Thyroid dysfunction
Peripheral neuropathy
Paromomycin MOA
Inhibits protein synthesis
Paromomycin Uses (2)
Luminal amebicide
Cryptosporidiosis in the AIDS patient
Paromomycin Adverse Effects (3)
Dizziness
Rashes
Arthralgia
Trypanosomiasis (Chaga’s Disease)
Trypanosoma cruzi, which is transmitted to animals and people by insect vectors (Triatomine bugs) and is found only in the Americas (mainly, in rural areas of Latin America where poverty is widespread
Trypanosomiasis (Chaga’s Disease) Complications (3)
Heart rhythm abnormalities that can cause sudden death
A dilated heart that doesn’t pump blood well
A dilated esophagus or colon, leading to difficulties with eating or passing stool
Trypanosomiasis (Chaga’s Disease) Rx (2)
Benznidazole
Nifurtimox
Trypanasoma brucei (African sleeping sickness) Transmission and MOA (3)
Tsetse fly
Extracellular replication cycle in blood and lymph
Invasion of CNS, inflammation, lethargy, coma, & death
Trypanasoma brucei (African sleeping sickness) Rx
Early stage: Pentamidine, suramin
Late (CNS) stage: melarsoprol, eflornithine, and nifurtimox
Leishmaniasis Defined (2)
Type of transmission (human-sand fly-human) is called anthroponotic
Visceral leishmaniasis (affects internal organs), cutaneous leisghmaniasis (affects the skin) and mucosal leishmaniasis (affects the nose and throat)
Leishmaniasis Rx (3)
Sodium stibogluconate
Miltefosine
Amphotericin B
Pentamidine MOA
Inhibition of glycolysis OR interferences with nucleic acid metabolism
Pentamidine Uses (2)
Pneumocystosis in HIV
Trypanosomiasis & kala azar form of leishmaniasis
Pentamidine Adverse Effects (6)
Respiratory abnormality
Hypotension
Hypoglycemia
Anemia
Hepatitis
Pancreatitis
Sodium Stibogluconate MOA
Inhibition of glycolysis OR nucleic acid metabolism
Sodium Stibogluconate Uses
Leishmaniasis
Sodium Stibogluconate Adverse Effects
Cardiotoxic (QT prolongation)
Eflornithine MOA
Suicide substrate of ornithine decarboxylase
Eflornithine Uses
African trypanosomiasis (enters CNS)
Eflornithine Adverse Effects (2)
Hematotoxicity
Seizures
Nifurtimox MOA
Inhibits trypanothione reductase
Nifurtimox Uses
Chaga’s disease
Nifurtimox Adverse effects (2)
GI irritation
CNS effects
Toxoplasmosis Parasite, Acquired, MOA
Toxoplasma gondii
Eating undercooked, contaminated meat (especially pork, lamb, and venison)
Eating food that was contaminated by knives, utensils, cutting boards and other foods that have had contact with raw, contaminated meat.
Drinking water contaminated with Toxoplasma gondii.
Accidentally swallowing the parasite through contact with cat feces that contain Toxoplasma.
**“Flu” with swollen lymph glands or muscle aches and pains that last for a month or more. Severe toxoplasmosis, causing damage to the brain, eyes, or other organs
Tachyzoites: rapidly growing tropozoites, in body fluids during acute infection, directly destroly tissues. Bradyzoites encysted in muscle, brain & eye
Toxoplasmosis Rx (2)
Pyrimethamine and Sulfadiazine
Clindamycin (Folinic acid)
Pneumocystis Defined, Symptoms, and When it starts
Pneumocystis jirovecii
Symptoms: fever, dry cough, shortness of breath, and fatigue
Can be serious with immunocompromised people
Start prophylaxis when CD4 drops
Pneumocystis Rx
Trimethoprim + Sulfamethoxazole (TMP-SMX)