1. Anti-parasitic Drugs - Antiprotozoals Part 2: Anti-helminthic Drugs Flashcards
Drugs Active Against Nematodes (4)
Albendazole (broad spectrum)
Diethylcabamazine (filariasis)
Ivermectin (oncercioasis)
Mebendazole (narrow spectrum)
Drugs Active Against Trematodes/Flues (1)
Praziquntel
Drugs Active Against Cestodes (2)
Albendazole: severe cases of tapeworm
Praziquantel: both cestode and tapeworms
Pinworm: Parasite, Symptoms, Transmission, and Diagnosis
Enterbius vermicularis
Seen in children
Symptoms: Pruritis ani
Transmitted by ingestion of eggs which hatch intestines, female migrates and deposits eggs in perianal area
Diagnosed by *Scotch tape test, look for eggs and white worms
Pinworm Rx (2)
Mebendazole
or
Pyrantel pamoate
Ascariasis lumbricoides: Parasite
Ascaris lumbricoides
Ascariasis lumbricoides: Tranmission (3)
Ingestion of eggs, humans are the ONLY HOST
Intestinal larva; migrates through blood to lung
Can cause intestinal obstruction, Loeffler’s eosinophilic pneumonitis
Ascariasis lumbricoides: Rx (2)
Mebendazole
Pyrantel pamoate
Visceral Larval Migrans (Toxicara canis, dog roundworm): Defined and Transmission
Young children ingest larva, which matures in intestines and then migrates to liver, brain, and eyes
Transmission: ingestion of eggs from dog feces
Visceral Larval Migrans (Toxicara canis, dog roundworm): Rx (2)
Diethylcarbamazine
or
Albendazole
Hookworm Disease: Parasites, MOA, Transmission
Old name: Acyclostoma duodenale (old)
New name: Necator americanus (new)
*MOA: Attaches to mucosa and causes Anorexia, Ulcer, and Iron deficiency microcytic anemia due to chronic intestinal blood loss
Transmission: Direct penetration of skin by larvae found in soil, larvae travel to lungs (Loffler’s), coughed up, swallowed, mature in gut and produce eggs
Hookworm Disease: Rx (2)
Mebendazole
and
Pyrantel pamoate
Schistosomiasis (Blood and Liver flukes, trematodes): Parasites, Hosts, and Symptoms
S. mansoni, japonicum, hematobium
Dermatitis/katayama fever
Snails are host
Cerecariae penetrate skin of humans, causes (5):
Granulomas
Fibrosis and inflammation of the spleen and liver
Portal hypertension
Hematuria
Bladder cancer
Schistosomiasis (Blood and Liver flukes, trematodes): Other Parasites, Causes, and Symtoms (2)
Clonorchis sinensis: undercooked fish; causes inflammation of the biliary tract - pigmented gallstones
Pargonimus westermani: undercooked crab meat: inflammation and bacterial infection of the lung; hemoptysis
Schistosomiasis (Blood and Liver flukes, trematodes): Rx (1)
Praziquantel
Echinococcosis (tape worm): Echinococcosis granulosis (dog tapeworm) - Defined, Transmission, and Dx
Hydratid cysts in liver, lung, and brain –> cysts rupture and causes anaphylactic shock
Transmission: Eggs from dog or sheep feces
Dx: CT or MRI
Echinococcosis (tape worm): Echinococcosis granulosis (dog tapeworm) - Rx (3)
Albendazole
Injection of ethanol
Surgery (not to rupture cyst)
Echinococcosis (tape worm): Taenia Solium (Pork tapeworm) - Defined and Symptoms
Pigs intermediate host
Scolex: head with suckers and hooks
Symptoms: brain cysts and seizures
Echinococcosis (tape worm): Taenia Solium (Pork tapeworm) - Rx (2)
Praziquantel for intestinal worms and cysticercosis
Albendazole for neurocyticerosis
Echinococcosis (tape worm): Taenia saginatum (beef tapeworm) - Defined and Transmission
*Scolex: head with suckers but NO HOOKS
Transmission: eggs or larvae in undercooked meat
Echinococcosis (tape worm): Taenia saginatum (beef tapeworm) - Rx (2)
Praziquantel or Niclosamide
Filariasis/Elephantasis: Parasite (2)
Wuchereria bancrofti, brugia malayi
Filariasis/Elephantasis: MOA
Filarial worms block the flow of lymph causing edema of arms, legs, and scrotum
Filariasis/Elephantasis: Transmission
Anopheles and culex mosquitoes
Filariasis/Elephantasis: Rx
Diethylcarbamazine or ivermectin
Oncocerciasis (River blindness): Transmission, MOA, and Symptoms
Transmitted by blackfly
Oncocerca form skin and subcutaneous tissues
Adult worms live in subcutaneous tissues
Microflilariae migrate across cornea, causing ocular damage
Oncocerciasis (River blindness): Rx (2)
Suramin (adult worms)
Ivermectin (microfilaria)
Albendazole: MOA (2)
Inhibits microtubule synthesis
Blocks glucose uptake
Albendazole: Uses (5)
Ascariasis
Trichuriasis
Hookworm and pinworm
Hydratid disease
Neurocysticerosis
Albendazole: Adverse Effects
Blood count and liver fxn tests should be monitored for long term use
Diethylcarbamazine citrate: MOA
Immobilizes the microfilaria and alters their surface structure
Diethylcarbamazine citrate: Uses (4)
Wuchereria bancrofti
Brugia malayi
Loa, loa
Tropical eosinophilia
Diethylcarbamazine citrate: Adverse Effects (5)
Headache
Malaise
Anorexia
Weakness
Mazzotti Reaction
Ivermectin: MOA
Paralyze nematodes and arthropods by intensifying GABA
Ivermectin: Uses (7)
Onchocerciasis
Strongyloidiasis
B. Malayi
W. Bancrofti
Scabies
Lice
Cutaneous larva migrans
Ivermectin: Adverse Effects (8)
Due to killing of worms, side effects include (8)
Fever
Headache
Dizziness
Somnolence
Rash
Pruritis
Joint and muscle pain
Hypotension
Mazotti Reaction: Defined and Symptoms
Seen with Diethylcarbamazine citrate
Common side effect of many anti-parasitic medication, depending on severity of parasite load
Symptoms: fever/chills, respiratory distress, and hypotension
Praziquantel: MOA
Causes paralysis of worms by increasing the permeability of calcium
Praziquantel: Uses (6)
Schistosomiasis
Clonorchiasis
Paragonimiasis
Taieniasis
Neurocystecercosis
Hydatid disease
Praziquantel: Adverse effects (4)
Fever
Rashes
Arthralgia
Neurologic abnormalities
Pyrantel Pamoate: MOA
Neuromuscular blocking by inhibition of cholinesterase –> paralysis of worms
Pyrantel Pamoate: Uses (3)
Ascariasis
Hookworm
Necator americans
Pyrantel Pamoate: Adverse Effects (1)
Liver dysfunction
Thiabendazole: MOA
Same as albendazole:
Inhibits microtubule synthesis
Blocks glucose uptake
Thiabendazole: Uses
Strongyloides
Thiabendazole: Adverse Effects (1)
More toxic than benzimidazoles
Anti-leprotic Drugs: Dapsone is rx for? (2)
Leprosy and dermatitis herpitiformis
Anti-leprotic Drugs: Thalidomide - Rx use, pregnancy category, and risk?
Rx for erythema nodosum leprosum
Pregnancy category X
Risk for phocomelia (congenital malformation of limbs)