12 Antiparasitic agents Flashcards

1
Q

what is a parasite

A

an organism that lives in or on an organism of another species (its host) and benefits by deriving nutrients at the other’s expense
protozoa or metazoa

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2
Q

what are the 4 main species of malaria and which are benign

A

1 Plasmodium falciparum
2 P. Vivax- benign
3 P. Ovale- benign
4 P. Malariae- benign

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3
Q

how do mosquitoes transmit malaria

A

the female anopheles mosquito spits out saliva into humans to clear their passage for blood, and in doing so transmit the parasite

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4
Q

what are hypnozoites

A

dormant forms in the life cycles of certain parasitic protozoa- stay in the liver and emerge later

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5
Q

describe the life cycle of a mosquito

A

mosquito->sporozoite->schizont (liver)->trophozoite (RBC)->merozoite (RBC)->gametocytes->mosquito
M-SSTMG-M

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6
Q

which is the most dangerous species of malaria

A

P, Falciparum

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7
Q

a parasite can either.. or .. when it enters the body

A

stay in the liver as hypnozoites or come out and multiply into blood stream and cause RBCs to burst open

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8
Q

describe the treatment for P. Falciparum malaria

A

combination therapy
severe= quinine (+doxycycline or clindamycin)
milder= atovaquone + proguanil
IV for severe

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9
Q

describe the treatment for benign species of malaria

A

chloroquine and primaquine to clear out liver so don’t get any trouble later from hypnozoites

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10
Q

describe the mechanism of action of chloroquine

A

in malaria, the plasma membrane invaginates and takes it in using transporters
the parasite imports it’s own transporters into membrane
haemoglobin is ingested by the parasitophorous vacuole and is broken up into globin and haem
free haem is toxic to plasmodium due to the high iron so it has an enzyme called haem polymerase which clots haem and neutralises toxicity
chloroquine neutralises haem polymerase so haem remains toxic to the parasite and is killed

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11
Q

describe chloroquine resistance

A

some parasites have transporters to efflux the chloroquine back out, so don’t get a chance to inhibit haem polymerase

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12
Q

describe how artemisinin derivatives started to be used against malaria
what is it used with

A

china looked back at ancient texts to see what herbs and plants used to be used in medicine
literature said qing hao (artemisia annua) was good for piles and fevers, tests showed it had anti-malaria activity
use in combination with lumefantrine

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13
Q

describe prophylaxis for different levels of risk for malaria

A

high= mefloquine, malarone, doxycycline
moderate= chloroquine and proguanil
low= chloroquine
very low= nothing

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14
Q

what is African trypanosomiasis

A

also known as African sleeping sickness when CNS is invaded: insect-borne parasitic disease
vector= tsetse fly
reservoir= cattle

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15
Q

treatment for African trypanosomiasis

A

stage 1= suramin, pentamidine
stage 2= melarsoprol, eflorithine, eflorithine and nifurtimox
stage 1&2= new drug- fexinidazole

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16
Q

describe how infection occurs in chagas disease

A

reduviid bug sleeps in cracks in walls, at night lands on exposed skin, breaks skin and sucks, defecates which makes sleeping person rub/itch, rubs it into broken skin causing infection

17
Q

what causes leishmaniasis

A

sandfly

18
Q

treatment for leishmaniasis

A

AmB but is IV so hard to give in poorer areas

miltefosine is widely used

19
Q

describe toxoplasmosis in the immunocompetent

A

glandular like illness, infections settle by themselves

20
Q

describe toxoplasmosis in the immunocompromised

A

can cause brain abscesses

use pyrimethamine, sulphadiazine and folinic acid

21
Q

treatment for luminal protozoa (3)

A

metronidazole (good for anaerobic infections)
co-trimoxazole
nitazonxanide

22
Q

which intestinal nematodes do mebendazole and albendazole treat and describe them

A

enterobius (pin or threadworm)- sheds eggs in perianal area
ascaris- can be found in cold meats in eastern Europe
trichuris (whipworm)- behaves like a corkscrew and burrows into submucosa leading to diarrhoea and stunted growth
hookworms- suck blood-> anaemia

23
Q

which drug treats strongyloides

A

ivermectin

24
Q

what transmits onchocerciasis

A

blackfly by fast flowing rivers, larvae migrate into eye and cause river blindness

25
Q

what drug regimen is used in ivermectin

A

2 doses of ivermectin 6 months apart, for 3 years

combined with nodulectomy to remove adult worms and blackfly vector control

26
Q

in lymphatic filariasis…is blocked

A

lymphatics

27
Q

name 4 nematodes

A

intestinal, strongyloidiasis, onchocerciasis, filariasis

28
Q

name 3 cestodes and their treatments

A

beef and pork tapeworm- praziquantel

hydatid disease- albendazole/surgery

29
Q

name a trematode and it’s treatment

A

schistosmiasis- praziquantel