28 - Antiprotozoal drugs

Question 1

These amebicides act on organisms in the bowel wall and the liver. Give examples

Answer 1

• Tissue amebicides

- chloroquine, emetines, metronidazole, tinidazole

Question 2

These amebicides act only in the lumen of the bowel. Give examples

Answer 2

• Luminal amebicides

- diloxanide furoate, iodoquinol, paromomycin

Question 3

Drug of choice for asymptomatic luminal cysts of E. histolytica:

Answer 3

Diloxanide furoate

Question 4

Drug of choice for severe intestinal and extraintestinal amebiasis:

Answer 4

Metronidazole

Question 5

SE for Metronidazole

Answer 5

Disulfiram-like reaction (do not take alcohol!)

Metallic taste

Question 6

DOC for cryptosporidiosis.

Answer 6

Nitazoxantide

Question 7

Treatment of Giardiasis:

Answer 7

Metronidazole

Question 8

Treatment for Trichomoniasis

Answer 8

Metronidazole 2 g oral single dose

Question 9

Term: These antimalarial drugs kill schizonts in the liver.

Give some examples

Answer 9

• Tissue Schizonticides

- primaquine

Question 10

Term: These antimalarial drugs kill the parasitic forms only in the RBCs.
Give some examples

Answer 10

• Blood schizonticides

- chloroquine, quinine

Question 11

Term: These antimalarial drugs kill gametocytes in human blood.
Give some examples

Answer 11

• gametocides

- primaquine

Question 12

Term: These antimalarial drugs prevent sporogony and multiplication in the mosquito.
Give some examples

Answer 12

• sporonticides

- proguanil, pyrimethamine

Question 13

MOA of chloroquine

Answer 13

Prevents conversion of heme to hemozoin

Question 14

MOA of quinine

Answer 14

complexes with DNA to prevent strand separation, blocking DNA replication and transcription

Question 15

MOA of primaquine

Answer 15

forms electron-transferring redox compounds that act as cellular oxidants.

Question 16

MOA of proguanil

Answer 16

inhibits folate synthesis - sporonticide

Question 17

Limitation of treatment with primaquine

Answer 17

Should be used with a blood schizonticide (e.g. chloroquine, quinine)

Question 18

MOA of pyrimethamine

Answer 18

sequential blockade of folic acid synthesis - sporonticide

Question 19

Anti-protozoal drug that can be used as a DMARD

Answer 19

Chloroquine

Question 20

Term: toxicity of quinine.

What are the components of the triad?

Answer 20

Cinchonism:

• headache
• tinnitus
• vertigo

Question 21

Prophylactic drug for drug-resistant P. falciparum

Answer 21

Doxycycline, 100 mg/tab OD, start 3 days before traveling

Question 22

Drug of choice for uncomplicated falciparum malaria in the Philippines

Answer 22

Co-artem (artemether-lumefantrine)

Question 23

Toxicity of pyrimethamine.

What is the rescue drug?

Answer 23

• folic acid deficiency

- leucovorin (folinic acid)

Question 24

Drug of choice for toxoplamosis?

MOA?

Answer 24

• sulfadiazine-pyrimethamine

- sequential blockade of dihydropteroate synthase (sulfadiazine) and dihydrofolate reductase (pyrimethamine)

Question 25

DOC for Chagas disease

Answer 25

Nifurtimox

Question 26

DOC for advanced West African sleeping sickness

Answer 26

Eflornithine

WE PESM

Question 27

DOC for advanced East African sleeping sickness

Answer 27

Melarsoprol

WE PESM

Question 28

DOC for early West African sleeping sickness

Answer 28

Pentamidine

WE PESM

Question 29

DOC for early East African sleeping sickness

Answer 29

Suramin

WE PESM

Question 30

DOC for pneumocystosis

Answer 30

Co-trimoxazole

Question 31

DOC for Leishmaniasis

Answer 31

Sodium stibogluconate

Question 32

alternative drug for cutaneous Leishmaniasis

Answer 32

fluconazole, metronidazole

Question 33

alternative drug for visceral Leishmaniasis

Answer 33

pentamidine, miltefosine

Question 34

alternative drug for mucocutaneous Leishmaniasis

Answer 34

amphotericin B

Question 35

drug of choice for primary amebic menigoencephalitis

Answer 35

Amphotericin B

Question 36

DOC for Babesiosis

Answer 36

Clindamycin or quinine

Question 37

drug of choice for Balantidium dysentery

Answer 37

Tetracycline