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Group Pharm II > 44-Antiparasitic Drugs > Flashcards

44-Antiparasitic Drugs Flashcards

1
Q

What are endoparasites and where do they live?

A

Worms (tapeworm, pinworm etc) and they live in a host

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2
Q

What are ectoparasites and where do they live?

A

Lice, mites, scabies and they live on the host

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3
Q

What are the reasons for the increase in prevalence of both endo and ectoparasites in the US?

A

Immigration
Travelers
AIDS

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4
Q

Name some of the lumen and tissue dwelling protozoans?

A

Amebiasis, Balantidiasis, Cryptosporidiosis, Giardiasis and trichomoniasis

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5
Q

What might be the first line drug to use against lumen and tissue dwelling protozoans

A

Metronidazole (Amebiasis, Giardiasis, Trichomoniasis, Enterocolitis by C-dif, Rosacea)

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6
Q

Name some of the properties of metronidazole?

A

It is orally well absorbed and distributed
It crosses the BBB
Extensively metabolized
Can be given IV
Active vs protozoa as well as H.pylori, B. Fragilis and C-dif and other anaerobic bugs

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7
Q

What do you want to caution the patient when putting them on Flagyl?

A

To avoid alcohol consumption while on this drug because it causes abdominal cramps, N/V/D, Headache and flushing.

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8
Q

What are some ADR’s of metronidazole?

A
  • GI discomfort, N/V/D, metalic taste, leukopenia, thrombocytopenia
  • Increases anticoagulant effects of coumadin (it kills the anaerobes in the stomach that synthesize Vit K)
  • Disulfiram reactions with ETOH
  • Photosensitivity
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9
Q

What other drug causes you to have a metallic taste? hint its macrolide.

A

Clarithromycin-used for pharyngitis/tonsilitis etc

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10
Q

If a patient is resistant to metronidazole, what other drug can you hit them with?

A

Tinidazole-used for metronidazole resistant trichomonas

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11
Q

What are some properties of Tinidazole?

A
  • it is also indicated for giardiasis, intestinal amebiasis, amebic liver abscess, B.frag, H.pylori
  • higher cure rate in a shorter amount of time than flagyl
  • Metabolized by CYTP450
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12
Q

What are some ADR’s of Tinidazole?

A

Anorexia, N/V/D, bitter taste in mouth and contraindicated in the first trimester.

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13
Q

What does the intestinal protozoa Cryptosporidiosis cause?

A

Chronic diarrhea in immunocompromised patients. it is also found in up to 50% of AIDS patients

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14
Q

What is the recommended treatment for Cryptosporidiosis?

A

Nitazoxanide-its a broad spectrum and approved for crypto and giardiasis in immunocompetant patients

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15
Q

What is the most common Infectious dz in the world

A

Malaria

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16
Q

How is malaria spread?

A

Mosquito bite

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17
Q

Describe Malaria’s mechanism of infection?

A

Mosquito bite transmits plasmodium sporozites in the blood which invade the liver, replicates into merozoites and then released into the blood stream infecting RBC

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18
Q

What are some drugs that can be used to treat malaria?

A

Primaquine, Chloroquine, Quinine, Mefloquine, Atovaquone and proguanil

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19
Q

What are the properties of primaquine?

A

Used to treat the persistent phase of malaria, eradicates the tissue plasmodia, prevents re-emergence from the liver and relapse.

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20
Q

What is an important ADR of primaquine?

A

In patients with G6PD deficiency, primaquine can accumulate in RBC and cause hemolytic anemia

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21
Q

Chloroquine used to be the DOC for malaria until the 80s, what happened?

A

There was resistance due to the arrival of HIV

22
Q

What are the ADR’s of chloroquine?

A

GI distress, N/V/D, high doses can cause retinal and fetal damage

23
Q

What do you know about Quinine?

A

It was the DOC prior to WWII, then chloroquine was introduced. Due to chloroquine resistance, quinine is now being used again and its good for leg cramps.

24
Q

What anti malaria drug is used as a prophylaxis treatment for chloroquine resistance malaria?

A

Mefloroquine

25
Q

What are there properties of mefloroquine?

A

It can be given orally and undergoes hepatic metabolism. It also has a half life of 14 days so its good for travelers (so too is Malarone)

26
Q

What are some ADRs of Mefloroquine?

A

It can cause severe neuropsychiatric syndrome associated with Hallucinations, anxiety, confusion and seizures.

27
Q

What combo anti-malaria drug is given to treat chloroquine resistant malaria?

A

Atovaguone (mepron) and Proguanil (HIV pts). This combo also stimulates appetite.

28
Q

________ is a common infection in immunocompetent patients but are rarely symptomatic?

A

Toxoplasmosis

29
Q

What serious complications can Toxo present in immunocompromised or congenitally infected neonates?

A

Ocular infections and encephalitis is the most common CNA dz in AIDS pts.

30
Q

What do you treat Toxo with?

A

Pyrimethamine and Sulfadiazine, Bactrim, Dapsone

31
Q

What medication may be given to Toxo patients taking as an adjunct therapy to prevent toxicities?

A

Folinic acid (leucovorin)

32
Q

What causes pneumonia in premature and malnourished infants as well as immunocompromised patients.

A

PCP Pneumonia

33
Q

What is the DOC for PCP PNA?

A

Bactrim- 1 DS tablet TID for 21 days. Steroid can be added to reduce lung swelling.

34
Q

What other medication helps to treat PCP PNA in HIV patients who have sulfa allergy?

A

Pentamidine. Given IV for treatment and inhaled for prophylaxis. Given once every 21days

35
Q

If a patient is too sick to receive chemotherapy, do you still give them a prophylaxis for PCP?

A

Yes, otherwise they will be twice as vulnerable for further opportunistic infections.

36
Q

How does helminth infections spread?

A

Spread by food, water, feces, unwashed hands, formites. Some can be via bug bites.

37
Q

What are parasitic worms that live in the hosts intestine causing malnourishment and anemia called?

A

Helminths

38
Q

What will be the definitive Dx for tapeworm?

A

Stool sample

39
Q

True of false, are helminths fat soluble?

A

True, that’s why they can stay in the body for long

40
Q

What oral meds are used to treat nematode infections?

A

Albendazole and Mebendazole. They inhibit metabolism in the parasites and exhibit selective toxicity.

41
Q

What aids in the absorption of Albendazole?

A

When taken with a high fat meal

42
Q

Where is the greatest parasitic resistance to drugs?

A

Livestock, not yet a problem with humans

43
Q

What are some ADRs of Albendazole?

A

N/V/D, delirium and hallucinations.

High doses used to treat tapeworm can cause hepatitis or hematologic toxicity. also Teratogenic

44
Q

What parasitic drug is dose yearly and also effective in river blindness?

A

Ivermectin

45
Q

What are ADRs of Ivermectin?

A

N/V/D, vertigo and sedation

46
Q

What is the most common helminth infection in the US?

A

Pinworm

47
Q

How does pinworm spread?

A

family members (bed linens), daycares. treat with albendazole/mebendazole

48
Q

What is the DOC for ectoparasites (lice, mites scabies)

A

Permethrin (apply on hair for 10mins and then rinse

49
Q

What must you tell the patient to use along with the permethrin medication?

A

Tell them to buy a comb and brush off the nits

50
Q

What is Lindane?

A

It is another ectoparasitic drug. Comes as a Topical lotion for scabies and shampoo for lice

51
Q

How much of Lindane should you dispense?

A

No more than 2 ounces and don’t leave on hair for >4mins, it causes brain damage (seizures and myelosuppression)

Group Pharm II (8 decks)

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