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Chemotherapy > 8 - Antiprotozoal > Flashcards

8 - Antiprotozoal Flashcards

1
Q

Classify 4 types of protozoa based on their characteristics.

A
  1. Flagellates –> whip like flagella
  2. Amoeboids –> have pseudopod / protoplasmic flow to move
  3. Sporozoa –> non motile
  4. Cilliates –> cilia around its body
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2
Q

To survive harsh environment, microorganisms form _____

A

cysts

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3
Q

Microorganisms that can’t form cysts rely on _______ (transmission type) and ______ to survive and complete life cycle.

A

direct transmission, vector

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4
Q

Transmission of protozoal infection can be done by (3 ways)

A
  1. Insect vector
  2. directly from other mammalian reservoirs
  3. one person to another
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5
Q

How to treat infected individuals and reduce protozoal infection transmission?

A

Chemotherapy

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6
Q

What is the main problem for protozoal infection?

A
  1. Toxic at therapeutic doses

2. Increasing drug resistance

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7
Q

What is opportunistic infection?

A

Infections that occur more often or become more severe in people with weaker immune system

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8
Q

Opportunistic infections with protozoa are prominent in?

A

Infants and immunocompromised patients

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9
Q

Antiprotozoal drugs are classified into 6 groups based on ____. What are they?

A

based on disease. based on:

Trypanosomiasis
Toxoplasmosis
Giardiasis
Amebiasis
Leishmaniasis
Malaria

Try to get a leish manager

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10
Q

Where does amebiasis infection occur? Which species cause it?

A

intestinal tract

entamoeba species: - E. dispar and E. moshkovskii –> 90% human infections
- E. histolytica –> 10% human infections)

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11
Q

Which protozoal infection occurs in the intestinal tract?

A

-amebiasis

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12
Q

What are the manifestations of Amebiasis?

A
  • Asymptomatic intestinal infection (only in GI tract)
  • Mild to moderate colitis
  • Severe intestinal infection (dysentry) –> bloody dhiarrea
  • Ameboma –> tumor in intestine
  • Liver abscess and other extraintestinal infection –> if severe
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13
Q

Which antiprotozoal has activity against more than 1 protozoal infection?

A

Chloroquine (amebiasis, malaria)

Metromidazole (amebiasis, giardiasis, and ___)

Paromomycin sulfate
(amebiasis, giardiasis, visceral leishmaniasis, cryptosporidiosis)

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14
Q

How is amebiasis transmitted?

A

Via fecal to oral route. Water/food contaminated with entamoeba.

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15
Q

Explain the life cycle of entamoeba species.

A

1.

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16
Q

3 Classes of amebicidal drugs based on their site of action:

A

Mixed amebicide –> lumen and systemic

systemic amebicide –> in lumen

luminal amebicide –> in lumen

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17
Q

Treatment if amebiasis depends on?

A

clinical condition of the patient

18
Q

Which class of amebicidal drug has to be given to which patients with amebiasis?

A

All patients –> give luminal amebicidal drugs

If it infects other organs –> + systemic amebicide.

19
Q

What is the main characteristic of luminal amebicides?

A

Have poor absorption –> remain in GI tract –> can kill cysts in lumen

20
Q

Iodoquinol

  1. classification (hint: treats amebiasis)?
  2. Structure
  3. Site of action?
  4. excretion?
  5. MoA?
A
  1. Luminal amebicide
  2. halogenated hydroxyquinolin
  3. lumen (90% retained in intestine)
  4. 90% through feces
  5. unknown
21
Q

What are the adverse effects of iodoquinol? Is there a way to limit gastrointestinal toxicity?

A

diarrhea, anorexia, nausea, vomiting, abdomina pain, headache, rash, pruritis.
Yes, by taking it with meals

22
Q

DDI iodoquinol-lab interaction

A

iodoquinol has iodine functional group –> can increase protein-bound serum iodine

if patient is receiving Iodine for therapy in thyroid cancer, the level of radioactive iodine measured will decrease.

23
Q

Can iodoquinol be used above its recommended dosage?

A

No!

24
Q

Iodoquinol should be used with caution in which patients?

A
  1. Optic neuropathy (damage on optic nerve of the eye)
  2. Renal or thyroid disease
  3. Non-amebic hepatic disease
25
Q

If these signs of iodine toxicity occur, iodoquinol should be stopped. What are the 4 signs of iodine toxicity? (hint: most has something to do with skin)

A
  1. dermatitis –> inflammation of the skin
  2. urticaria –> raised itchy rash on the skin
  3. pruritus –> itchy skin
  4. fever
26
Q

In which patients are iodoquinol contraindicated?

A

Patients with iodine intolerance.

27
Q

Diloxanide Furoate

  1. classification (hint: treats amebiasis)?
  2. Structure
  3. Site of action?
  4. MoA?
A
  1. Luminal amebicide
  2. derivative of dichloroacetamide
  3. lumen
  4. Prodrug!
    Hydrolysis in intestine –> DILOXANIDE (active) + furoate
    90% diloxanide is absorbed into the body. Remaining 10% is sufficient to kill amoeba in intestine.
28
Q

Diloxanide furoate adverse effects?

A

No serious adverse effects.
Common: flatulence (kembung angin).
Infrequent : abdominal cramps
Rare: rash

29
Q

Diloxanide furoate is not recommended in pregnancy. T/F?

A

T

30
Q

Can diloxanide furoate alone be used treat serious intestinal and extraintestinal infections?

A

No. But it can be combined with tissue amebicide (metronidazole) to treat it.

31
Q

Paromomycin Sulfate

  1. classification (hint: treats amebiasis)?
  2. Structure
  3. Site of action?
  4. MoA?
A
  1. Luminal amebicide
  2. Aminoglycoside antibiotic
  3. lumen
  4. target protein synthesis by binding to 30S subunit
32
Q

Rate these luminal amebicide based on their toxicity (least to most toxic).
A) Diloxanide furoate
B) Iodoquinol
C) Paramomycin Sulfate

A

C, A, B

33
Q

What are the adverse effects of Paramomycin Sulfate?

A

Rare:

  • GIT disturbance
  • Rash
  • Headache
34
Q

There are 3 other uses for paramomycin sulfate aside from treating amebiasis. What are they?

A
  1. Visceral leishmaniasis (Parenteral paramomycin)
  2. cryptosporidiosis in AIDS patients
  3. Giardiasis in pregnant women (especially in 1st trimester).
35
Q

Which amebicide can be used in pregnant women suffering from giardiasis?

A

Paramomycin sulfate

36
Q

Why is emetine and dehydroemetine (amebicide) administered subcutaneously or intramuscularly, not orally?

A

They irritate gastric mucosa and are an emetic (cause vomiting by stimulating chemoreceptor trigger zone)

37
Q

Emetine (amebicide) is an alkaloid derived from a flowering plant called?

A

ipecac

38
Q

Name 3 luminal amebicides

A

Diloxanide furoate
Iodoquinol Paromomycin
(DIP)

39
Q

Name 3 systemic amebicides

A

Chloroquine
Emetine
Dehydroemetine

40
Q

Name 2 mixed amebicides

A

Metronidazole

Tinidazole

Chemotherapy (22 decks)

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