Anti Helminthic Drugs Flashcards
Helminthiasis or parasitic worm infection
•Prevalence greatest in the ______
•Spread is by _______,____,______ activity
tropics
travel, migration, military
These helminthes are Metazoa:
Roundworms (_________)
Flatworms 2a._____(______) 2b. Another type of flatworms are ______ (________)
nematodes
Flukes; trematodes
tapeworms; cestodes
The helminthes are biologically diverse eukaryotes
T/F
T
(Mature or Immature?) forms of helminths invade human beings through the ______ or ____
Immature
skin or GIT
Apart from few exceptions such as _________ and _________ , these organisms do not normally _________ in humans
Therefore the _________ to the organisms dictates the ______ of infection
reduction of adult worm by chemotherapy is sustained unless ______ occurs.
Strongyloidis and Echinococcus
complete their life cycle
extent of exposure
severity
reinfection
Antihelminthes act (locally or systematically?) to ____ worms from the ____ or (locally or systemically?) to eradicate adult worms or developemental stages from ____ and ____
Locally
expel; GIT
systemically
tissues and organs
FILARIASIS
ADULT WORMS DWELL IN THE ____ TISSUES ALONE IN THE INFECTIONS CAUSED BY- ______,______,______
LYMPHATIC
Wurchereria bancrofti, Brugia malayi, Brugia timori
FILARIASIS
WHILE FOR THE FOLLOWING INFCTIONS ADULT WORMS ARE FOUND IN OTHER TISSUES- _______,___________,_________
Loa loa, Onchocerca volvulus, Mansonella species.
FILARIASIS
Nearly ________ people are affected, 90% by _______, 90% of the remaining by _________.
90 million
W. bancrofti
Brugia malayi
FILARIASIS
W. bancrofti- IS FOUND IN _______, ______, India, Sothern China, widely through out the ______
Brugia malayi –_________,______, _______
Brugia timori-_______
Central Africa; S. America; tropics
Indonesia; South East Asia; Central Africa
Indonesia
Bancroftia And Brugian HOST Reactions To adult Worms Include fevers , __________,____________; lymphatic obstructions Is Typified BY _______,_______,_________ .
Tropical ______________ also Occurs In Some INDIVIDUALS
LYMPHANGITIS, LYMPHADENITIS
Lymphedema, Hydrocele, Elephantiasis
Pulmonary Eosinophilia
Loa loa-
•Transmitted by ______
•L. loa, aka _________
•Is a ________ parasite In large ____ Of central Africa And west Africa .
Deer flies
African eye Worm
Migrating Filarial ; Rivers
Loa loa-
•Adult worms occur in ______ tissue
•causes Episodic _______ and _______
- can Penetrate the ______ and _____
•rarely, __________,_______, or ________ With Heavy Infection occur.
Subcutaneous
Calabar Swellings; Allergic reactions
Skin And Conjunctiva.
Encephalopathy, Cardio pathy OR nephropathy
O. vulvulus-
•transmitted by _____ near __________ and _______
•Inflammatory reactions TO _______ not ______
black Flies; Fast Flowing Streams And Rivers
Microfilaria; Adult worms
O. vulvulus-
•Affect _______________ and _________
•____ LEADING CAUSE OF _____ WORLD WIDE
Subcutaneous lymph Nodes and Eyes
2ND
BLINDNESS
Mansonella spp.
•Transmitted By _________
• Is (common or rare?) And Variably Responsive to Chemotherapy.
midges
Rare
____________(DCM)
___________(IVM)
Diethylcarbamazine
Ivermectin
________ and _______ ARE Primary Compounds For The Treatment Of lymphatic Filariasis
Diethylcarbamazine(DCM) and Ivermectin (IVM)
Filariasis treatment
Population Based, Yearly Single dose of ______ or -______
Or
______ + ________, Or ________ + ________ markedly decrease microfilarial and prevalence
DCM Or IVM
IVM+ ALBENDAZOLE
DCM+ ALBENDAZOLE
_____ Is safer when Bancrofti coexists with Loasis Or Onchocerciasis
________ + _________ MAY BE USED IN OTHER CASES
IVM
DCM+ ALBENDAZOLE
Treatment of filariasis
IT IS better TO start Treatment early before ___________ OCCUR IN Wurchereria and Brugia INFECTIONS,
HOWEVER, IN SOME LATE STAGES SOME IMPROVEMENT OCCUR
OBSTRUCTION OF THE LYMPHATICS
IN LONG STANDING ELEPHANTIASIS, _____ IS NEEDED TO INCREASE LYMPH DRAINAGE AND REMOVE REDUNDANT TISSUE
SURGERY
_______ IS THE BEST SINGLE DRUG FOR LOASIS, BUT SHOULD START WITH ——— DOSE TO DECREASE ________ TO DESTROYED _________
DCM
SMALL
HOST REACTION
MICROFILARIAL WORMS
____________ NEEDED TO CONTROL ACUTE ADVERSE DRUG REACTIONS
GLUCOCORTICOIDS ARE
Rarely, Serious cerebral reactions occur because of ___________________
IF Severe ______ Occurs Or there Is evidence OF Adult Worm near THE ____, caution IS REQUIRED FOR INITIAL DOSING
Destruction OF Microfilaria IN Brain
headache
Orbit
____________ IS THE BEST SINGLE DRUG FOR CONTROL AND TREATMENT OF Onchocerciasis Because of __________ and Few ______ complication
IVERMECTIN
MILDER REACTIONS
Occular
DIETHYLCARBAMAZINE DCM
A water (soluble or insoluble?) salt
_______ TASTE,_______ ODOR
(Stable or unstable ?) to heat
Soluble
TASTELESS
ODORLESS
Stable
DIETHYLCARBAMAZINE DCM
ANTIHLMINTHIC ACTION: KILLS ______ Of _________,______, and ________ IN BLOOD
Microfilaria
Wuchereria bancrofti
Brugia malayi and Loaloa
DIETHYLCARBAMAZINE DCM
KILLS MICROFILARIA OF Onchcerca IN ___ BUT NOT IN _____ WHERE _____\ ARE.
SKIN
NODULE
ADULT WORMS
DIETHYLCARBAMAZINE DCM affects Microfilaria in hydrocoele
T/F
F
IT DOES NOT AFFECT MICROFILARIA IN HYDROCELE DESPITE PENETRATION THERE
DIETHYLCARBAMAZINE DCM KILLS ADULT WORMS OF Wuchereria , Brugia, Loaloa.
T/F
F
IT IS NOT CERTAIN IF DCM KILLS ADULT WORMS OF W, B, L
DCM Exerts No action Against adult worms OF Onchocerca
T/F
F
little action
Mechanism of action of DCM:
•IT appear To perturb ______________IN humans AND Host _____________ cells With Resultant Vaso__________ and HOST’S Platelet and Granulocyte __________________ Around ______ OF damaged parasites
Arachidonic Acid Metabolism
constriction; Aggregation
membrane
Mechanism of action of DCM:
It Activates ______ But not _______ Immunity.
It also appears To compromise _______________ and ____________ TO plasma Membranes.
Innate
Adaptive; Intracellular Processing AND transport OF certain Macromolecules
A F E of DCM:
(Slowly or Rapidly?) Absorbed from GIT.
Peak plasma Levels IN 1-2 HRS, after single ____
T1/2 IS 2-10 HRS Depending ON ________ PH
Rapidly
P.O.
Urinary PH
(Slow Or Rapid?) and extensive metabolism occurs.
Major metabolite Is ____________ IS (active or inactive ?) .
Rapid
DITHYLCARBAMAZIN-N-OXIDE
Active
Excretion of DCM
• Is Both ________ and ______
• >50% Appears In (Acid or Alklaine ?) urine AS urine IS _______
URINARY And EXTRAURINARY
Acid
ALKALINE
Excretion of DCM
•(Acidifying or Alkalinizing?) urine Increases plasm level, Prolongs T1/2
•THE dose Should Be _____eased IN renal dysfunction Or there should be sustained ______________
Alkalinizing
decr
ALKALINIZATION OF urine
Therapeutic uses of DCM in Wurchereria bancrofti, Brugia malayi and Brugia timori
Mass Treatment To Decrease To _______ Levels and Therefore Interrupt ______ transmission
Sub infective; Mosquitoes
Therapeutic uses of DCM in Wurchereria bancrofti, Brugia malayi and Brugia timori
the _____ Is given As 0.2% TO 0.4% weight of the base, This decreases The prevalence, severity and transmission.
table Salt
Therapeutic uses of DCM in Wurchereria bancrofti, Brugia malayi and Brugia timori
•Single ____ Dose of ___ mg/kg every ________ is equally effective
•annual single P.O. Dose ____ MG/KG + another Anti helminthic E.G. _____ Is equally Effective
•6 mg/kg _____+ 400MG _____ IS more appropriate
P.O. ; 6; 6-12 months
6; Ivermectin
DCM; albendazole
Therapeutic uses of DCM in Wurchereria bancrofti, Brugia malayi and Brugia timori
•While 2 mg/kg _____ X 14/7 IS PRESCRIBED FOR TROPICAL _____________________
•test Dose, Of _____ Is Adviceable Before the Full Dose of ___ mg/kg
TID
Pulmonary eosinophilia
50mg; 6
TID Is administered FOR 21/7 In the case of _______ In the clinic, this Is different From __________ Described Above, which was to reduce _______,______, and _______
Treatment
mass Eradication
Prevalence, severity And transmission.
Loa loa
• ________ + ______/_____
•ADRs Includes severe ______ To Dying Microfilaria and Adult worms and Occasionally ________ and ______ because Of Invasion OF ____ by microfilaria.
DCM + Glucocorticoids or antihistamines
Allergic Reaction
MENINGOENCEPHALITIS AND coma
brain
In treatment of LOA LOA
ADRs are rare unless _____ OF 8-10MG/KG Is ______ And ADRs ________________ as treatment continues.
daily dose
exceeded; disappear In few days
In treatment of LOA LOA
ADRs
ANOREXIA, nausea, Headache, AND Vomiting Occur
______ damage Occurs In Heavy Loa loa Infection and ______
RETINAL
ENCEPHALITIS
____ reaction May occur IN Onchocerca volvulus.
Mazzotti
In treatment of onchocerca volvulus
Mazzotti:
A few hours after 1ST ____ dose, Intense ________,______, INCREASE IN _____ and _____ OF lymph nodes, Fine papular rash, FEVER, Tachycardia, Arthralgia, Headache,
Oral
ITCHING, Rashes
Size And TENDERNESS
In treatment of onchocerca volvulus
Mazzotti:
These Last for _________ Days, Then subside
3-10
After the mazzotti reaction, high doses ARE Tolerated
T/F
T
In treatment of onchocerca volvulus
Mazzotti:
Occular affection include ______, PUNCTATE _____, _____ , atrophy of ____________________
LIMBITIS; KERATITIS; UVITIS
Retinal pigment epithelium
In treatment of bancroftian or brugian infections, _________ along THE LYMPHATICS and LYMPHADENITIS subside in ____ DAYS.
______ occur ON second DAY OF Treatment and peak by the _____ or ____ Day, It Subsides over A few weeks
Reversible ______ and ______ ALSO
Occur
NODULAR SWELLINGS
Few
LEUKOCYTOSIS
4TH OR 5TH
Proteinuria AND EOSINOPHILIA
IVERMECTIN
MECHANISM OF ACTION :
•ITS EFFECT IS ON _____ GATED CL- CHANNEL OF MUSCULATURE.
•THIS INCLUDES THE MUSCULATURE OF _______ MUSCLES thereby PREVENTING _____ OF THE FILARIAL WORMS,
GLUTAMATE
PHARYNGEAL
IVERMECTIN
MECHANISM OF ACTION :
•ALSO CAUSES _____ OF THE WORMS, thereby PREVENTING ____ of______ FROM ADULT FEMALE UTERUS.
PARALYSIS
EGRESS OF MICROFILARIA
Ivermectin : mechanism of action
THESE glutamate gated Cl- CHANNELS OCCUR IN INVERTEBRATES and VERTEBRATES.
T/F
F
ONLY IN INVERTIBRATES
ALSO, IVERMECTIN BINDS ____ RECEPTORS IN INVETEBRATES AND VERTEBRATES
GABA
ANTIHELMINTIC ACTION of ivermectin:
CAUSES MARKED DECREASE IN ________ IN ______ and _______ LASTING 6-12/12
MICROFILARIA
Skin
Ocular tissue
ABSORPTION FATE AND EXCRETION of ivermectin:
•(Little or Large?) APPEARENT VOLUME OF DISTRIBUTION IS NOTED, IT IS ____% BOUND TO PLASMA PROTEIN
•IT IS EXTENSIVELY CONVERTED BY CYP ____ TO >___ METABOLITES (MOSTLY _________ and ________ DERIVATIVES)
Large
93; 3A4
10; HYDROXYLATED AND DEMETHYLATED
Absorption fate and excretion of overmen:
•IT PENETRATES THE CNS (well or Poorly?) (THOUGH HIGHLY LIPO_____)
•__________ PUMP IN BLOOD BRAIN BARRIER PREVENTS ACCESS TO THE BRAIN
Poorly
PHILIC
P-GLYCOPROTEIN EFFLUX
THERAPEUTIC USES of ivermectin on onchocerciasis
•IT CAUSES _______ OF _______ AND ACUTE INFLAMMATORY CHANGES IN ____ TISSUES AND ARRESTS FURTHER _____ PATHOLOGY
•IT CAUSES DECREASE OF MICROFILARIA IN _______ and _______ TISSUE IN FEW DAYS, THE EFFECT LASTS 6- 12 MOTHS AFTER WHICH THE DOSE HAS TO BE REPEATED
REVERSAL; LYMPHADENOPATHY
OCCULAR; OCCULAR
SKIN AND OCCULAR
Ivermectin in onchocerciasis results in cure
T/F
With reason
F
IT DOES NOT RESULT IN CURE BECAUSE OF LITTLE EFFECT ON ADULT WORMS
Ivermectin to treat LYMPHATIC FILARIASIS:
_______ 400MG+IVERMECTIN 200-400 μg/Kg SINGLE ANNUAL DOSE, PERIOD OF TREATMENT IS 4-6YEARS
ALBENDAZOLE
SINGLE DOSE OF 150-200 μg/Kg OF IVERMECTIN CAN CURE HUMAN STRONGYLOIDIASIS
T/F
T
INFECTIONS WITH INTESTINAL NEMTODES: SINGLE DOSE OF 150-200 μg/Kg OF IVERMECTIN CAN CURE ____________
ALSO, THIS DOSE IS EFFECTIVE AGAINST CO-EXISTING ______,______ and ______
HUMAN STRONGYLOIDIASIS
ASCARIASIS, TRICURIASIS AND ENTEROBIASIS
100 μg/Kg IVERMECTIN + _________ IS EFFECTIVE AGAINST INTESTINAL STRONGYLOIDIS AND (MORE OR LESS?) TOXIC THAN USE OF HIGHER DOSES OF THIABENDAZOLE ALONE
THIABENDAZOLE
Less
150-200 μg/Kg SINGLE DOSE IVERMECTIN, P.O. FOR CUTANEOUS ________ BY DOG OR CAT _______,
And THE SAME DOSE IS REQUIRED FOR _______ and _______ EVEN IN HIV INFECTED PATIENTS
LAVAL MIGRANS
HOOKWORMS
HEAD LICES AND SCABIES
Ivermectin’s ADRs: ______ LIKE REACTIONS TO DYING ______, THE INTENSITY AND NATURE OF THIS RELATE TO _______ AND DURATION AND TYPE OF FILARIAL INFECTION.
AFTER TREATMENT, ADRs LIMITED TO _________,_______, and _______ IN 5%-35%
OF PEOPLE, IT LASTS FEW DAYS AND IS RELIEVED BY ______,________ DRUGS.
MAZZOTTI
MICROFILARIA; MICROFILARIAL BURDEN
MILD ITCHING, SWOLLEN, TENDER LYMPH NODES
ASPIRIN, ANTIHISTAMINE
Ivermectin’s ADR:
RARELY, PATIENTS CAN EXPERINCE HIGH FEVER, ____CARDIA, ____TENSION, _______, DIZZINESS, HEADACHE, MYALGIA, ARTHRALGIA, DIARRHOEA, FACIAL _______ WHICH RESPOND TO ________.
TACHY; HYPO
PROSTRATION
PERIPHERAL EDEMA; GLUCOCORTICOIDS
IVRMCTIN WILL EXACERBATE LESSIONS OF OOULAR TISSUES IN Onchocerciasis
T/F
F
IVRMCTIN WILL NOT EXACERBATE LESSIONS OF OOULAR TISSUES IN Onchocerciasis
Using ivermectin, IN Onchocerciasis there IS MARKED ________ and _______ WHEN CO- INFECTED WITH HEAVY BURDENS OF L. loa microfilaria
DISABILITY AND ENCHEPHALOPATHIES
IVERMECTIN IS CONTRAINDICATED IN PATIENTS WITH ________________, FOR EXAMPLE THOSE WITH ___________ or ____________ BECAUSE OF THE EFFECT ON _____ RECEPTORS IN THE _____.
IMPAIRED BLOOD-BRAIN-BARRIER
AFRICAN TRYPANOSOMIASIS AND MENINGITIS
GABA
CNS
Ivermectin
CAUTION SHOULD BE EXERCISED IN PATIENTS ON ________
CNS DEPRESSANTS
HIGH LEVELS OF IVERMECTIN ARE FOUND IN BREAST MILK
F
LOW LEVELS OF IVERMECTIN ARE FOUND IN BREAST MILK
DRACOTIASIS
CAUSED BY _____________
OTHER NAMES INCLUDE _________ or ___________.
Dracunculus medinensis.
GIUNEA DRAGON OR MEDINA WORMS
DRACOTIASIS
•IT IS IN (INCLINE OR DECLINE?) , MOSTLY FOUND IN SUDAN AND WEST AFRICA
•IT IS CAUSED BY ________ THAT CONTAINS ______ THAT CARRY INFECTIVE LARVAE.
Decline
DRINKING WATER
COPEPODS
DRACOTIASIS
AFTER ____ ADULT FEMALE WORM EMMERGE FROM THE _____
1 YEAR
SKIN
DRACOTIASIS
TREATMENT: _______ on _______ , BUT RISK IS _________ IF _______ OCCURS.
WINDING ON STICK
SEVERE INFECTION
RUPTURE
DRACOTIASIS : TREATMENT
•____________ 200MG TID X 10/7, THE MEDICATION ALLEVIATES THE SYMPTOMS AND CAUSES FUNCTIONAL RELIEF BECAUSE IT ____________ THEREBY FACILITATING REMOVAL OF WORM.
•________ OF DRINKING WATER
•AVOID CONTACT OF INFECTED PERSONS WITH ________
METRONIDAZOLE
REDUCES HOST’S INFLAMMATORY RESPONSE
FILTRATION
SURFACE WATER
METRONIDAZOLE IS A PRODRUG
T/F
T
METRONIDAZOLE
•IS A PRODRUG WHICH REQUIRES _____ ACTIVATION OF THE _____ GROUP BY SUSCEPTIBLE ORGNISMS.
•IT POSSESS SELECTIVE TOXICITY TOWARDS ____________________________ PATHOGENS E.G. ________ PROTOZOA, T._________ , E._______ and G._______ Because OF THEIR METABOLISM.
REDUCTIVE; NITRO
ANAEROBIC AND MICROAEROPHILIC
AMITOCHONDRIATE
vaginalis; histolytica; lamblia
METRONIDAZOLE
Activation of metronidazole:
THESE ORGANISMS AND ANAEROBIC BACTERIA CONTAIN ELECTRON TRANSPORT COMPONENTS E.G. ______,______ THAT HAVE A SUFFICIENTLY ____________________ TO DONATE e- TO METRONIDAZOLE.
FERRODOXINS, SMALL Fe-S PROTEINS
Negative REDOX POTENTIAL
METRONIDAZOLE
Mechanism of action:
THE SINGLE ELECTRON TRANSFER FORMS A ________ ——— _____ ——— _______ THAT KILLS SUSCEPTIBLE ORGANISMS TARGETING ____ AND OTHER BIOMOLECULES
HIGHLY REACTIVE NITRO RADICAL ANION
DNA
ABSORPTION FATE AND EXCRETION:
•metronidazole Is (completely or incompletely?) And (slowly or rapidly?) ABSORBED
completely
Rapidly
Metronidazole
ADRs:
•GIT (NAUSEA,________, ___ MOUTH), VOMITING, ABDOMINAL PAIN
•CNS- DIZZINESS,____,_____, _______ , ATAXIA, SENSORY NEUROPATHY
METALLIC TASTE; DRY
VERTIGO; ENCEPHALOPATHY; CONVULSION
Metronidazole
ADRs:
•PATIENTS EXPERIENCE _______ EFFECT IF ALCOHOL IS TAKEN AT SAME TIME OR WITHIN 3/7 AFTER TREATMENT
•_______INCREASES ITS PLASMA LEVEL.
DISULFIRAM
CIMETIDINE
METRONIDAZOLE (PROLONGS or SHORTENS?) PROTHROMBIN TIME OF PATIENTS ON COUMARIN ANTICOAGULANTS
PROLONGS
BENZIMIDAZOLES:
_______,_______,________
thiabendazole, mebendazole albendazole
BENZIMIDAZOLES
________ is significantly more toxic than others so currently use more ______ for _____________
While ________ and _____ are used for GIT helminthiasis
thiabendazole
topically
cutaneous larva migrans
mebendazole, albendazoloe+
ALBENDAZOLE: metabolism
•IT IS ______ and _____ ABSORBED AFTER P.O.
•ABSORPTION IS INCREASED BY ____ FOODS AND _______.
VARIABLY AND ERRATICALLY
FATTY; BILE SALTS
ALBENDAZOLE : metabolism
•IT IS (slowly or Rapidly?) METABOLISED IN THE ______ and ____ TO 2 SULFOXIDE METABOLITE WHICH HAVE (mildly or Highly?) POTENT ANTIHELMINTIC ACTIVITY.
Rapidly
LIVER AND INTESTINE
Highly
ALBENDAZOLE IS (WELL or POORLY?) DISTRIBUTED
WELL
ALBENDAZOLE UNDERGOES SELF INDUCED HEPATIC METABOLISM.
T/F
T
ALBENDAZOLE : excretion
THERE IS FURTHER OXIDATION TO (ACTIVE or INACTIVE?) NONCHIRAL SULFONE METABOLITE WHICH IS EXCRETED IN THE ______
INACTIVE
URINE
MEBENDAZOLE
Like Albendazole is a (natural, semi synthetic, or synthetic?) _______ compound
•(well or Poorly?) absorbed, excreted as the decarboxylated compound
synthetic; benzimidazole
Pooh
MEBENDAZOLE
•It possibly acts by inhibiting _______ formation
mirotubule
MEBENDAZOLE
•Side effects are (mild or severe?) , but the drug is ______ in animals
•However ________ reactions may occur in high doses
•_______ have been reported in children under 2
Mild
teratogenic
hypersensitivity
Convulsions
PYRANTEL PAMOATE :
•It is a _______________ derivative
•Active only against _____ organisms, peak concentrations are reached in 1-3 hours and excreted mostly unchanged
tetrahydropyrimidine
luminal
PYRANTEL PAMOATE :
•It is a _____________
•Dose: 11 mg/kg as a single dose but may be repeated
neuromuscular blocker
PYRANTEL PAMOATE :
Indications: _______,________,_________
ADR: (mild or severe?)
pinworms, ascariasis, Trichostrongylus orientalis
Mild
SCHISTOSOMIASIS:praziquantel
•Indicated for (all ,some or most?) schistosome infections (all, some , or most?) trematode and cestode infections, and _______
•It is a (natural,synthetic or semi synthetic ?) isoquinoline-pyrazine derivative
All
Most
cysticercosis
Synthetic
SCHISTOSOMIASIS:praziquantel
•it is (able or not able?) to cross the blood brain barrier
•It is extensively _______
•Its bioavailability is improved by _____ and ______ but reduced by ______ and ______
Able
hydroxylated
food and cimetidine
phenytoin andcarbamazepine
SCHISTOSOMIASIS:praziquantel
It acts by ___________ of trematodes and cestodes membranes to _____
increasing the permeability
calcium
SCHISTOSOMIASIS:praziquantel
Clinical Indications: _________, _____, opisthorchiasos, ________,______,_______,________,_______ , hydatid disease
all forms of schistosomiasis
clonorchiasis
paragonimiasis
Teeniasis, Diphylobothriasis, neurocysticercosis, hymenolepsis nana
SCHISTOSOMIASIS:praziquantel
ADR:
•mild reactions, in ________
•neurological abnormalties may be exergerated due to _________: _____, nausea, vomiting, seizures,
metrifonate,oxamiquine
neurocysticercosis
inflammation around the dying worms
meningism
oxamiquine
•Indicated in _______ infections not effective against ________ or ________
•It is a (synthetic or semi-synthetic?) tetrahydroquinoline
S mansoni
S haematobium or S japonicum
semi-synthetic
oxamiquine
•it is extensively metabolized with inter individual variations. The metabolite is (active or inactive?)
•Active against the __________ stages of S mansoni
Inactive
mature and immature
oxamiquine
ADR: _____ to _____ discoloration of the urine, nausea, vomiting, diarrhoea, colic, _____ and ______
Used with care in _____ and contraindicated in _____
orange to red
pruritus and urticaria
epilepsy; pregnancy
METRIFONATE
•It is an _________ compound indicated for _________________________ but not _____
•It is transformed to ______ which is the active metabolite
organophosphate
schistostoma haematobium adult worms
the eggs
dichlorvos
METRIFONATE
Its mechanism of action is through _________________
The _____ worms are shifted from the _______ to the ________ where they are trapped and encased by the immune system
cholinesterase inhibition
paralysed
bladder venous plexus to the lungs
METRIFONATE
ADR:(mild or severe?) ____________ symptoms
mild cholinergic
