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Pharmacology Exam #3 > Anti-Malarial/Protozoal > Flashcards

Anti-Malarial/Protozoal Flashcards

1
Q

Causes of Protozoal Infections

A

Insect Bites
* Malaria
* Trypanosomiasis
* Leishmaniasis

Ingestion or Contact with the Causal Organism
* Amebiasis
* Giardiasis
* Trichomoniasis

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2
Q

Risk Factors for protozoal infections

A
  • Unsanitary, crowded conditions: unclean water, poor waste removal practices
  • Poor hygienic practices: not washing hands after using bathroom or before eating
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3
Q

Plasmodium falciparum

A

Protozoal Parasite identified as a cause of malaria
* Considered the MOST dangerous type of protozoan
* Causes severe fever, hypotension, ⬇️ RBCs, death

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4
Q

Plasmodium vivax

A

Protozoal Parasite identified as a cause of malaria
* Milder form of disease
* Seldom results in death

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5
Q

Plasmodium malariae

A

Protozoal Parasite Identified as a cause of malaria
* Endemic in tropical countries
* Mild symptoms

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6
Q

Plasmodium ovale

A

Protozoal Parasite identified as a cause of malaria
* Caused by two different species
* Both are most prevalent in Africa
* Mosquito has developed resistance to inseticides

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7
Q

What does Malaria mostly affect?

A
  • Destroys red blood cells
  • Causes severe acute reaction in the body
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8
Q

Lifespan considerations for Antiprotozoal Therapy
In Children

A
  • Very sensitive to effects of drugs; more severe reactions
  • Extreme caution should be used
  • Avoid travel in endemic areas
  • Consult health department when travel is necessary
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9
Q

Lifespan considerations for Antiprotozoal Therapy
In Adults

A
  • Advise about the need for prophylaxis
  • It is essential to mark a calendar as a reminder of days drugs should be taken
  • Avoid in pregnancy and lactation
  • Women of childbearing age should use contraceptives
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10
Q

Lifespan considerations for Antiprotozoal Therapy
In Older Adults

A
  • More susceptible to adverse effects; monitor closely
  • Hepatic dysfunction at increased risk of worsening hepatic problems
  • Dose may need to be lowered
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11
Q

Antimalarials
Drug Names

A

“quins”
Quinine
Chloroquine
Hydroxychloroquine
Mefloquine
Primaquine

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12
Q

Antimalarials
Adverse Effects

A
  • CNS: headache, dizziness, fatigue
  • GI: Nausea, vomiting, anorexia
  • Hepatic dysfunction
  • Dermatological: rash, pruritis, hair loss
  • Blindness
  • Ototoxicity
  • Cinchonism syndrome: Overdose of “quins” leading to N/V, ringing in ears, vertigo
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13
Q

Antimalarials
Drug Interactions

A
  • Quinine and quinine derivative - increased risk of cardiac toxicity and convulsions
  • Anti-folate drugs - increased risk of bone marrow suppression (ie Methotrexate & Sulfonamides)
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14
Q

Antimalarials
Mechanism of Action

A

Varies by drug; prevents malaria replication or causes malaria cell death

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15
Q

Antimalarials
Contraindication

A

Absolute:
* Known Allergy
* Pregnancy and Lactation

Cautions:
* Liver disease (infection damages liver as well)
* Alcoholism (inc. risk of toxicity)
* Retinal disease (makes worse)
* Psoriasis (makes worse)
* Porphyria (makes worse)

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16
Q

Antimalarials
Assessment

A

History:
* Check for allergy, pregnancy, lactation
* Check for liver disease, alcoholism, retinal disease, psoriasis, or porphyria

Physical:
* CNS: reflexes, muscle strength, LOC, seizure activity, altered mental status
* Ophthalmic and retinal examination
* Auditory screening: check for baseline tinnitus
* Inspect skin for color, temperature, texture, lesions

Labs:
* Liver function
* Blood culture (confirm presence of parasite)

17
Q

Antimalarials
Diagnoses

A
  • Impaired comfort (r/t GI, CNS, and skin adverse effects)
  • Altered sensory perception (r/t CNS effects)
  • Injury risk (r/t CNS changes)
18
Q

Antimalarials
Implementation/Patient Teaching

A
  • Arrange for culture and sensitivity tests before beginning therapy
  • Administer full course of the drug
  • Mark a calendar for prophylactic doses to remember when they should be taken
  • Monitor hepatic function and perform ophthalmological examination before and during treatment
  • If CNS effects occur, provide comfort and safety measures (sisde rails, assistance with ambulation)
  • Provide oral hygiene and ready access to the bathroom
  • Monitor nutritional status; encourage small frequent meals for GI effects
  • Instruct patient on appropriate dosage and importance of adhering to the drug schedule.
  • Report vision changes; hearing changes; jaundice
19
Q

Amebiasis

A
  • Contaminated food or water or direct contact with contaminated feces
  • Causes GI symptoms
  • Treated with: Metronidazole and Tinidazole
20
Q

Leishmaniasis

A
  • Carried by sand flies
  • Causes skin sores and organ damage
  • Treated with Pentamidine
21
Q

Trypanosomiasis
(aka Chagas)

A
  • Carried by “kissing bugs”
  • Acute phase of disease causes fever, fatigue, swelling at bite location
  • Untreated, disease can lead to serious heart or digestive issues (sometimes 10-30 years later)
  • Treated by Pentamidine, pediatric: Benznidazole 9
22
Q

Trichomoniasis

A
  • Sexually transmitted
  • Causes genital itching, discharge, discomfort (men usually have no symptoms but can transmit it)
  • Treated with: Metronidazole & Tinidazole
23
Q

Giardiasis

A
  • Transmitted through contaminated water
  • Causes GI issues
  • Treated with Tinidazole & Metronidazole
24
Q

Pneumocystic jiroveci pneumonia

A
  • Airborne
  • Mostly affects immunocompromised
  • Lung infection
  • Treated with Atovaquone & Pentamidine
25
Q

Toxoplasmosis

A
  • Transmitted commonly through cat litter or uncooked meat
  • Can cross the placenta and cause major birth defects or miscarriage
  • Flu-like symptoms
  • Treated with Pyrimethamine
26
Q

Atovaquone

A
  • Other antiprotozoal drug
  • Prevents and treats Pneumocystic jirovecii pneumonia (PCP)
27
Q

Metronidazole

A
  • Other antiprotozoal drug

Treats
* Amebiasis
* Trichomoniasis
* Giardiasis

28
Q

Pentamidine

A
  • Other antiprotozoal drug

Treats
* Pneumocystic jirovecii pneumonia
* Trypanosomiasis
* Leishmaniasis

29
Q

Tinidazole

A
  • Other antiprotozoal drug

Treats
* Trichomoniasis
* Giardiasis
* Amebiasis

30
Q

Benznidazole 9

A
  • Other antiprotozoal drug

Treats
* Pediatric patients with Chagas (trypanosomiasis)

31
Q

Pyrimethamine

A
  • Other antiprotozoal drug

Treats
* Toxoplasmosis

32
Q

Other Antiprotozoal Drugs
Mechanism of Action

A

Inhibit DNA synthesis in susceptible protozoa

33
Q

Other Antiprotozoal Drugs
Adverse Effects

A
  • Headache, dizziness, ataxia, peripheral neuropathies, loss of coordination
  • Nausea, vomiting, unpleasant taste, diarrhea
34
Q

Other Antiprotozoal Drugs
Contraindications

A

Absolute:
* Allergy

Cautions:
* CNS diseases: seizures, stroke, brain tumor
* Hepatic disease
* Pregnancy/lactation

35
Q

Other Antiprotozoal Drugs
Drug Interactions

A
  • Alcohol (within 3 days)
  • Anticoagulants (within 8 days)
  • Disulfiram (within 2 weeks)
36
Q

Other Antiprotozoal Drugs
Assessment

A

History:
* Check for allergy, liver impairment, pregancy/lactation, CNS issues

Physical:
* CNS: reflexes and muscle strength
* Examine skin for lesions, color, temperature, and texture

Labs:
* Hepatic function tests
* Cultures to confirm parasite

37
Q

Other Antiprotozoal Drugs
Nursing Diagnoses

A
  • Impaired comfort (r/t GI and CNS effects)
  • Malnutrition (r/t severe GI effects)
  • Altered sensory perception (r/t CNS effects)
  • Knowledge Deficit
38
Q

Other Antiprotozoal Drugs
Implementation/Patient Teaching

A
  • Arrange for culture and sensitivity tests before beginning therapy
  • Administer a complete course of the drug
  • Monitor hepatic function
  • For CNS effects: side rails, assistance with ambulation, ready access to bathroom
  • GI effects: small frequent meals, take with food
  • Arrange for treatment of superinfections
  • Monitor nutritional status
  • Report impaired liver symptoms: yellowing, dark urine, pale stools, abdominal pain

Pharmacology Exam #3 (8 decks)

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