Anti-Parasites Flashcards
Helminths, Malaria, Amebiasis, Giardiasis, Leishmaniasis, Toxoplasmosis
Albendazole
MOA: prevents polymerization of parasite microtubules - inhibits fumarate reductase
Use: cestodes/tapeworms give with corticosteroids
AE: hepatotoxic, agranulocytosis
CI: preggers, kids
cimetidine inc plasma concen and half life
Praziquantel
MOA: blocks vg Ca channels - Ca floods in - paralysis of worm
Use: cestode, trematode (fluke)
S/E: bloody diarrhea
CI: preggers, nursing, ocular cysticercosis
crosses BBB
Mebendazole
MOA: binds to microtubules; blocks glc absorption –> paralysis
Use: whipworm, hookworm, pinworm, roundworm
AE: GI, agranulocytopenia, alopecia
CI: pregnancy
carbamazepine and phenytoin dec serum concen
doesn’t interact with cimetidine
Thibendazole
Use: strongyloides, trichinosis
S/E: hallucinations, severe diarrhea, nausea/vomiting
Ivermectin
MOA: binds to Glu-Cl channels and causes hyperpolarization leading to paralsysis of worm
Use: strongyloides, trichinosis (used with thiabendazole)
S/E: arthralgia
CI: preggers, meningitis, CYP3A4
doesn’t cross BBB
Diethylcarbamazine
MOA: immobilizes microfiliariae
Use: microfilariasis
S/E: swelling/itching face, loss of vision
Metronidazole (luminal and systemic)
MOA: forms toxic metabolites in bacterial cell
Use: Giardia, gardnerella vaginalis, entamoeba, trichomonas vaginalis
S/E: disulfiram reaction with alcohol, metallic taste
CI: pregnancy, alcohol
Chloroquine
MOA: generates toxic heme byproducts that kill the parasite within RBCs
Use: malaria, amebiasis
S/E: severe hemolysis in G6PD
crosses BBB and placenta
Nifurtimox
MOA: reactive O2 intermediate
Use: Chagas due to T cruzi
AE: early and late HSR, peripheral neuropathy
Suramin, melarsoprol
MOA: interacts with -SH and inactivates pyruvate kinase causing –> dec ATP production
Use: African sleeping sickness
S/E: stinging sensation on skin
crosses BBB
CI: influenza
Sodium stibogluconate
Use: leishmaniasis
AE: prolonged QT, pancreatitis, rash
Sulfadiazine + pyrimethamine
MOA: pyr inhibits DHFR. Sulf inhibits dihydropteroate synthetase
Use: toxoplasmosis, malaria
S/E: folate deficiency (so add leucovorin)
Tinidazole
MOA: toxic metabolites (like metronidazole)
use: luminal and systemic amebiasis
Iodoquinol
Use: luminal amebiasis
AE: rash, diarrhea
Paramomycin
use: luminal amebiasis, leishmaniasis
note, it is an aminoglycoside
Emetine
MOA: blocks 40s
use: systemic amebiasis
AE: emetic, liver issues
must be given in the hospital; monitor pt carefully
Dehydroemetine
synthetic version of emetine
Use: systemic amebiasis
Mefloquine
MOA:?
use: malaria
AE: neuropsychiatric - dreams, nausea, inc QT interval, dec HR
safe in pregnancy
Quinine/Quinidine
MOA: like quinolines, interferes with DNA strand separation
use: malaria
AE: cinchonism (tinnitus, deafness, headache), prolonged QT
CI: pregnancy
Atovaquone/Proguanil
MOA: synergy
AE: fever, rash
Artemisinin
MOA: produces free radicals within plasmodium food vacuole
AE: nausea, vomiting, diarrhea
peroxide bridge
Primaquine
MOA:?
use: tissue schizonticide (P vivax and ovale = PRIMEtime tiVO)
AE: methemoglobinemia, G6PD
CI: pregnancy
Eflornithine
MOA: suicide inhibitor of ornithine decarboxylase
use: African sleeping sickness, female hirsutism
Pentamidine isethionate
MOA:?
use: African sleeping sickness, Leishmaniasis
AE: nephrotoxic, hypoTN
no CNS
