Anti-Parasitic Agents

Question 1

Chloroquine MOA

Answer 1

Prevents polymerization of heme to hemozoin;

build up of free heme; toxic to parasite

Question 2

Chloroquine SE

Answer 2

Pruritis

Question 3

Mefloquine Indications

Answer 3

Option for prophylaxis in areas of cholorquine-resistant

P. falciparum

Question 4

Mefloquine SE

Answer 4

Neuropsychiatric toxicities, nausea, vomiting, sleep & behavioral problems

Question 5

Mefloquine Contraindications

Answer 5

Seizures, psychological disorders, arrhythmia

Question 6

Atovaquone MOA

Answer 6

Inhibits parasite mitochondrial electron transport

Question 7

What is atovaquone used in combination with?

Answer 7

Proguanil

Question 8

Doxycycline MOA

Answer 8

Protein synthesis inhibition

Question 9

What is doxycycline the drug of choice for?

Answer 9

Prophylaxis against mefloquine-resistant P falciparum

Question 10

What is quinine the drug of choice for?

Answer 10

DOC for treatment of severe disease with chloroquine-resistant P. falciparum malaria

Question 11

Quinine SE

Answer 11

GI, Cinchonism (headache, nausea, visual disturbances, dizziness, tinnitus)

Question 12

Primaquine Indications

Answer 12

Used to treat exoerythrocytic forms of vivax and ovale malaria; gametocidal

Question 13

Primaquine MOA

Answer 13

Prevents polymerization of heme to hemozoin;

build up of free heme; toxic to parasite

Question 14

Primaquine Contraindications

Answer 14

G6PD deficiency 􏰂hemolysis; Testing recommended prior to Rx

Question 15

Primaquine SE

Answer 15

Infrequent - nausea, abdominal pain, cramps

Rare - hematologic, arrhythmias

Question 16

Artemisinin MOA

Answer 16

Production of toxic free radicals in parasite food vacuole

Question 17

What combination therapy is used for high Plasmodium parasite burden?

Answer 17

Artemisinin + Mefloquine

Question 18

Treatment of Amebiasis

Answer 18

Metronidazole plus luminal agent:
• Iodoquinol
• Paromomycin

Question 19

Metronidazole MOA

Answer 19

Ferredoxin-linked processes reduce nitro group to a product that is lethal against anaerobic organisms

Question 20

Metronidazole SE

Answer 20

Nausea, vomiting, metallic taste, disulfuram-like

Question 21

Iodoquinol SE

Answer 21

Neurotoxicity and nausea and vomiting reported but rare at recommended doses

Question 22

Treatment of Giardiasis

Answer 22

Metronidazole

Question 23

Treatment of Cryptosporidiosis

Answer 23

Nitazoxanide and Paromomycin

Question 24

Treatment of Toxoplasmosis

Answer 24

Pyrimethamine and Sulfadiazide

Question 25

Treatment of Leishmaniasis

Answer 25

Sodium Stibogluconate for cutaneous Leishmaniasis

Amphotericin B for visceral Leishmaniasis

Question 26

What is the treatment of choice for T. cruzi?

Answer 26

Nifurtimox

Question 27

Nifurtimox SE

Answer 27

GI, rash, CNS

Question 28

Treatment of Neurocystercosis (Taenia solium)

Answer 28

Albendazole and Praziquantel

Question 29

Praziquantel Contraindications

Answer 29

Ocular cysticercosis, pregnancy and lactation

Question 30

Mebendazole Indications

Answer 30

Ascariasis, hookworm, pinworm, Taeniasis,Trichinosis, Strongyloidiasis

Question 31

Mebendazole SE

Answer 31

Minimal GI to neutropenia and hepatic with long term therapy; hypersensitivity

Question 32

Pyrantel Pamoate Indications

Answer 32

It is a luminal agent used for pinworm, Ascaris, hookworm

Question 33

Pyrantel Pamoate MOA

Answer 33

Depolarizing neuromuscular blocking that causes release of AcH and inhibition of cholinesterase resulting in worm paralysis

Question 34

Treatment for Filariasis

Answer 34

Diethylcarbamazine

Question 35

Treatment for Onchocercoisis

Answer 35

Ivermectin

Question 36

Ivermectin MOA

Answer 36

Paralyzes nematodes and arthropods by intensifying GABA-mediated signals

Question 37

Ivermectin SE

Answer 37

Hypersensitivity from worm death

• Mazotti reaction* – severe in onchocerciasis

Question 38

Ivermectin Contraindications

Answer 38

Pregnancy, coexisting CNS inflammation