Anti-Parasitic Agents Flashcards
Protozoan clinical illness requires how many exposures?
Single exposure
Helminth clinical illness requires how many exposures?
Many exposures
Treatment goal for Protozoan infections
Eradication
Treatment goal for Helminth infections
Eradication or reduction of worm burden
What is the difference between definitive, intermediate, and incidental hosts?
Definitive- harbors sexual parasitic stage
Intermediate - harbors larval or asexual parasitic stage
Incidental - not necessary for parasitic survival
Chloroquine
MOA
Prevents plymerization of heme to hemozoin, causing a buildup of free heme that is toxic to the parasite
Chloroquine
Indications
Prophylaxis and treatment
Schizonticidal in blood to all Plasmodium species, not active against liver phase parasites
Chloroquine
Resistance
Widespread in P. falciparum
Mefloquine
MOA
Like chloroquine, increases free heme which is toxic to parasite
Schizonticidal in blood
Mefloquine
Indications
Option for prophylaxis in areas of chloroquine-resistant P. falciparum
Prophylaxis and treatment of all forms of malaria
Mefloquine
Adverse Effects
Neuropsychiatric (seizures, psychosis)
Sleep and behavioral issues
Nausea, vomiting
Atovaquone
MOA
Inhibits parasite mitochondrial electron transport
Atovaquone is commony prescribed with…
Proguanil
Together, they are called Malarone
Doxycycline
MOA and Indications for parasites
Protein synthesis inhibition
Prophylaxis against mefloquine-resistant P. falciparum
Quinine and Quinidine
Indications
DOC for treatment of severe disease with chloroquine-resistant P. falciparum
Quinine may be used in pregnancy
Quinine and Quinidine
Adverse Effects
Cinchonism (headache, nausea, tinnitus, visual disturbance)
GI upset
Primaquine
Indications
Treat exoerythrocytic forms of vivax and ovale malaria
Primaquine
Contraindication
G6PD Deficiency –> hemolysis
Artemisinin
MOA
Rapidly acting schizonticide
Produces toxic free radicals in parasite food vacuole
Using Artemisinin with what drug is best for high parasite burden malarial infection?
Mefloquine
What drugs are commonly used in malaria prophylaxis?
Mefloquine
Atovaquone and Proguanil (Malarone)
Doxycycline
When should you start and end mefloquine prophylaxis for malaria?
Start 1-2 weeks prior to trip
End 4 weeks after trip
When should you start and end malarone prophylaxis for malaria?
Start 1-2 DAYS prior to trip
End 7 days after trip
P. Vivax and P. ovale infections should be treated with…?
Chloroquine and Primaquine
Uncomplicated P. falciparum infections should be treated with…?
Atovaquone-proguanil
Quinine plus doxy, tetracycline, or clindamycin
Mefloquine
Chloroquine resistant (complicated) P. falciparum infections should be treated with…?
Quinidine + doxy or clindamycin
Artemisinin drugs
Treatment of Entamoeba histolytica infection
Metronidazole (colitis, liver absness, ameboma)
Luminal agents:
Paramycin
Iodoquinine
Diloxanide furoate
Treatment of Giardiasis
Metronidazole
Nitoxanide
Furazolidone
Albendazole
Treatment of Cryptosporidiosis
Restore immune response in HIV patients!
Lactose free diet
Antimotility agent
Nitazoxanide may be used in moderately immunosuppressed pts
Treatment of Toxoplasmosis
Pyrimethamine with folinic acid
May add sulfadiazine or clindamycin
Treatment of Leishmaniasis
Sodium Stibogluconate- cutaneous and visceral
Amphotericin B - visceral
Treatment of Trypanosoma brucei
Metarsoprol
Suramin (alternate: Pentamidine)
Treatment of Trypanosoma cruzi (Chagas)
Is it used for acute or chronic disease?
Nifurtimox
Used for acute disease only, not effective in chronic disease management
Which drugs used in the treatment of Trypanosoma brucei will NOT cross the BBB?
Suramin
Pentamidine
What is the most common symptom of Neurocysticercosis? What organism is it associated with?
Seizures
Taenia solium
Treatment of Neurocysticercosis
Albendazole and Praziquantel
Albendazole is used to treat what infections?
Pinworm Ascaris Hookworm Tichuriasis Strongyloides Echinococcus Neurocysticersosis
Pyrantel Pamoate is used to treat what infections?
Pinworm
Hookworm
Ascaris
What drug should be used to treat lymphatic filiariasis?
Diethylcarbamazine
What drug is used to treat river blindness (caused by what organism)?
Onchocerciasis
Ivermectin used to treat
Ivermectin is used to treat what infections?
Strongyloides and Onchocerciasis
Ivermectin MOA
Paralyzes nematodes and arthropods by intensifying GABA mediated signals
Pyrantel Pamoate MOA
Depolarizes neuromuscular blocking
Causes release of Ach and inhibition of cholinesterase, resulting in worm paralysis
