Anti-Parasitic Agents

Question 1

Protozoan clinical illness requires how many exposures?

Answer 1

Single exposure

Question 2

Helminth clinical illness requires how many exposures?

Answer 2

Many exposures

Question 3

Treatment goal for Protozoan infections

Answer 3

Eradication

Question 4

Treatment goal for Helminth infections

Answer 4

Eradication or reduction of worm burden

Question 5

What is the difference between definitive, intermediate, and incidental hosts?

Answer 5

Definitive- harbors sexual parasitic stage

Intermediate - harbors larval or asexual parasitic stage

Incidental - not necessary for parasitic survival

Question 6

Chloroquine

MOA

Answer 6

Prevents plymerization of heme to hemozoin, causing a buildup of free heme that is toxic to the parasite

Question 7

Chloroquine

Indications

Answer 7

Prophylaxis and treatment

Schizonticidal in blood to all Plasmodium species, not active against liver phase parasites

Question 8

Chloroquine

Resistance

Answer 8

Widespread in P. falciparum

Question 9

Mefloquine

MOA

Answer 9

Like chloroquine, increases free heme which is toxic to parasite

Schizonticidal in blood

Question 10

Mefloquine

Indications

Answer 10

Option for prophylaxis in areas of chloroquine-resistant P. falciparum

Prophylaxis and treatment of all forms of malaria

Question 11

Mefloquine

Adverse Effects

Answer 11

Neuropsychiatric (seizures, psychosis)

Sleep and behavioral issues

Nausea, vomiting

Question 12

Atovaquone

MOA

Answer 12

Inhibits parasite mitochondrial electron transport

Question 13

Atovaquone is commony prescribed with…

Answer 13

Proguanil

Together, they are called Malarone

Question 14

Doxycycline

MOA and Indications for parasites

Answer 14

Protein synthesis inhibition

Prophylaxis against mefloquine-resistant P. falciparum

Question 15

Quinine and Quinidine

Indications

Answer 15

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

Quinine may be used in pregnancy

Question 16

Quinine and Quinidine

Adverse Effects

Answer 16

Cinchonism (headache, nausea, tinnitus, visual disturbance)

GI upset

Question 17

Primaquine

Indications

Answer 17

Treat exoerythrocytic forms of vivax and ovale malaria

Question 18

Primaquine

Contraindication

Answer 18

G6PD Deficiency –> hemolysis

Question 19

Artemisinin

MOA

Answer 19

Rapidly acting schizonticide

Produces toxic free radicals in parasite food vacuole

Question 20

Using Artemisinin with what drug is best for high parasite burden malarial infection?

Answer 20

Mefloquine

Question 21

What drugs are commonly used in malaria prophylaxis?

Answer 21

Mefloquine
Atovaquone and Proguanil (Malarone)
Doxycycline

Question 22

When should you start and end mefloquine prophylaxis for malaria?

Answer 22

Start 1-2 weeks prior to trip

End 4 weeks after trip

Question 23

When should you start and end malarone prophylaxis for malaria?

Answer 23

Start 1-2 DAYS prior to trip

End 7 days after trip

Question 24

P. Vivax and P. ovale infections should be treated with…?

Answer 24

Chloroquine and Primaquine

Question 25

Uncomplicated P. falciparum infections should be treated with...?

Answer 25

Atovaquone-proguanil Quinine plus doxy, tetracycline, or clindamycin Mefloquine

Question 26

Chloroquine resistant (complicated) P. falciparum infections should be treated with...?

Answer 26

Quinidine + doxy or clindamycin Artemisinin drugs

Question 27

Treatment of Entamoeba histolytica infection

Answer 27

Metronidazole (colitis, liver absness, ameboma) Luminal agents: Paramycin Iodoquinine Diloxanide furoate

Question 28

Treatment of Giardiasis

Answer 28

Metronidazole Nitoxanide Furazolidone Albendazole

Question 29

Treatment of Cryptosporidiosis

Answer 29

Restore immune response in HIV patients! Lactose free diet Antimotility agent Nitazoxanide may be used in moderately immunosuppressed pts

Question 30

Treatment of Toxoplasmosis

Answer 30

Pyrimethamine with folinic acid May add sulfadiazine or clindamycin

Question 31

Treatment of Leishmaniasis

Answer 31

Sodium Stibogluconate- cutaneous and visceral Amphotericin B - visceral

Question 32

Treatment of Trypanosoma brucei

Answer 32

Metarsoprol | Suramin (alternate: Pentamidine)

Question 33

Treatment of Trypanosoma cruzi (Chagas) Is it used for acute or chronic disease?

Answer 33

Nifurtimox Used for acute disease only, not effective in chronic disease management

Question 34

Which drugs used in the treatment of Trypanosoma brucei will NOT cross the BBB?

Answer 34

Suramin | Pentamidine

Question 35

What is the most common symptom of Neurocysticercosis? What organism is it associated with?

Answer 35

Seizures Taenia solium

Question 36

Treatment of Neurocysticercosis

Answer 36

Albendazole and Praziquantel

Question 37

Albendazole is used to treat what infections?

Answer 37

``` Pinworm Ascaris Hookworm Tichuriasis Strongyloides Echinococcus Neurocysticersosis ```

Question 38

Pyrantel Pamoate is used to treat what infections?

Answer 38

Pinworm Hookworm Ascaris

Question 39

What drug should be used to treat lymphatic filiariasis?

Answer 39

Diethylcarbamazine

Question 40

What drug is used to treat river blindness (caused by what organism)?

Answer 40

Onchocerciasis Ivermectin used to treat

Question 41

Ivermectin is used to treat what infections?

Answer 41

Strongyloides and Onchocerciasis

Question 42

Ivermectin MOA

Answer 42

Paralyzes nematodes and arthropods by intensifying GABA mediated signals

Question 43

Pyrantel Pamoate MOA

Answer 43

Depolarizes neuromuscular blocking Causes release of Ach and inhibition of cholinesterase, resulting in worm paralysis