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CMBM exam 4 > Anti Parasitic drugs > Flashcards

Anti Parasitic drugs Flashcards

0
Q

Inhibitors of parasite electron transport system

A

Atovaquone

Primaquine

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1
Q

Protozoal infections?

A

Plasmodium sp
Giardia lamblia
Entamoeba Histolytica
Toxoplasma Gondii

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2
Q

Inhibitors of Translation

A

bind to 30s or 50s ribosomal subunit to prevent parasite protein synthesis
Tetracycline
Doxcycline
Clindamycin

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3
Q

Inhibitors of Heme metabolism

A 
results in build up of toxic heme metabolites which are lethal to the parasite 
Chloroquine 
Quinine, quinidine 
Mefloquine 
Artemisinins
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4
Q

Inhibitors of Folate metabolism

A

inhibits parasite nucleotide
Sulfadoxine plue pyrimethamine
Proguanil

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5
Q

pt has high fever, chills, severe headache, malaise and myalgia 4 days after returning from Nigeria. He took chloroquine prophylactically to prevent malaria. Blood smear shows banana shaped gametocytes. How should he be treated?

A

Artemisinin

Plasmodium Falciparum

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6
Q

What would you give for prevention of Malaria?

A

Remember to consider species and geographic region
Atovaquone/Proguanil
Chloroquine
Doxycycline
Mefloquine - worst side effects - crazy dreams
Primaquine

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7
Q

Sensitive (all four) strains of Plasmodium can be treated with?

A

Chloroquine or

Hydroxychloroquine

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8
Q

When treating P. vivax and ovale, you want to add?

A

Primaquine for the hypnozoites

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9
Q

Prescribe what for Chloroquine resistant P falciparum?

A

Atovoquone-proguanil

artemisinin

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10
Q

25yo medical student going on medical mission to Uganda, what should be given for prophylaxis?

A

All plasmodium species found here
Risk of malaria is High
Drug resistance to Chloroquine
Should give - Atovaquone-proguanil, doxycycline or mefloquine

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11
Q

33yo pt with high fever and chills. Returned from two month trip to India. Stopped prophylaxis (Atovaquone-proguanil)day before leaving India. Diagnosed with P. Vivax. Whats the treatement?

A

Chloroquine plus Primaquine

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12
Q

What are the drug options for Chloroquine resistant P. Falciparum?

A

Mefloquine
Quinine plus doxycycline or Clindamycin
Atovaquone plus proguanil (which is Malarone)

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13
Q

What can you give for chloroquine sensitive P falciparum and P malariae?

A

Chloroquine

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14
Q

P. Vivax and P. ovale infections, you would give?

A

chloroquine plus primaquine

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15
Q

12yo with 1 week of malaise, weakness, abdominal cramps and diarrhea. Pt is also bloated and has excessive flatulence. Stool is grey or light colored and greasy/fatty (steatorrhea) and not bloody. He has recently been camping and drink some of the stream water. what is the parasite? How would you treat it?

A

Giardia lamblia
Treat with Metronidazole, Nitazoxanide or Tinidazole
all three induce DNA damage and generate toxic radicals

16
Q

what can be used for Entamoeba histolytica and Trichomonas vaginalis?

A

Metronidazole
Nitazoxanide
Tinidazole

17
Q

An ultrasound is performed on pregnant woman in 24th week. Fetus shows hydrocephalis and intracranial calcifications. Mother was tested and found to have IgM antibodies to Toxoplasma gondii. What is the treatment?

A

Spiromycin - macrolide antibiotic - binds 50s ribosomes to block protein synthesis. This is DOC for this infection.
or
pyrimethamine/sulfadiazine (folate metabolism inhibitors) and D- Leucovorin (rescue antidote to prevent toxicity)

18
Q

26yo volunteer returning from Kenya reports RUQ pain, abdominal pain, nausea, vomiting and diarrhea. Exam reveals Hepatosplenomegaly. Stool is positive for blood. Pt is dx with Schistosoma mansoni. Treatment?

A

Schistosomas are trematodes

would treat this with Praziquantel

19
Q

what is the mechanism of Praziquantel?

A

used for tapeworm and trematode infections

Acts by increasing parasite membrane permeability to calcium. Results in parasite muscle contraction and paralysis

20
Q

Childern in Peru village present with varying degrees of abdominal discomfort. Ova and parasite exam results from stool show Ascaris, Ancyclostoma and Trichuris. Treatment?

A

Albendazole, Mebendazole, Thiabendazole

21
Q

How does Albendazole, Mebendazole and Thiabendazole work?

A

act by interfering with tubulin polymerizaiton leads to degradation of the integument
damages parasite intestinal epithelial cells
these are for treating nematode infections, cysticercosis (pig tapeworm in brain), echinococcosis

22
Q

Pyrantel Pamoate

A

for round worms and hookworms
Acetylcholine agonist and depolarizing neuromuscular blocking agent
produces rigid contraction of nematode muscles

23
Q

In village north of Cairo, WHO is attempting to reduce cases of lymphatic filariasis. What can cause this?

A

Wuchueria bancrofti

Brugia Malayi

24
Q

What can cause SubQ filariasis?

A

Oncocerca volvulus

Loa Loa

25
Q

How is Lymphatic and SubQ filariasis treated?

A

Ivermecitn

Diethylcarbamazine

26
Q

Ivermectin

A

Microfilariae of Oncocera
binds with high affinity to glutamate gated chloride channels which occur in invertebrate nerve and muscle cells. Causes increase in permeability of cell membrane to chloride ions with hyperpolarization. Results in paralysis and death of parasite by causing worm to starve
Kills microfilariae slowly and thus prevent a host systemic immune response

27
Q

Diethylcarbamazine

A

treat filarial worm infections
drug kills adult worms
Kills microfilariae quickly which can cause a systemic inflammatory response in pt with heavy microfilariae burden
acts by inhibiting microtubule polymerization in parasites

28
Q

Treat Babesia microti with?

A

Clindamycin plus quinine
or
Atovaquone plus azithromycin

29
Q

Treat toxoplasma gondii with?

A

spiromycin

Pyrimethamine/sulfadiazine and leucovorin

30
Q

Treat Giardia lamblia with?

A

Metronidazole
Nitazoxanide
Tinidazole

31
Q

Cestodes and Trematodes treatments?

A

Praziquantel

Albenazole

32
Q

Nematodes

A

Albendazole, Mebendazole, Thiabendazole
Pyrantel pamoate
Ivermectin
Diethylcarbamzine

CMBM exam 4 (27 decks)

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