Anti-parasitics Flashcards by Bina Malapur

what are two major categories for major parasitic diseaeses

protozoan

helminthic

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what are 3 types of treatment

suppressive therapy
clinical cure
radical cure

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suppressive therapy

elimination of parasite from responsible for acute symptoms

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clinical cure

removal of all parasites from blood

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radical cure

elimination of all parasites forms from the body

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Malaira: parasites digest what of host red cells

HgB

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what is HgB degradation product

Ferriprotoporphyrin IX –> toxic to parasite membranes and essential enzyme

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how does parasite protect itself from Ferriprotoporphyrin IX

heme polymerase

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MOA of Chlorouine

results in?

inhibit sequestration of heme and inhibits heme polymerase

- results in oxidative damage to cell membrane, digestive enzymes

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what is the half life for Chloroquine

4 DAYS ( ALLOWS FOR ONCE A WEEK PROPHYLAXIS)

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how does parasite gain resistance with Chloroquine

pfcrt gene codes for transport protein in membrane of acidic digestive vacuole
parasites transports Chloroquine out of vacuole

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where does Chloroquine work in the parasite cells

vacuole

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Chloroquine has effects on what parasites

asexual and erythrocytic forms of parasites

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what is Chloroquine used for

prevention/treatment of malariae
extraintestinal amebiasis
inflammatory diseases

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MOA for Primaquine

interferes with mitochondria function

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Primaquine is the only agent available for treating

exoerythrocytic hypnozoite forms of P. vivax and P. ovale in liver

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adverse effects for Primaquine

Hemolysis when G6PD deficiency

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Primaquine is a radical cure for what

P. vivax

P. ovale

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when is Primaquine used

after chloroquine in treatment or shortly before or after chloroquine prohylaxis

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what is toxicity for primaquine

uncommon in whites
mild abdominal distres
hemolysis is G6PD deficiency patients

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MOA for Quinine

similiar to chloroquine

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Quinine can be used for what kind of therapy

parenteral therapy against chloroquine resistance

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adverse effects for Quinine

poorest therapeutic to toxic ratio

- Chinchonism

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Chinchonsim

Tinnitus, decreased hearing, HA, N/V, visual distrubances

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MOA for Quinidine

similiar to Chloroquine

Adverse effects for Quinidine

EKG changes | hypotension

what is Mefloquine used for

prophylaxis against and treatment of drug resistant P. falciparium and P. vivax for travelers spending long time in endemic areas

Mefloquine is considered what type of drug

Schizontocidal drug

Mefloquine does not effect what

exoerythrocytic stage

where is resistance to Mefloquine gaining

Thailand | West Africa

what are some adverse effects of Mefloquine

vivid dreams | neuropsychiatric symptoms

Pyrimethamina is used in combination with what drug

Sulfonamide and quinine

MOA for Pyrimethamina

structurally related to trimethoprim; binds to and reversibly inhibits dihydrofolate redctase

Adverse effects of Pyrimethamine

hypersensitivity reaction hematologic rxns anemia

For Pyrimethamine how do you decrease anemia side effect

give with leucovorin

what makes up malarone

Atovaquone and proguanil

what is Malarone used for

malaria chemoprphylaxis | - treatment of uncomplicated P. flaciparium

MOA for Atovaquone-proguanil

Atovagquone : mitochondrial toxicant in parasites | Proguanil: cyclic active form inhibits DNA synthesis

Artemisinin and Derivatives are dervied from what

qing hae or sweet wormwood

what are artemisinin used for

P. falciparium ( combination with other drugs) - asexual erythrocytic stages of P. vivax - not for chemoprophylaxis

what drugs are used for malaria prophylaxis

Atovaquone Mefloquine Chloroquine Primaquine

how do you treat p. falciparium

chloroquine OR artemisinin derivatives, malarone, mefloquine, clindamycin + quinine, doxycycline + quinine

how do you treat P. vivax

Malarone, chloroquine, primaquinem clindamycin + quinine, doxycylcine + quinine

what is the most prevalent enteric parasite in the US

Giardiasis- Giardia intestinalis

Name 3 treatment options for Giadiasis

metronidazole Tinidazole Nitazoxanide/Furazolidone PEDS

what is the clinical presentation for Amebiasis- Entamoeba species

GI complaints RUQ pain, hepatomegally - suggest liver abcess ASK ABOUT HISTORY OF TRAVEL

what are two types of treatment for Amebiasis

Luminal agents | tissue agents

Ambeicidic agents: metronidazole: site of activity

systemic and luminal activity

Ambeicidic agents: metronidazole: adverse effects

GI metallic taste Disulfiram-like effect ( alcohol intolerance)*

Ambeicidic agents: metronidazole: MOA

nitro group serves as an electron acceptor forming a reduced cytotoxic agent. - toxic form can bind to protein and DNA and my generate free radicals

Ambeicidic agents: metronidazole: what is it used for

``` anaerobic bacteria, entamoeba histolytica E. polecki Giardia lamblia Trichomonas vaginalis ```

Ambeicidic agents: Idoquinol:

luminally active - eradicates cysts in asymptomatic persons

Ambeicidic agents: Idoquinol: adverse effects

GI seizures encephalopathy high iodine content interefere with TFT

Ambeicidic agents: Paromomycin:

aminoglycoside, poorly absorbed after administraiton

Ambeicidic agents: Paromomycin: adverse effects

GI complains, potentially nephrotoxic, ototoxic

Antiprotozoal agents: Leishmaniasis ( female sand fly) what would you use

antimonial agents | Sodium stibogluconate

Antiprotozoal agents: trypanosomiasis: Chagas Disease

Nifurtimox

Antiprotozoal agents:Trypanosomiasis: African sleeping sickness

Eflornithine Suramin Pentamidine

Antiprotozoal agents: Toxoplasmoisis

pyrimethamine + sulfadiazine | pyrimethamine + clindamycin

Nematode Infections: Enterobiasis - pinworm:

Pyrantyl pamoate or mebendazole or albendazolde

Nematode Infections: ascariasis roundworm

pyrantyl pagmoate mebendzole albendazolde

Nematode Infections: Filariasis

Diethylcarbamazine

Nematode Infections:Trichurisais whipworm

Mebendazole | aldbendazole

Nematode Infections:hookworm

albendzole> Mebendazole or pyrantyl pamoate

Nematode Infections:Strongyloidiasis Threadworm

ivermectin | alternative: thiabendazole

Anthelmintic agents: Mebednazole: MOA

selectivly binds to helminthic tubulin - blocks mictortubule assembly in helminths - inhibits glucose uptake, resulting in immobilization and death

Anthelmintic agents: Mebednazole: adverse effects

abdominal pain

Anthelmintic agents: Ivermectin: MOA

GABA receptor agonist - GABA controls neurotransmission by sending inhbitory signals to motor neurons- - paralysis

Anthelmintic agents: Ivermectin is the drug choice for what nematode

Stornglyoidiasis

Anthelmintic agents: Ivermectin: adverse effects

minimal | GI complains

Anthelmintic agents: Pyrantel Pamoate: MOA

depolarizing neuromuscular blocking agent

Anthelmintic agents: Pyrantel Pamoate is an alternate to what other drug

mebendazole or albendazole for roundworm hookworm and pinworm

Anthelmintic agents: Pyrantel Pamoate adverse effects

minimal | GI complaints

Anthelmintic agents: Thiabendazole: MOA

Inhibits fumurate reductase of susceptible helminths | -interefere with microtubule assembly

Thiabendazole is commenly used for what

Storngyloidiasis but not drug of choice

Anthelmintic agents: Trematodes (Flukes) MOA

increase trematode cell membrane permeability to calcium - paraylsis

Anthelmintic agents: cestodes ( tapeworms/flatworms) MOA

decreased ATP production by tapeworm mitochondria