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POD exam 4 > Anti-parasitics > Flashcards

Anti-parasitics Flashcards

1
Q

what are two major categories for major parasitic diseaeses

A

protozoan

helminthic

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2
Q

what are 3 types of treatment

A
  1. suppressive therapy
  2. clinical cure
  3. radical cure
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3
Q

suppressive therapy

A

elimination of parasite from responsible for acute symptoms

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4
Q

clinical cure

A

removal of all parasites from blood

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5
Q

radical cure

A

elimination of all parasites forms from the body

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6
Q

Malaira: parasites digest what of host red cells

A

HgB

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7
Q

what is HgB degradation product

A

Ferriprotoporphyrin IX –> toxic to parasite membranes and essential enzyme

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8
Q

how does parasite protect itself from Ferriprotoporphyrin IX

A

heme polymerase

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9
Q

MOA of Chlorouine

results in?

A
  • inhibit sequestration of heme and inhibits heme polymerase

- results in oxidative damage to cell membrane, digestive enzymes

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10
Q

what is the half life for Chloroquine

A

4 DAYS ( ALLOWS FOR ONCE A WEEK PROPHYLAXIS)

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11
Q

how does parasite gain resistance with Chloroquine

A
  • pfcrt gene codes for transport protein in membrane of acidic digestive vacuole
  • parasites transports Chloroquine out of vacuole
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12
Q

where does Chloroquine work in the parasite cells

A

vacuole

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13
Q

Chloroquine has effects on what parasites

A

asexual and erythrocytic forms of parasites

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14
Q

what is Chloroquine used for

A
  • prevention/treatment of malariae
  • extraintestinal amebiasis
  • inflammatory diseases
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15
Q

MOA for Primaquine

A

interferes with mitochondria function

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16
Q

Primaquine is the only agent available for treating

A

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

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17
Q

adverse effects for Primaquine

A

Hemolysis when G6PD deficiency

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18
Q

Primaquine is a radical cure for what

A

P. vivax

P. ovale

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19
Q

when is Primaquine used

A

after chloroquine in treatment or shortly before or after chloroquine prohylaxis

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20
Q

what is toxicity for primaquine

A

uncommon in whites
mild abdominal distres
hemolysis is G6PD deficiency patients

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21
Q

MOA for Quinine

A

similiar to chloroquine

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22
Q

Quinine can be used for what kind of therapy

A

parenteral therapy against chloroquine resistance

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23
Q

adverse effects for Quinine

A
  • poorest therapeutic to toxic ratio

- Chinchonism

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24
Q

Chinchonsim

A

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

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25
Q

MOA for Quinidine

A

similiar to Chloroquine

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26
Q

Adverse effects for Quinidine

A

EKG changes

hypotension

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27
Q

what is Mefloquine used for

A

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

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28
Q

Mefloquine is considered what type of drug

A

Schizontocidal drug

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29
Q

Mefloquine does not effect what

A

exoerythrocytic stage

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30
Q

where is resistance to Mefloquine gaining

A

Thailand

West Africa

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31
Q

what are some adverse effects of Mefloquine

A

vivid dreams

neuropsychiatric symptoms

32
Q

Pyrimethamina is used in combination with what drug

A

Sulfonamide and quinine

33
Q

MOA for Pyrimethamina

A

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

34
Q

Adverse effects of Pyrimethamine

A

hypersensitivity reaction
hematologic rxns
anemia

35
Q

For Pyrimethamine how do you decrease anemia side effect

A

give with leucovorin

36
Q

what makes up malarone

A

Atovaquone and proguanil

37
Q

what is Malarone used for

A

malaria chemoprphylaxis

- treatment of uncomplicated P. flaciparium

38
Q

MOA for Atovaquone-proguanil

A

Atovagquone : mitochondrial toxicant in parasites

Proguanil: cyclic active form inhibits DNA synthesis

39
Q

Artemisinin and Derivatives are dervied from what

A

qing hae or sweet wormwood

40
Q

what are artemisinin used for

A

P. falciparium ( combination with other drugs)

  • asexual erythrocytic stages of P. vivax
  • not for chemoprophylaxis
41
Q

what drugs are used for malaria prophylaxis

A

Atovaquone
Mefloquine
Chloroquine
Primaquine

42
Q

how do you treat p. falciparium

A

chloroquine

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

43
Q

how do you treat P. vivax

A

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

44
Q

what is the most prevalent enteric parasite in the US

A

Giardiasis- Giardia intestinalis

45
Q

Name 3 treatment options for Giadiasis

A

metronidazole
Tinidazole
Nitazoxanide/Furazolidone PEDS

46
Q

what is the clinical presentation for Amebiasis- Entamoeba species

A

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

47
Q

what are two types of treatment for Amebiasis

A

Luminal agents

tissue agents

48
Q

Ambeicidic agents: metronidazole: site of activity

A

systemic and luminal activity

49
Q

Ambeicidic agents: metronidazole: adverse effects

A

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

50
Q

Ambeicidic agents: metronidazole: MOA

A

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

51
Q

Ambeicidic agents: metronidazole: what is it used for

A 
anaerobic bacteria, 
entamoeba histolytica
E. polecki
Giardia lamblia
Trichomonas vaginalis
52
Q

Ambeicidic agents: Idoquinol:

A

luminally active - eradicates cysts in asymptomatic persons

53
Q

Ambeicidic agents: Idoquinol: adverse effects

A

GI
seizures
encephalopathy
high iodine content interefere with TFT

54
Q

Ambeicidic agents: Paromomycin:

A

aminoglycoside, poorly absorbed after administraiton

55
Q

Ambeicidic agents: Paromomycin: adverse effects

A

GI complains, potentially nephrotoxic, ototoxic

56
Q

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

A

antimonial agents

Sodium stibogluconate

57
Q

Antiprotozoal agents: trypanosomiasis: Chagas Disease

A

Nifurtimox

58
Q

Antiprotozoal agents:Trypanosomiasis: African sleeping sickness

A

Eflornithine
Suramin
Pentamidine

59
Q

Antiprotozoal agents: Toxoplasmoisis

A

pyrimethamine + sulfadiazine

pyrimethamine + clindamycin

60
Q

Nematode Infections: Enterobiasis - pinworm:

A

Pyrantyl pamoate or mebendazole or albendazolde

61
Q

Nematode Infections: ascariasis roundworm

A

pyrantyl pagmoate
mebendzole
albendazolde

62
Q

Nematode Infections: Filariasis

A

Diethylcarbamazine

63
Q

Nematode Infections:Trichurisais whipworm

A

Mebendazole

aldbendazole

64
Q

Nematode Infections:hookworm

A

albendzole> Mebendazole or pyrantyl pamoate

65
Q

Nematode Infections:Strongyloidiasis Threadworm

A

ivermectin

alternative: thiabendazole

66
Q

Anthelmintic agents: Mebednazole: MOA

A

selectivly binds to helminthic tubulin

  • blocks mictortubule assembly in helminths
  • inhibits glucose uptake, resulting in immobilization and death
67
Q

Anthelmintic agents: Mebednazole: adverse effects

A

abdominal pain

68
Q

Anthelmintic agents: Ivermectin: MOA

A

GABA receptor agonist

  • GABA controls neurotransmission by sending inhbitory signals to motor neurons-
  • paralysis
69
Q

Anthelmintic agents: Ivermectin is the drug choice for what nematode

A

Stornglyoidiasis

70
Q

Anthelmintic agents: Ivermectin: adverse effects

A

minimal

GI complains

71
Q

Anthelmintic agents: Pyrantel Pamoate: MOA

A

depolarizing neuromuscular blocking agent

72
Q

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

A

mebendazole or albendazole for roundworm hookworm and pinworm

73
Q

Anthelmintic agents: Pyrantel Pamoate adverse effects

A

minimal

GI complaints

74
Q

Anthelmintic agents: Thiabendazole: MOA

A

Inhibits fumurate reductase of susceptible helminths

-interefere with microtubule assembly

75
Q

Thiabendazole is commenly used for what

A

Storngyloidiasis but not drug of choice

76
Q

Anthelmintic agents: Trematodes (Flukes) MOA

A

increase trematode cell membrane permeability to calcium - paraylsis

77
Q

Anthelmintic agents: cestodes ( tapeworms/flatworms) MOA

A

decreased ATP production by tapeworm mitochondria

POD exam 4 (6 decks)

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