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PHARM 2 > anti-parasitics > Flashcards

anti-parasitics Flashcards

1
Q

DOC for invasive amebiasis

A

metronidazole

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2
Q

Metronidazole use

A 
giardia
trichomonas
anaerobic cocci
anaerobic gram - bacili
h. pylori in combo tx
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3
Q

metronidazole MOA

A

reduced by reacting with reduced ferredoxin = produces cytotoxic compounds

these bind proteins and DNA = unstable molecules - cell death

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4
Q

metronidazole PK

A

hepatic oxidation
glucuoronidation
CYP P450s

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5
Q

metronidazole AE

A

GI distress
**disulfiram with alcohol
leukopenia
unpleasant metallic taste

safety in pregnancy not established

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6
Q

Tinidazole

A

2nd generation nitroimidazole

better tolerated and shorter duration that metronidazole

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7
Q

Tinidazole AE

A

same as metronidazole

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8
Q

diloxanide furoate

A

luminal antiamebics

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9
Q

iodoquinol

A

luminal antiamebics

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10
Q

paraymomycin

A

luminal antiamebics

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11
Q

What can be used by itself to tx asymptomatic ameobiasis

A

diloxanide furoate

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12
Q

Iodoquinol use

A

orally against luminal trophozoite and cyst forms of entamobea

alternative to diloxanide furoate for mild-severe infections

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13
Q

Iodoquinol AE

A

Adverse: with long term use - risk of optic neuritis

rash, diarrhea, dose related peripheral neuropathy

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14
Q

Paramomycin

A

aminoglycside antibiotic

only effected against luminal forms of E. histolytica and tapeworm

alternative agent for cryptosporidiosis in AIDS pt

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15
Q

paromycin MOA

A

amebicidal = cell membranes become leaky

interferes with bacterial protein synthesis - binds to 30s ribosomal subunits

reduces intestinal flora population

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16
Q

chloroquine use

A

combo: metroniazole, diloxanite furoate

eliminates trophozites in liver abscesses

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17
Q

emetine/dihydroemetine

A

back up drugs for tx of severe intestinal or hepatic amebiasis

MOA: inhibit protein synthesis by bloking ribosomal movement along mRNA

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18
Q

albendazole MOA

A

tx of cestodal infections (t. solium, e. granulosis)

inhibits microtubule synthesis and glucose uptake

ATP production is decreased = worm immobilization and death

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19
Q

albendazole AE

A

1-3 days of tx: HA, nausea

3 months/hydatid tx: hepatotoxicity, agranulocytosis/pancytopenia

CONTRAINDICATED in pregnancy/children

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20
Q

DOC for trichuris trichuria

A

mebendazole (or albendazole)

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21
Q

DOC for enterobius vermicularis

A

mebendazole (or pyrantel pamoate)

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22
Q

DOC for hookworms/n. americanus and a. duodenale:

A

mebendazole (pyrantel pamoate or albendazole)

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23
Q

roundworm/ascariasis lumbricoides DOC:

A

mebendazole (albendazole, pyrantel pamoate)

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24
Q

mebendazole MOA

A

inhibts formation of helminth microtubules

blocks glucose tuptake

affects parasitse that are expelled with feces

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25
Q

mebendazole AE

A

contraindic in preg

caution in children <2 or with cirrhosis

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26
Q

Thiabendazole

A

tx: strongyloidiasis, cutaneous larva migrans, early stage of trichinosis

MOA: affects microtubular aggregation

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27
Q

thiabendazole AE

A

more toxic than other benzimidazoles

CNS disturbance
contraindic in pregnacy
erythema multiforme - stevens johnson

not used in presence of liver or kidney disease

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28
Q

doc for onchoceriasis

A

ivermectin

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29
Q

doc for CLM

A

ivermectin

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30
Q

doc for strongyloides

A

ivermectin

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31
Q

ivermectin MOA

A

GABA agonist

Cl- influx = inc hyperpolarization - death occurs later

does not cross BBB

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32
Q

Ivermectin AE

A

mazotti reactions with onchoceriasis: fever, dizzy, somnolence, hypotension

contraindic in pregnacy and meningitis

DONT give with drugs that enhance GABA: barbiturates and benzos

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33
Q

piperazine

A

alt drug for tx of pinworm and roundworm

34
Q

piperaize MOA

A

GABA agonist -
explusion of worm by peristalsis

contraindicated in seizure pt’s

35
Q

pyrantel pamoate

A

tx roundworms, pinworms, hookworms

36
Q

pyrantel pamoate MOA

A

depolarizing , NM blocker = persistent activation of parasite nicotinic-r = release of Ach and inhibition of cholinesterase

37
Q

diethylcarbamazine

A

immobilizes microfilarier - makes suscpetible t ohost defense

38
Q

DOC lymphatic filarisis

A

diethycarbamazine

39
Q

diethylcarbamazine MOA

A

immobilizes microfilariae - susceptible to host defense

40
Q

Doxycycline MOA

A

macrofilaricidal against wuchereria bancrofti

active against onchoceriasis

MOA - indirectly kills wolbachia - intracellular bacterial symbiont of parasite

41
Q

Praziquantel

A

shisto, trematode, cestode, cysticerosis

42
Q

DOC for schistomasiasis

A

Praziquantel

43
Q

Praziquantel MOA

A

inc perm of cell membrane to calcium causing contracture and paralysis of worm = detachment of suckers from BV walls

44
Q

DOC for cysticerosis

A

albendazole (praziquantel has similar efficacy)

45
Q

praziquantel PK

A

extensive 1st pass metabolism

46
Q

praziquantel AE

A

contraindicated in pregnancy, nursing mothers, and OCULAR CYSTICERCOSIS - destroying organism may damage eye

drug interactions (CYP P450)

47
Q

bithionol

A

fasciolosis

alternative tx for pulmonary paragonimiasis

48
Q

bithionol MOA

A

inhibition of helminth electron transport chain

49
Q

DOC fasciolosis

50
Q

niclosamide

A

2nd line drug for most cestodes

uncommon b/c of effectiveness of praziquantel

51
Q

niclosamide MOA

A

inhibition of parasite’s mitochondrial phosphorylation of ADP

Lethal for cestode’s scolex and segments - BUT not for ova

52
Q

Niclosamide PK

A

laxative given prior to niclosamide to purge bowel of dead segments - in order to preclude digestion and liberation of ova

alcohol should NOT be given within 1 day of dose

53
Q

tinidazole use

A

amebiasis
amebic liver abscess
giardiasis
trichomoniasis

54
Q

diloxanide furoate MOA

A

converted in gut to diloxanide freebase active form

55
Q

DOC for luminal amebicide

A

diloxanide furoate - not available in US

56
Q

paromycin AE

A

GI distress - diarrhea

HA, dizzy, rash, arthralgia

57
Q

systemic antiamebics

A

chloroquine
emetine
dehydroemetine

tx liver abscesses or intestinal wall infections

58
Q

emetine/dihydroemetine AE

A

**pain at site of infection
cardiotoxicity
NM weakness
nausea

59
Q

DOC asymptomatic intestinal infection

A

diloxanide furoate

alternative: iodoquinol, paromycin

60
Q

DOC mild to mod intestinal infection

A

metronidazole + diloxanide furoate

alternatives: tinidazole or tetracycline or erythromycin + diloxanide furorate

61
Q

DOC severe intestinal infection

A

metronidazole/tinidazole + diloxanide furoate

alternatives: tetracycline/emetine/dihydroemetine + diloxanide furoate

62
Q

DOC hepatic abscesses and other extraintestinal disease

A

metronidazole/tinidazole + diloxanide furoate

alternatives: emetine/dihydroemetine + chloroquine + diloxanide furoate

63
Q

DOC loiasis

A

diethylcarbamazine

64
Q

DOC tropical eosinophilia

A

diethylcarbamazine

65
Q

diethylcarbamazine AE

A

d/t host response following parasite death:

  • fever, malaise, myalgias
  • leukocytosis

can use anti-histamines/steroids to resolve AE

66
Q

DOC visceral larva migrans (toxocariasis)

A

albendazole

67
Q

DOC trichinosis (trichinella spiralis)

A

albendazole or mebendazole

68
Q

DOC clonorchis sinesis

A

praziquantel

69
Q

DOC paragonimus westermani

A

praziquantel

70
Q

DOC echinococcosis

A

albendazole

71
Q

DOC taeniasis solium/saginata

A

praziquantel or niclosamide

72
Q

cysticercosis DOC

A

albendazole or praziquantel

73
Q

diphyllobothriasis DOC

A

praziquantel or niclosamide

74
Q

DOC giardia

A

metronidazole

75
Q

DOC trichomonas vaginalis

A

metronidazole

76
Q

DOC trypanosomiasis

A

melarsoprol or suramin

77
Q

DOC hemolymphatic stage of trypanosomiasis and PCP infection

A

pentamidine

78
Q

toxoplasmosis encephalitis DOC

A

pyrimethamine + clindamycin or sulfadiazine or folinic acid

79
Q

DOC leishmaniasis (all stages)

A

sodium stibogluconate/amphoteracin B

80
Q

DOC cystercosis with taenia solium larva

A

albendazole or praziquantel

PHARM 2 (18 decks)

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