Anti protozoal Flashcards
blood schizontocidal agents - erythrocytic stage
rapid acting - chloroquine and artemisinin within 24 hr
tissue schizontocidal agents - pre erythrocytic and latents forms (hypnozoites)
primaquine
gametocidal agents - kill gametocytes in blood
chloroquine
primaquine
atrmisinin
active against all species plasmodia (except falciparum)
Tx Vivax malaria - does not prevent relapse in vivax
accumulates in several tissues
chloroquine
MOA: food vacuole raises pH, inhibits polymerization of toxic heme to nontoxic hemozoin
resistance - mut in transporters PfCRT
chloroquine
ADR: nausea, epigastric pain, arrhythmias - parenteral, ocular toxicity
prolonged use - retinal damage, hearing loss, graying of hair, Bulls eye retinopathy, hemolysis in G6PD def
chloroquine
Contra - psoriasis, porphyria, retinal or visual field abnormal and myopathy
chloroquine
acts against sexual erythrocytic forms and has no significant effect on hepatic forms of malaria parasites
safe in pregnancy
quinine
ADR: cinchonism, hypoglycemia, hypotension, prolonged QT, hemolysis in G6PD def
quinine
hemolysis and hemoglobinuria associated with quinine therapy - occurs with heavy parasitization of RBCs with p falciparum
black water fever
drug resistant p falciparum
chemoprophylaxis for traverlers
generally combo with artemisinin
Mefloquine
release highly reactive free radicals
bind to membrane proteins; damages ER
oral - dihydro-artemisinin, artesunate, artemether
Artemisinin
DOC fro cerebral malaria and complicated malaria
artemisinin
safe drug
rapid acting blood schizonticide + gametocidal
WHO recomm. combo artemether + lumefantrine
artemisinin
used for drug sensitive p falciparum, vivax
inhibits dihydrofolate reductase
proguanil
disrupts mitochondrial membrane potential
target: both tissue and RBC schizonts
treatment for uncomplicated malaria and chemoprophylaxis
atovaquone
malarone (atovaquone + proguanil)
tissue schizontocide for all 4 species of plasmodia
gametocidal activity
MOA: produces reactive oxygen species, cellular oxidative damage
primaquine
Used: radical cure - to prevent relapse by eliminating hypnozoites - p vivax: once daily 14 days
primaquine
combo with clindamycin to treat p jiroveci
contra: in G6PD def.. pregnancy, infants, granulocytopenia
primaquine
long trip over 6 weeks
once a week started 3-4 weeks earlier continued for 4 weeks after
Mefloquine
long trip less than a month
once a week started 3 weeks before continued 4 weeks after
Chloroquine
short trip under 6 weeks
once a day started 1-2 days earlier continued for 4 weeks after return
doxycycline
short trip under 7 days
once a day started 1-2 days earlier continued for 7 days after trip
atovaquone/proguan (malarone)
ingestion of cysts of E histolytica
adhere to clinic epithelial cells
lyse host cell
invades submucosa
amoebiasis infection
