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Pharmacology > Anti-Protozoal & Anti-Helminthic Drugs > Flashcards

Anti-Protozoal & Anti-Helminthic Drugs Flashcards

1
Q

Treatment for Naegleria fowleri (brain-eating amoeba)

A

Miltefosine (trade names Impavido and Miltex)

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2
Q

Mechanism of Miltefosine

A

A PL drug originally developed as an antineoplastic for topical use.
As an antiprotozoal drug, it can be oral or topical
Acts as an Akt inhibitor, thereby inhibiting the parasite or viruses from entering cells and spreading.
Also under investigation as a potential therapy against HIV infection.

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3
Q

Treatment for amebiasis (amebic colitis and amebic liver abscess) (Entamoeba histolytica) and Giardia

A

Nitroimidazole antibiotics (metronidazole) + iodoquinol

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4
Q

Mechanism of nitroimidazole ABx (i.e., metronidazole)

A

Taken up by diffusion and reduced to nitrose intermediates, which either deactivate cysteine-containing enzymes or intercalate within bacterial DNA to form unstable molecules.

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5
Q

Mechanism of iodoquinol

A

chelates ferrous ions essential for metabolism of single-celled organisms

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6
Q

Treatment for cyclospora, isospora

A

Bactrim (TMP-SMX)

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7
Q

Mechanism of bactrim

A

Inhibits the folate synthesis pathway

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8
Q

Treatment for cryptosporidium

A

Nitazoxanide

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9
Q

Mechanism of nitazoxanide

A

Interference with the pyruvate:ferredoxin oxidoreductase (PFOR) enzyme dependent electron transfer reaction which is essential to anaerobic energy metabolism
Following oral admin, it is rapidly hydrolyzed to its active metabolite, tizonoxanide

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10
Q

Presents with 2-5 semi-formed stools (steatorrhea)/day and moderate gas/bloating. Can be associated with malabsorption syndrome and FTT

A

Giardia

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11
Q

Presents with alternating (bloody) diarrhea and formed stools every 1-2 days and moderate fatigue and weight loss

A

Entamoeba histolytica

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12
Q

Presents with sudden watery diarrhea followed by UGI sxs, severe gas/bloating, anorexia, fatigue and weight loss

A

cyclospora

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13
Q

Presents with acute watery diarrhea of short duration (5-10 d) and mild to moderate weight loss

A

Cryptosporidium

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14
Q

Treatment of giardiasis

A

Tinidazole, metronidazole, and nitazoxanide

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15
Q

SIgns and symptoms of isosporosis

A

Chronic diarrhea (mos-yrs)
Abdominal pain, weakness, weight loss
Anorexia
EOSINOPHILIA (rare in protozoan infections)

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16
Q

Intestinal flukes

A

Fasciolopsis buski
Metagonimus yokogawai
Heterophyes heterophyes

17
Q

Treatment for intestinal flukes

A

Praziquantel

18
Q

Liver flukes

A 
Fasciola hepatica (sheep liver fluke)
Clonorchis senensis (Chinese liver fluke)
Dicrocoelium dendriticum
19
Q

Treatment for liver flukes

A

Triclabendazole
Nitazoxanide
Praziquantel (except for F. hepatica)
Albendazole

20
Q

Lung fluke

A

Paragonimus westermani

21
Q

Treatment for lung fluke

A

Praziquantel

Triclabendazole

22
Q

Blood flukes

A

Schistosomas: S. japonicum, S. mansoni

23
Q

Treatment for blood flukes

A

Praziquantel. But infections often resolve without treatment

24
Q

Mechanism of praziquantel

A

Increases Ca permeability of the schistosome and causes paralysis of the fluke, allowing phagocytosis. May interfere with adenosine uptake.
Absorbed very well in the GI tract
Metabolized through the cyto P450 pathway (CYP3A4)

25
Q

Mechanism of mebendazole

A

Inhibits the formation of worms’ microtubules and causes the worms’ glucose depletion

26
Q

Mechanism of albendazole

A

Inhibits tubulin polymerization, resulting in the loss of cytoplasmic microtubules (many drug interactions)

27
Q

Mechanism of Ivermectin

A

A macrocyclic lactone which kills by interfering with nerve and muscular fx, in particular by enhancing inhibitory neurotransmission.
Causes bowel obstruction with heavy worm load.

28
Q

Mechanism of pyrantel pamoate

A

Acts as a depolarizing neuromuscular blocking agent, thereby causing sudden contraction, followed by paralysis, of the helminths. Worm “loses its grip” on the intestinal wall and may be passed out of the system then.
Causes bowel obstruction with heavy worm load
Popular heart worm medication for pets

29
Q

Mechanism of niclosamide

A

Used specifically to treat tapeworms by uncoupling oxphos; not effective against other worms

30
Q

Treatment for Enterobius vermicularis (pinworm)

A

Mebendazole
Pyrantel pamoate
Albendazole

31
Q

Prevalence of ascariasis

A

3-4 million US cases/year

32
Q

Treatment for ascarosis

A

Mebendazole
Albendazole
Ivermectin

33
Q

Treatment for trichuris trichiura

A

Mebendazole
Albendazole
Ivermectin
Iron for microcytic anemia

Pharmacology (16 decks)

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