Anti Protozoal /malaria Flashcards
What does distributional selectivity mean
Where the drug is directed/administered to into a limited compartment concentrated with parasite
Why are protozoan plasmodium hard to target
Eukaryotic
What causes malarial symptoms like fever pain
Rbc lysis
What are the 4 types of plasmodium
Falciparum
Virax
Ovale
Malarie
Which plasmodium takes shortest time (6 days) to infect
Falciparum
Which 2 plasmodium exist as hypnozoites in liver
Virax and ovale
Who is the definitive host for plasmodium (sexual reproduction)
Female mosquito
What are injected into our blood from mosquito saliva and where do they go
Sporozoites
Enter blood to the liver
After replication in liver what is released to go to the rbc
Merozoites
What is the stage in the liver called
Exo erythrocytic cycle
Once merozoites penetrate rbc, what are they called
TrophoZoites
What are trophozoites whixh then lay dormant in liver called
Hypnozoites (ovale and virax)
Name some things which trophozoites do in asexual reproduction in the rbc
Digest AA, Hb for energy
Convert heme to hemeozoin (less toxic for them)
Trophozoites which are released from burst rbc are called merozoites again. What do they develop into
Gametocytes
Which then infect next mosquito in blood
What are the 4 targets in life cycle
Exo erythrocytic cycle
Erythrocytic cycle
Link between liver and rbc
Gametocytes infecting a new mosquito
What are drugs called which act on exo erythrocytic cycle and which parasites do they work best on
radical cure
Work best on hypnozoites eg virax or ovale
What is a clinical cure
Works on erythrocytic cycle for ones which don’t reproduce in the liver
What do prophylaxis treatment do
Stop the transfer between liver and rbc
What are 4 amino quinolones and give example
Drugs which target clinical and prophylaxis (erythrocytic forms)
Chloroquine example
What 2 effects do 4 amino quinolones have eg chloroquine
Stop Hb digestion in RBCs to stop energy transfer
Stop production of hemeozoin from toxic heme
Which enzyme does chloroquine (4amino quinolones) inhibit to stop production of hemeozoin
Heme polymerase
What are the good things about chloroquine (4 amino quinolone)
Well absorbed
Long t1/2
How do chloroquines stay in the parasite to block heme polymerase and digestion of Hb
Get ionised by acid in the parasitic lysosomes
What is an issue with chloroquine 4 amino quinolone for clinical cure
Parasites become resistant due to efflux of drug
Which types of drugs are quinine methanols
Also clinical / prophylaxis
Give 2 examples of quinine methanols which target erythrocytic forms (clinical)
Quinine
Mefloquine
Which 2 effects does quinine methanols like quinine have on erythrocytic forms
Bind to their dna to prevent rep
Block heme polymerase forming hemeozoin
What is a disadvantage to quinine compared to chloroquine
Quinine has shorter half life
Which Quinine methanol has longest half life
Mefloquine
What are the side effects of Quinine methanols eg quinine
Cns effects like delerious or headache
What do 8 amino quinolones target
Exo erythrocytic stages / radical cure/ hypnozoites eg ovale or virax
Which 2 types of cells do 8 amino quinolone skill
Hypnozoites and gametocytes
What is produced by pro drugs 8 amino quinolones when metabolised in liver which is cytotoxic to host
Quinolone
What does metabolism of 8 amino quinolones cause in people with a G6PDH deficiency
Haemolysis of rbc
Which ADME negative do 8 amino quinolone have
Short t1/2
How do 8 amino quinolone a work for radical / exo erythrocytic cure
Produce ROS which stops dna synthesis and also mt disruption of energy
What type of drugs are anti folates and give example
Prophylaxis
Proguanil
Which metabolic enzyme activated proguanil prodrug
Cyp 2c19
Which enzyme does anti folate proguanil inhibit (type II anti folate)
Dihydrofolate reductase
How have parasites become resistant to anti folates like proguanil
Mutation to their dihydrofolate reductase enzyme
What can anti folates type II like proguanil be given with to stop full dna synthesis
Type I eg sulphonamides
What is the other prophylaxis drug apart from anti folates
Hydroxynapthoquinone
How does hydroxynapthoquinone work
Disrupts ETC to stop getting mt energy
Looks like ubiquinol
What is hydroxynapthoquinone given with for synergistic reasons and to stop resistance
Proguanil anti folate
Which mutation acquired by parasites causes its resistance to hydroxynapthoquinone
Cyt BC1 complex in mitochondria
What are given with anti malarial drugs to stop resistance and enhance their ADME
Artemisin (ACTs)
Which 4 mutations have given malarial parasites resistance
Falciparum transporter gene
Falciparum Na/H exchanger gene
Dihydrofolate reductase (stop anti folates)
Cyt BC1 complex (stops hydroxynapthoquinone)
Which antigen on falciparum is used to detect type
HRP 2
Which other 2 other than falciparum HRP2 antigen is used for diagnostic
Aldolase
Lactate dehydrogenase