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Pharmacology Infectious Disease > Antihelminthic > Flashcards

Antihelminthic Flashcards

1
Q

What is unique about the lifecycle of worms?

A

Multiply outside of their hosts - killing adults in host leads to permanent reduction of worm burden.
Exceptions: Strongyloides, Echinococcus.

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2
Q

Name 6 Intestinal Roundworms and their sources.

A
  1. Enterobius vermicularis (pinworm)- Food w/ eggs
  2. Ascaris lumbricoides (giant round) - Fecal-oral eggs
  3. Strongyloides stercoralis (thread) - Larvae penetrate skin
  4. Necator/Ancylostoma (hook) - Larvae penetrate skin
  5. Trichuris trichura (whip) - Food w/ eggs
  6. Trichinella spiralis - Larvae in undercooked pork
    MNEUMONIC: Ryan had 2 TRICHS played on him and he got ASCARe and ROLLED (roundworm) his ankles even through he had STRONG ANCYLs. This gave him ENTERic problems (enterobius and intestinal roundworms).
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3
Q

Medications for Intestinal Roundworms

A

Bendazoles, pyrantel pamoate, Ivermectin (strongyloides)

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4
Q

Name 4 Tissue Roundworms and their transmission.

A
  1. Dracunculus medinensis - Drinking water
  2. Onchocerca volvulus - Female blackfly
  3. Loa loa - Deer, horse, and mango flies
  4. Wuchereria bancrofti - Female mosquito
  5. Toxocara canis/cati - Food w/ eggs
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5
Q

Name 4 tapeworms (cestodes) and their transmission.

A
  1. Taenia saginata - larvae undercooked beef
  2. Taenia solium - larvae undercooked prok
  3. Diphyllobrothrium latum - Larvae freshwater fish
  4. Echinococcus granulosus - Eggs dog feces
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6
Q

Which is the largest tapeworm?

A

Diphyllobrothrium latum - 10m

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7
Q

What is the main problem with Taneia solium infections?

A

Neurocysticercosis. Ingest oncospheres –> hatch –> invade and migrate into mm, brain, liver –> cysticerci

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8
Q

Name 3 trematodes (flukes) and their transmission.

A

Schistosoma - snails
Clonorchis sinensis - undercooked fish
Paragonimus westermani - undercooked crab

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9
Q

What causes the symptoms associated with bloodflukes (schistosoma)?

A

Immune reaction with eggs.

Headache, fatigue, fever, GI problems, Hepatic fibrosis, ascites, bladder cancer.

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10
Q

What drug is used for flatworms? What is the one exception?

A

Praziquantel - for cestodes and trematodes.

Except - Echinococcus granulosus - use bendazoles.

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11
Q

What is the most common worm infection in the world?

A

Ascarasis. Associated with poor sanitation.

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12
Q

What two worms are associated with undercooked pork?

A

Taenia solium - Intestinal and neural stage

Trichinella spiralis - Intestinal and mm stages

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13
Q

What is one major sign of filariasis?

A

Elephantiasis from lymphatic dwelling.

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14
Q

What is the main goal of helmnith therapy?

A

Reduce the worm burden.

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15
Q

What is the mechanism of Praziquantel? What do you treat with this?

A

Disrupts clacium homeostasis –> mm spasms –> dislodge and kill worms

Treat Flatworms (trematodes, cestodes)

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16
Q

What is the mechanism of Benzimidazoles? What are three examples?

A

Bind microtubule + end and prevents growth. Shortening continues from the - ends.

Examples: Albendazole, Mebendazole, Thiabendazole

17
Q

A fatty meal needs to be taken with what anti-helminthic medication and why?

A

With ALL benzimidazoles WHEN TREATING TISSUE INFECTIONS - needed to enhance tissue uptake of the medication.

For luminal infections - take on an empty stomach

18
Q

Why would you use Albendazole over Mebendazole?

A

Albendazole:

  • Also treats cystercosis (cestode) in addn. to Intestinal nematodes
  • CAN be used in pregnancy
  • Activated in liver (less toxicity/less excretion impairment if liver damage)
19
Q

When would you use Thiabendazole?

A

Never - toxicity, Can’t be used in pregnancy.

20
Q

What is Diethylcarbamazine used to treat? What might you co-administer and why?

A

Filariasis: Loa Loa, Wurchereria bancrofti (drug of choice)

Possibly with doxycycline: Kill Wolbachia encosymbiont

21
Q

What is the Mazzotti reaction? When is this seen?

A

An immune reaction to dying worms: Papular rash, itching, enlarged lymph nodes, fever, arthralgias.

Seen especially in filiarial diseases, particularly Onchocerca volvulus.

22
Q

What is Ivermectin used to treat? What is its mechanism of action?

A

Strongyloides and Onchocerca.

Paralyzes parasites by binding Cl- ion channels - ENHANCES GABA signaling.

23
Q

What drug is sometimes used in mass treatment programs - e.g. in school children?

A

Ivermectin - because larvae in soil penetrate skin for Strongyloides

24
Q

What is Pyrantel pamoate used to treat?

A

Broad spectrum

Alternative to Benzimidazoles for Enterobius, Ascaris, and Necator/Ankylostomata

25
Q

What is the mecahnism of pyrantel pamoate? What anti-helmnithic is it similar to and how do the two differ?

A

Both ivermectin and pyrantel pamoate work on neurotransmitters to paralyze and expel the organism.

Pyrantel pamoate causes Ach release and Cholinesterase inhibition.

26
Q

What is the treatment for head lice and scabies?

A

permethrin w/ 2nd application 10 days following

pre treat scabies w/ salicyclic acid if crusted

Pharmacology Infectious Disease (8 decks)

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