Antimalarial

Question 1

What are the two Plasmodium protozoans?

Answer 1

Plasmodium Vivax

Plasmodium Falciparum

Question 2

What disease is Plasmodium associated with?

Answer 2

Malaria

Question 3

What are the symptoms of Malaria?

Answer 3

fever
chills
headaches
sweats
fatigue

Question 4

When do the symptoms of Malaria appear?

Answer 4

9-40 days after infection

Question 5

What stage does Chloroquine act on?

Answer 5

erythrocytic stage

Question 6

ADRs of Chloroquine?

Answer 6

Bitter taste
Non-allergic pruritis (constant itching) of African descent
PROLONGED QTc
HEART BLOCK

Question 7

What must you monitor with Chloroquine?

Answer 7

QTc
K+
Magnesium

Question 8

What must you dose adjust for with Chloroquine?

Answer 8

liver

Question 9

What stage does Atovaquone-Proguanil act on?

Answer 9

Erythrocytic AND exo-erythrocytic stages

Question 10

What is the MOA of Atovaquone-Proguanil?

Answer 10

Atovaquone = inhibits mitochondrial electron transport
Proguanil = inhibits dihydrofolate reductase required for deoxythmidylate (pyrimidine) synthesis

Disrupts DNA synthesis in malarial parasite

Question 11

What are the ADRs of Atovaquone-Proguanil?

Answer 11

Nausea/Vomiting
Insomnia
Headache
Mouth Ulcers
Hairloss
Thrombocytopenia

Question 12

What must you monitor with Atovaquone-Proguanil?

Answer 12

CBC
SCr
BUN

Question 13

What must you dose adjust for with Atovaquone-Proguanil?

Answer 13

REnal

Question 14

What stage does Artemether-Lumefantrine act on?

Answer 14

erythrocytic stage

Question 15

What is the MOA of Artemether-Lumefantrine?

Answer 15

both inhibit DNA and protein synthesis

Question 16

What are the ADRs of Artemether-Lumefantrine?

Answer 16

Nausea/Vomiting
Arthalgia
Headache
Sleep Disturbances
Weakness
Fever/Chills
QTc PROLONGATION

Question 17

What must you monitor with Artemether-Lumefantrine?

Answer 17

QTc
K+
Magnesium

Question 18

What must you dose adjust for with Artemether-Lumefantrine?

Answer 18

Liver

Question 19

What is the IV formulation of Artemether-Lumefantrine and where is it available?

Answer 19

Artesunate

From CDC

Question 20

What stage does Mefloquine act on?

Answer 20

erythrocytic stage

Question 21

What are the ADRs of Mefloquine?

Answer 21

Nausea/Vomiting
Mood Changes
Strange Dreams
Insomnia
Convulsions
Prolonged Qtc

Question 22

What patients must you avoid use of Mefloquine in?

Answer 22

those with psychiatric disorders or seizure disorders

Question 23

What must you monitor with Mefloquine?

Answer 23

Qtc
K+
Magnesium

Question 24

What must you dose adjust for with Mefloquine?

Answer 24

Liver

Question 25

What stage does Primaquine work on?

Answer 25

exoerythrocytic stage

Question 26

What are the ADRs of Primaquine?

Answer 26

Nausea/Vomiting

Question 27

What must you monitor with Primaquine?

Answer 27

CBC

Question 28

What must you get when using Primaquine?

Answer 28

initial G6PD screen

Question 29

What patients can you NOT use Primaquine with?

Answer 29

patients with G6PD deficiency/Hemolytic Anemia

Question 30

What stage does Quinine work on?

Answer 30

Erythrocytic stage

Question 31

What are the ADRs of Quinine?

Answer 31

``` Tinnitus headache visual disturbances hemolytic anemia arrythmias hypoglycemia ```

Question 32

What must you monitor with Quinine?

Answer 32

CBC

Question 33

What must you get when using Quinine?

Answer 33

initial G6PD screen

Question 34

What patients can you NOT use Quinine in?

Answer 34

those with G6PD deficiency

Question 35

What stage does doxycycline work in?

Answer 35

erythrocytic stage

Question 36

What is the MOA of doxycycline?

Answer 36

inhibits protein synthesis

Question 37

What are the ADRS of doxycycline?

Answer 37

Hepatotoxicity Photosensitivity Enamel agenesis Vestibular toxicity

Question 38

What must you monitor with Doxycycline?

Answer 38

LFTs

Question 39

What must you dose adjust for with Doxycycline?

Answer 39

Liver

Question 40

What stage does Clindamycin work on?

Answer 40

Erythrocytic stage

Question 41

What is the MOA of Clindamycin?

Answer 41

inhibits protein synthesis

Question 42

What are the ADRs of Clindamycin?

Answer 42

Nausea/Vomiting | Diarrhea (C.diff)

Question 43

What must you dose adjust for with Clindamycin?

Answer 43

Liver