Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology Infectious Disease > Antimalarial & Antiparasitic > Flashcards

Antimalarial & Antiparasitic Flashcards

1
Q

Three parasitic infections associated with HIV in the US

A

Pneumocystic jirovecii - Pneumonia
Toxoplasma gondii - Encephalitis
Cryptosporidium - Cryptosporidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Three parasitic infections associated with HIV Globally

A

Malaria, Leshmania

Trypanosoma cruzi - Chagas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Who is most likely to contract fatal malarial cases?

A

African children < 5 years old. If they make it past 5, they developed preventative immunity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the Plasmodium responsible for most malarial deaths and why?

A

P. falciparum. Africa, SE Asia, South America. P. falciparum can infect RBCs of all ages (vs. others can only infect reticulocytes).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Regions here P. vivax and P. ovale are found. What type of malaria do they cause and why?

A

vivax - subtropics and temperate regions.
ovale - West Africa.
relapsing - hypnozoites in the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the time courses of the erythrocytic lytic cycle of P. falciparum, P. vivax, P. ovale, P. malariae, and P. knowlesi?

A

P. falciparum - continuous
P. malariae - 72 hrs. (quartan)
P. vivax and ovale - 48 hours (tertian)
P. knowlesi - 24 hrs. (secondary) - RAPID DISEASE progression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the names of the different stages of the malaria parasite life cycle? Which stage is infectious? which stage is latent? Which stages are sexual vs. asexual?

A

Sporozoites injected by mosquito, Schizonts and Hypnozoites (latent) formed in the LIVER. Schizonts are asexual. Schizonts invade RBCs, divide, rupture RBC, release Merozoites that re-invade. Merozoites are sexual and produce gametocytes. Gametocytes taken up by mosquito.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What do most malarial drugs target? What are there NO drugs for, and why is this significant?

A

Target parasite lifecycle and NOT the inflammatory response. No drugs for sporozoite form - therefore cannot prevent infection of cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a schizonticide? An exoerythrocytic schiznocide? An erythrocytic schizonticide?

A

Attacks the liver forms (exoerythrocytic) and early blood stages (erythrocytic).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a gametocide?

A

Kills sexual stages and prevents transmission to mosquito.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is cinchonism? What can cause these?

A

Tinnitis, headache, nausea, dizziness, flushing, & visual disturbances. Quinine adverse effect.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What constitutes a severe malarial infection? How do you treat this?

A

Impaired consciousness/coma, severe normocytic anemia, renal failure, pulmonary edema, etc. Quinidine gluconate IV + antibiotic w/ cardiologist & infectious diseases consult OR Artesunate IV from CDC (IND) with Malarone, Doxy/Clinda, or Melfloquine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which drugs act on the gametocyte stages of plasmodium?

A

Artemisin (dihydroartemisinin, aresunate, artemether), melfloquine, primaquine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What drugs act on the liver stages of plasmodium?

A

Primaquine and Atovaquone. Only primaquine acts on the hypnozoites.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which drugs can be used for malaria prophylaxis? What are their dosing regimens?

A

Melfloquine - >2wks before, 4 wks after
Chloroquine - 1-2 wks before, 4 wks after
Doxycycline/Tetracycline - 1-2 days before, 4 wks after
Primaquine - 1-2 days before, 7 days after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which anti-malarial is first line treatment?

A

Chloroquine/Hydroxychloroquine - ONLY IN SENSITIVE AREAS. High levels of resistance.

17
Q

G6PDH Deficiency is a contraindication for the use of which anti-malarials and why?

A

Quinine, Quinidine, Primaquine. Can cause severe hemolytic anemia.

18
Q

What two anti-malarials can be given IV? Why is this significant?

A

Quinine/Quinidine and Aresunate. They are both agents used for severe malarial infections.

19
Q

What two anti-malarials cannot be used prophylactically and why?

A

Artemisinins and Quinine/Quinidine - They are rapid acting and don’t stay around long enough to be prophalactic.

20
Q

What three anti-malarials also have activity against other parasites?

A

Quinine/Quinidine - Babesiosis
Atovaquone - Pneumocystis jiroveci
Pyrimethamine/Proguanil - Toxoplasmosis

21
Q

Which anti-protozoal drugs are contraindicated in pregnancy

A

Artemisinin - in the 1st trimester
Doxycycline/Tetracycline - Use Chloroquine alternatively
Meltifosine

22
Q

What anti-malarial is contraindicated in patients with psoriasis, porphyrias, retinal/visual field abnormalities, or myopathies?

A

Chloroquine, Hydroxychloroquine

23
Q

What are 3 Artemisinin antimalarial drugs? What is their mechanism of action?

A

Artemisinins: Artemisinin, dihydroartemisinin, aresunate, artemether.

Artemisinins - Endoperoxide generates toxic free radicles that damage ATPase in ER (PfATP6). CONCENTRATION DEPENDENT KILLING

24
Q

What are five 4-aminoquinoline antimalarial drugs? What is their mechanism of action

A

4-Aminoquinolines: Chloroquine, Hydroxychloroquine, quinine, Quinidine, Melfloquine.

4-Aminoquinolines: Prevent heme polymerization and detoxification to hemozoin in plasmodium food vacoule. TIME-DEPENDENT KILLING

25
Q

What is the mechanism of Atovaqone?

A

Antimalarial - Binds CytC and disrupts electron transport

26
Q

What anti-folates can be used for malaria treatment? What are their mechanisms?

A

Pyrimethamine/Proguanil - Inhibits plasmodium dihydropteroate synthase

Sulfadoxine - Inhibits plasmodium dihydrofolate reductase

Should be taken in combination

27
Q

What 6 Anti-Malarial Drugs should be taken in combination?

A
  1. Artemisinins - Lumefantrine, melfloquine (slower acting pair prevents recrudescence)
  2. Dihydroartemisinin - + piperaquine
  3. Atovaquone - prevent resistance
  4. Pyrimethamine/Proguanil - + Sulfadiazine or clinda if treating toxoplasma
  5. Pyrimethamine/Proguanil + sulfadoxine - prevent resistance
  6. Doxy/Tetra - w/ quinine/quinidine
28
Q

Which drug puts patients at risk for cnincohonisms, hypotension, and Blackwater Fever?

A

Quinine/Quinidine
Hypotension - w/ rapid infusion
Blackwater fever - in G6PD deficient

29
Q

What drug has P. falciparum developed widespread resistance to and how? How does P. Vivax resistance to this drug differ?

A

Chloroquine - efflux pump (PfMDR1) from mutation in PFCRT1 prevents accumulation in food vacoule

P. vivax - different mechanism, ONLY in Papua guinea and Indonesias

30
Q

Which antimalarial can cause neuropsychiatric toxicity?

A

Melfloquine

31
Q

What can be used to treat Anaerobic protozoa & bacteria (Giardia, Entamoeba, Trichomonas)?

A

Metronidazole (flagyl) or TInidazole - Activated by e- donation from microbe ETC.

Treat EXTRAINTESTINAL infection - combine w/ luminal durg

32
Q

What luminal agent can be used to treat Entamoeba histolytica dysentry?

A

Iodoquinol

Combo for systemic infections. Solo for asymptomatic infections.

33
Q

What can pentamidine be used to treat?

A

T. brusi (Gambiense - West African) Acute
Visceral leishmania
Pneumocystis jirovecii

34
Q

What are the acute and late (CNS) treatments for Trypanosoma brusi (African Sleeping Sickness) - both East (Rhodesiense) and west (Gambiense)?

A

Rhodesiense - East: Acute - Suramin, Late - Melarsoprol

Gambiense - West: Acute - Pentamidine, Late - Eflornithine

35
Q

What is used to treat T. cruzi (Chagas)

A

Nifurtimox or Benznidazole - Acute phase only, does not prevent disease progression

36
Q 
What are the toxicities of the following non-malarial antiprotozoal drugs:
Metronidazole
Tinidazole
Pentamidine
Melarsoprol
Nifurtimox
Miltefosine
A 
Metronidazole & Tinidazole - Neurotoxicity, Antabuse w/ alcohol
Pentamidine - Hypoglycemia, nephrotoxic
Melarsoprol - Encephalopathy, 50% death
Nifurtimox - Hypersensitivity, GI upset
Miltefosine - Tetratogen
37
Q

What two drugs are contraindicated in alcoholics?

A

Metronidazole and Tindazole - Inhibit Acetaldehyde DH

38
Q

What are these drugs?
Fandisar
Lariam
Coartem

A

FANDISAR - combination pyrithamine + sulfadoxine
LARIAM - Melfloquine
COARTEM - Artemeter + Lumefantrin

Pharmacology Infectious Disease (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions