Antimalarials (lecture) Flashcards
What is the MoA of Quinoline?
Impair intra-parasitic heme polymerization into hemozoin - the parasite chokes on its own shit.
What drug must be used in Pv and Po infections and why?
Primaquine: it will get Plasmodium in the gamete and schizont (liver) stages.
What is first line treatment in complicated P. falciparum infection?
quinine
What is the most concerning toxicity of quinine?
prolonged QT interval
Patient returned from South America and exhibited signs of uncomplicated malaria infection. Two days after admission and treatment he began to show confusion and seizure activity. What is the most likely cause of his confusion and seizures?
Quinine is known to induce hypoglycemia.
What is the second line Rx for P. falciparum (chloroquine resistant)?
Mefloquine
Pregnant woman who was recently started on malaria treatment is now complaining of extreme nightmares. What is the most likely cause?
Mefloquine (first line treatment for pregnancy) is known to cause very vivid dreams.
What must be verified prior to Primaquine administration?
No G-6-PD deficiency - it causes hemolytic anemia in this population
Proguanil and Pyrimethamine are both examples of what class of medications?
Antifolates
What is the first line intermittent preventive treatment used in pregnant women?
sulfadoxine-pyrimethamine
What is given for causal prophylaxis of malaria?
Atovaquone
What is first line treatment in uncomplicated malaria?
Artemether-lumefantrine
What is first line treatment in severe malaria infections worldwide? What about in the U.S.?
Artesunate - worldwide
Quinidine in the U.S.
