Antiparasitic (MC) - Block 3 Flashcards
How do helmiths differ from other parastic infections?
- Multiplies outside definitive host
- Unique ability to evade host immune defenses
Examples of flatworms (platyhelminths)?
Cestode (tapeworms)
Trematode (Flukes or schistosomes)
Examples of nematodes/aschelminths?
Roundworm, hookworm, pinworm, whipworm
Common benzimidazoles?
- Albendazole
- Mebendazole
- Thiabenazole
MOA of benzimidazoles?
- Inhibition of fumarate reductase (involved with the oxidation of NADH ro NAD) -> diminished ATP production and parasite immobilization and death
- Tubulin binding to prevent tubulin polymerization to microtubules
* Impairs glucose uptake and depletes glycogen stores
* Prevents formation of spindle fibers needed for cell division -> blocking egg productio
PK of benzimidazoles?
- Fattymeal will increase absorption
- Poor absorption may be beneficial because the drugs are used to treat intiestinal helminths
Indication for thiabendazole?
Drug of choice for cutaneuos larva migrans (creeping erruption)
MOA of diethylcarbamazine (DEC)?
- Involvement of blood platelets triggered by action of filarial excretory antigens
- Inhibition of microtubule polymerization and diruption of preformed microtubules
- Interference with arachidonic acid metabolism
Describe the activity of DEC?
- Parent drug is active component
- Drug is inactive in vitro -> activation of a cellular component is essential to activity
Indication of DEC?
Effective against microfalariae, however, not effective against adult worm
ADR of DEC?
Mazzotti reaction from host immune response to the presence of dead microfilariae
Inidication for ivermectin?
Effective against nematode infection
MOA of ivermectin?
- interference of microfilarial motility
- Degeneration of microfilariae in utero
How does IVM cause microfilarial motility interference?
IVM binds irreversibly to glutamate gated chloride channels and GABA agonist -> Chloride ion influx appears to be more plausible mechanism -> hyperpolarization and muscle paralysis
How does IVM cause degerenation of microfilariae in utero?
Presence of degenerated microfilariae in utero prevents further fertilization and production of microfilariae
Metabolism of IVM?
- Absorption is significanly affected by the presence of alcohol
- Administration as an alcoholic solution -> 100% increase in absorptio
Indication for IVM?
Treatment for onchocerciasis (African river blindness) caused by Onchocerca vovulus
Indication for moxidectin?
Onchocerca infection (River blindenss) -> milbemycin class
Activity of Praziquantel?
- Highly effective against cestodes and trematodes
- No acivity against nematodes
MOA of Praziquantel?
- Ca2+ redistribution either directly or indirectly
- Helmiths found in the host’s lumen can cause muscle contraction and paralysis leading to worm expulsion
- Worm paralysis by inhibiting phosphoinositide metabolism