Antiparasitics

Question 1

Most common and severe form of malaria

Answer 1

Falciparum malaria

Question 2

Milder form of malaria that can remain dormant in liver and relapse

Answer 2

Vivax malaria

Question 3

Drugs for malaria prophylaxis

Answer 3

Chloroquine
Primaquine

Question 4

Drugs for treatment of active or latent malarial infection

Answer 4

Artemether/lumefantrine
Chloroquine
Primaquine

Question 5

Blood stage antimalarials (produce clinical cure)

Answer 5

Chloroquine
Artemisinins

Question 6

Liver stage antimalarials (produce radical cure of relapsing malaria)

Answer 6

Primaquine

Question 7

____ stage antimalarials are ineffective against ____ stage parasites

Answer 7

Blood
Liver

Question 8

Prophylactic drugs must be ____ effective, ____ half lives, and ____ toxicity

Answer 8

Orally effective
Long half-lives
Low toxicity

Question 9

Chloroquine MOA

Answer 9

Inhibits biocrystallization of toxic hematin (product of hemoglobin digestion) by ion trapping of drug in parasite food vacuole

Question 10

Clinical uses of chloroquine

Answer 10

Clinical cure and prophylaxis against sensitive strains (ineffective against most strains of P. falciparum in Africa, Asia, and S. America)
Can be used during pregnancy

Question 11

Chloroquine adverse effects

Answer 11

Prophylactic doses- none
Curative doses- pruritus, headaches, CV toxicity

Question 12

Artemether MOA

Answer 12

Unclear; may produce free radicals in presence of heme

Question 13

Why is Artemether not useful for prophylaxis?

Answer 13

Short half-life (1-3 hr)

Question 14

What drug is Artemether usually combined with?

Answer 14

Lumefantrine

Question 15

Why is lumefantrine added to Artemether?

Answer 15

Has a long half life to sustain antimalarial activity so it’s more useful for prophylaxis

Question 16

First line oral treatment of MDR falciparum malaria

Answer 16

Artemether-lumefantrine

Question 17

Prototype liver stage antimalarial

Answer 17

Primaquine

Question 18

Primaquine MOA

Answer 18

Unknown

Question 19

Clinical uses of primaquine

Answer 19

Paired with chloroquine to achieve clinical and radical cure
Terminal prophylaxis
Primary prophylaxis

Question 20

Contraindications of primaquine

Answer 20

Hemolytic anemia in pts with G6PD deficiency
Pregnancy (in endemic areas)

Question 21

Common protozoal infections

Answer 21

Trichomoniasis (genital STI)
Giardiasis (GI)
Amebiasis (GI)
Cryptosporidiosis (GI)

Question 22

Systemic antiprotozoal

Answer 22

Metronidazole

Question 23

Metronidazole MOA

Answer 23

Prodrug converged to DNA-damaging metabolite in anaerobic organisms

Question 24

Luminal antiprotozoal drug

Answer 24

Paromomycin

Question 25

Paromomycin MOA

Answer 25

Aminoglycoside not absorbed in GI tract

Question 26

Clinical uses of Paromomycin

Answer 26

Amebiasis
Cutaneous leishmaniasis
Alternative to metronidazole in pregnancy

Question 27

Benzimidazoles are anti____

Answer 27

Antheominthics

Question 28

Prototype benzimidazole drug

Answer 28

Albendazole

Question 29

Albendazole MOA

Answer 29

Inhibits parasite B-tubulin to prevent formation of microtubules to disrupt motility and uptake of glucose of organism

Question 30

Adverse effects of Albendazole

Answer 30

Teratogenic
Hepatotoxicity
Bone marrow suppression

Question 31

Ivermectin is anti___

Answer 31

Anthelminthics

Question 32

Ivermectin MOA

Answer 32

Immobilization of parasite by tonic muscle paralysis

Question 33

Ivermectin clinical uses

Answer 33

Broad spectrum against nematodes and arthropods in vet medicine
Scabies and lice
Onchocerciasis

Question 34

Adverse effects of ivermectin

Answer 34

Mazzotti reaction- immune reaction to dying worms o
Teratogenic