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Pharmacology > Antiparasitics > Flashcards

Antiparasitics Flashcards

1
Q

symptoms of amebiasis

A

mild diarrhea to fulminating dysentery

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2
Q

form of entamoeba histolytica and where they survive

A

cysts (survive outside the body)

trophozoite (do not survive outside body)

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3
Q

what are mixed antamebics and name them

A

Metronidazole and Tinidazole

they are active against luminal and systemic disease

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4
Q

what happens to metronidazole once it is absorbed aka mechanism of the drug

A

nonenzymatically reduced by reacting with ferredoxin –> production of cytotoxic compounds –> bind to protein and DNA –> CELL DEATH

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5
Q

adverse effects of metronidazole

A
  • Disulfiram like reaction
  • Dark colored urine
  • Unpleasant metallic taste
  • GI distress
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6
Q

what is Tinidazole used for and compare it to metronidazole

A

-better tolerated than metronidazole and has shorter duration of effects

used for amebiasis, amebic liver abscesses, giardiasis, trichomoniasis

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7
Q

what are the luminal antiamebics

A

Diloxanide Furoate
Iodoquinol
Paromomycin

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8
Q

adverse effects of diloxanide furoate

A

mild GI distress

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9
Q

adverse effects of Iodoquinol

A

if used long term –> optic neuritis

dose related peripheral neuropathy

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10
Q

mechanism of paromomycin

A

aminoglycoside antibiotic that causes cell membrane to leak by interfering with bacterial protein synthesis by binding to 30S

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11
Q

adverse effect of paromomycin

A

GI distress and diarrhea

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12
Q

what are the systemic antiamebics and what they are used to treat

A

Chloroquine
Emetine
Dehydroemetine

used for treating liver abscesses or intestinal wall infections

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13
Q

mechanism of chloroquine

A

it eliminates trophozoites in liver abscesses

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14
Q

mechanism of emetine and dehydroemetine

A

inhibits protein synthesis by blocking ribosomal movement along messenger RNA

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15
Q

adverse effects of emetine and dehydroemetine

A

Pain at site of injection
Cardiotoxicity
Neuromuscular Weakness

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16
Q

what are the three helminths and describe them

A

Nematodes - elongated roundworms that cause infection of intestine, blood, and tissue

Trematodes - leaf shaped flatworms: liver, intestinal, or blood flukes

Cestodes - flat, segmented bodies that attach to host’s intestines

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17
Q

how do antihelminths works

A
  • locally to expel worms from GI tract

- systemically to eradicate adult helminths or developmental forms

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18
Q

what are the benzimidazoles and a common contraindication they all share

A

Albendazole
Mebendazole
Thiabendzole

Pregnancy

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19
Q

mechanism of Albendazole

A

inhibits microtubule synthesis and glucose uptake –> reduction of ATP production –> worm immobilization –> death

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20
Q

what is Albendazole used to treat

A

cestodal infections like

  • Cysticercosis (Tania Solium)
  • Hyatid disease (Echinococcus)
21
Q

adverse of albendazole

A

inflammatory responses to dying parasites in CNS

-headache, hyperthermia, vomiting, convulsions

22
Q

contraindications of albendazole

A

pregnancy and children under 2

23
Q

mechanism of mebendazole

A

inhibits formation of helminths microtubules by irreversibly blocking glucose uptake –> parasites expelled in feces

24
Q

clinical applications of mebendazole

A

Whipworm - Trichuris
Pinworm - Enterobius Vermicularis
Hookworms - Necator americanus and Anyclostoma duodenale
Roundworms - Ascaris

25
Q

contraindication of mebendazole

A

pregnancy

cautious in those under 2 and those with cirrhosis

26
Q

mechanism of thiabendazole

A

affects microtubular aggregation

27
Q

clinical applications of thiabendazole

A

Strongyloides Stercoralis (threadworm)
Cutaneous Larva Migrans
Trichinosis

28
Q

adverse effects of thiabendazole

A

Stevens Johnson rash
Erythema Multiforme
CNS disturbances

29
Q

mechanism of Ivermectin

A

GABA agonist –> Cl influx –> hyperpolarization of nerve/muscle cell –> paralysis of parasite –> death of parasite

30
Q

clinical application of ivermectin

A

Strongyloides (STI)
Onchera Volvulus
Cutaneous Larva Migrans

31
Q

adverse effect of Ivermectin and contraindication

A

Mazotti like reactions with onchoceriasis
-fever, somnolence, dizziness, hypotension

-Contraindicated in pregnancy and meningitis (may cross BBB)

32
Q

What is Piperazine used to treat and its mechanism

A

GABA agonist that causes expulsion of warm by peristalsis –> used to treat pinworms and roundworms

33
Q

contraindications of piperazine

A

seizure disorders

34
Q

MOA of Pyrantel Pamoate and clinical application

A

depolarizing, neuromuscular blocker

round worms, pinworms, hookworms

35
Q

MOA of diethylcarbamazine and clinical application

A

immobilizes microfilariae and makes them susceptible to host defenses

lymphatic filariasis, loiasis, and tropical eosinophilia

36
Q

what are most diethylcarbamazine adverse effects due to and what is most common

A

due to host responses following damage or death of parasite

leukocytosis

37
Q

MOA of doxycycline and what it is used for

A

indirectly kills wolbachia (intracellular bacterial symbiont of filarial parasites)

Wuchereria Bancrofti and Onchocerciasis

38
Q

MOA of pranziquantel and clinical applications

A

increases permeability of cell membrane to calcium –> contracture and paralysis of worm –> detachment of suckers from blood vessel walls

schistosomiasis and most trematode and cestode infections

39
Q

adverse effects of pranziquantel and contraindications

A

drug interaction of CYP450

contraindicated in pregnancy, nursing mothers, and treatment of ocular cysticercosis

40
Q

MOA and clinical application of bithionol

A

inhibition of helminth’s electron transport chain

drug of choice for fasciolosis (sheep liver fluke)

41
Q

MOA and clinical app of niclosamide

A

inhibits mitochondrial phosphorylation of ADP –> lethal to cestode scolex and segments of cestode but not ova

most cestode infections

42
Q

what do you give before administering niclosamide and what do you avoid

A

give laxative to purge all dead segment of cestode in order to preclude digestion of and liberation of ova

avoid alcohol within a day of giving dose

43
Q

what are the antihelminths

A

PPPin bamDD

Piperazine
Praziquantel
Pyrantel Pamoate
Ivermectin
Niclosamide
Bithionol
Albendazole
Mebendazole
Diethylcarbamazine
Doxycycline
44
Q

what is pentamidine used for

A

hemolymphatic stage of trypanosomiasis and pneumocystis jirovecii infections

45
Q

used for treatment of toxoplamosis

A

Pyrimethamine + Clindamycin or Sulfadiazine + folinic acid

46
Q

treatment of leishmaniasis of all stages

A

sodium stibogluconate or amphoteracin B

47
Q

uses to treat African Trypanosomiasis (sleeping sickness)

A

Suramin or Melarsoprol

48
Q

what is co-trimoxazole used for (trimethoprim-sulfamethoxazole)

A

pneumocystic jirovecii infections

Pharmacology (79 decks)

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