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Pharm Final > Antiprotazoal > Flashcards

Antiprotazoal Flashcards

1
Q

Etiology of amebiasis

A

E. histolytica

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2
Q

Etiology of giardiasis

A

Giardia lamblia

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3
Q

Etiology of Trichomoniasis

A

Trichomonas vaginalis

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4
Q

Etiology of Toxoplasmosis

A

Toxoplasma gondii

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5
Q

Etiology of PCP

A

Pneumocystis jirovecii

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6
Q

Symptomatic form of amebiasis

A

tissue form

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7
Q

Transmission of amebiasis

A

contaminated food, water or direct contact

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8
Q

Infective form of amebiasis

A

cysts (trophozoites invade and replicate in tissue)

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9
Q

What do trophozoites invade?

A

Intestine (diarrhea) and liver (abscess)

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10
Q

Giardiasis transmission

A

contaminated food, water, direct contact (very low infective dose)

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11
Q

Most common cause of non-bacterial diarrhea

A

Giardiasis

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12
Q

“beaver fever”

A

giardiasis

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13
Q

Sexually transmitted

A

Trichomoniasis

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14
Q

Sx of trich

A

vaginitis and frothy, yellow discharge

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15
Q

Transmission of toxoplasmosis

A

animals (especially cats)

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16
Q

Fetal infection of toxoplasmosis

A

heart problems, hydrocephalus, retinochoroiditis

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17
Q

PCP etiology

A

pneumocystis jirovecii (carinii); not a protozoa - yeast like fungus

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18
Q

Major cause of death in AIDS patients

A

PCP (give prophylaxis)

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19
Q

Tissue amebicides

A

metronidazole, tinidazole, emetine and dehydroemetine

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20
Q

Luminal amebicides

A

Iodoquinol, Paromomycin, tetracycline & erythromycin

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21
Q

DOC for e. hystolytica

A

Metronidazole + luminal

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22
Q

Giardia lamblia DOC

A

metronidazole

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23
Q

Trich vaginalis DOC

A

metonidazole

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24
Q

Toxoplasma gondii DOC

A

Pyrimethamine-Sulfadiazine (daraprim)

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25
Q

PCP DOC

A

Trimethoprim sulfamethoxazole (Bactrim)

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26
Q

Asymptomatic amebiasis tx

A

luminal (iodoniquinle, paramomycin, tetracycline, erythromycin)

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27
Q

MOA of metronidazole

A

prodrug that reacts with ferredoxin (anaerobes); metabolites are taken up into DNA and form unstable molecules

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28
Q

Kinetics of metronidazole

A 
O, P, T
liver metabolism
distributes widely, CSF
kills amoeba in tissue; combine w/ luminal
eliminated in urine
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29
Q

Side effects of metronidazole

A 
metallic taste (disguesia)
disulfiram-like reaction
GI distrubance
CNS/PNS sx: seizures, peripheral neuropathy (prolonged use)
Candida super infection
hypersensitivity
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30
Q

Tinidazole use

A

used for amebiasis, giardia and trich when metronidazole isn’t tolerated

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31
Q

Kinetics of tinidazole

A

oral; 12 hours half life so one dose/day

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32
Q

Emetine and dehydroemetine (mebadin) use

A

3rd alternative for severe intestinal or systemic E. histolytica

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33
Q

Emetine and dehydroemetine kinetics

A

SC or IM (pain, tenderness and weakness at injection site)

34
Q

emetine and dehydroemetin toxicities

A

cardiotoxicity
serious GI
teratogenicity

35
Q

Contra for emetine

A

renal or cardiac disease

pregnancy

36
Q

Iodoquinol use

A

asymptomatic amebiasis

37
Q

Iodoquinol kinetics

A

oral; little absorption (luminal)

38
Q

Toxicities of iodoquinol

A

skin rxn, H/A, diarrhea
High iodine content- thyroid enlargement
Eye effects (neuritis, atroph) leading to blindness

39
Q

Paromomycin MOA

A

aminoglycoside; 30s subunit

40
Q

Paromomycin kinetics

A

Oral, cream (t. vaginalis)

not signnificantly absorbed from GI (luminal)

41
Q

Paromomycin use

A

asymptomatic amebiasis (w/ metro of symptomatic), giardiasis, T. vaginalis

42
Q

Side effect of paromomycin

A

GI upset

43
Q

Tetracycline and erythromycin use

A

amebiasis and giardiasis (+ metro for symptomatic)

44
Q

DOC for toxoplasmosis

A

Daraprim

45
Q

Toxicity of daraprim

A

heme disorder at high dose

46
Q

What do you give with daraprim and why?

A

Leucovorin; folic acid syn inhibitor (DHFR)

47
Q

PCP DOC

A

Bactrim

48
Q

MOA of Bactrim

A

folic acid syn inhibitor

49
Q

Use of Bactrim

A

DOC for PCP

Can be used as 2nd option for toxoplasmosis (daraprim is firrst)

50
Q

Prophylaxis for P. jirovecii in HIV

A

Bactrim (30% of patients can’t tolerate; give pentamidine instead)

51
Q

Pentamidine use

A

alternative for PCP (P. jirovecii) in those that can’t tolerate bactrim

52
Q

MOA of pentamidine

A

inhibit DNA replication

53
Q

Pentamidine kinetics

A

IM injection (active) or nebulization (prophylaxis)

54
Q

Toxicities of pentamidine

A

hypoglycemia, hypotension, arrythmias (occasion: hyperglycemia, tachy, H/A, vomiting, bronchospasm, renal dysfunction, Ca loss, hepatic failure)

55
Q

Nematodes

A

Roundworms

56
Q

Cestodes

A

Tapeworms

57
Q

Trematodes

A

flukes

58
Q

Shistosomes

A

blood flukes

59
Q

MOA of antihelminthic tx

A

energy metabolism
neuromuscular coordination
microtubular function
cell permeability

60
Q

DOC for roundworms

A

abendazole, mebendazole or pyrantel pamoate

61
Q

Alternative for round worm tx

A

ivermectin

62
Q

DOC for flukes

A

praziquantel

63
Q

DOC for tapeworms

A

Praziquantel

64
Q

Alternate for flukes

A

bithionol

65
Q

Alternate for tapeworms

A

Niclosamide

66
Q

Albendazole/Mebendazole kinetics

A

Oral

broad-spectrum: round, whip, hook, pin (mixed roundworm infections)

67
Q

MOA of albendazole/mebendazole

A

inhibits microtubule polymerization by binding to B-tubulin; inhibits microtubule-dependent uptake of glucose leading to immobilization and death

68
Q

Effects of albendazole/mebendazole

A

embryotoxic/teratogenic
well tolerated- some ab discomfort
Monitor LFT in long term tx

69
Q

Pyrantel pamoate kinetics

A

Oral;
broad spectrum (round, pin, hook)
Available OTC

70
Q

MOA of pamoate

A

cholinesterase inhibitor; produces depolarizing neuromuscular blockade in the worm

71
Q

OTC tx for roundworm

A

pyrantel pamoate

72
Q

Ivermectin use

A

alternative for roundoworm tx; (nematodes, insects, and acarine parasites, threadworm , round, cutaneous larva migrans)

73
Q

MOA of ivermectin

A

paralyzes parasite; intensifies GABA-mediated transmission of signals in peripheral nerves

74
Q

Side effects of ivermectin

A

minimal, pruritus, tender lymph nodes and fever

75
Q

Praziquantel use

A

DOC for flukes and tapeworm (all schistosomes too)

76
Q

Praziquantel kinetics

A

oral

77
Q

MOA of praziquantel

A

increasing worms permeability to Ca, results in contraction and paralysis of worms muscles, dislodgement and death

78
Q

Side effects of praziwuantel

A

N/V, ab discomfort

79
Q

Bithionol use

A

alternative for fluke tx

Only DOC for sheep liver flukes

80
Q

Side effects of bithionol

A

mild N/V, H/A, diarrhea, dizziness, urticaria, and rash

81
Q

What are the toxic effects of antihelmnith tx due to

A

release of antigens from dying worm

Pharm Final (6 decks)

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