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Pharm I Final Review > Antiprotozoal & Antihelmintic Agents > Flashcards

Antiprotozoal & Antihelmintic Agents Flashcards

1
Q

Amebiasis

A

Entamoeba histolytica
Often infects whole household
Can be symptomatic and asymptomatic (but infective)

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2
Q

Treatment of Amebiasis

A 
Luminal stage (infective cysts in intestines but NOT symptomatic)
• Treat with luminal amebicide (paromomycin or Iodoquinol)
Systemic stage (trophozoites in liver —> symptoms!)
• Treat with tissue amebicide AND luminal amebicide
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3
Q

DOC for Amebiasis

A

Metronidazole

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4
Q

Giardiasis

A

Transmission from contaminated water/food
Most common cause of non-bacteria diarrhea in US
“Beaver fever” - zoonotic disease, colonizes in small intestine —> extreme malabsorption

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5
Q

DOC for giardiasis

A

Metronidazole

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6
Q

Trichomoniasis

A

Sexually transmitted urogenital parasite
Men asymptomatic
Women —> vaginitis with frothy, yellow discharge

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7
Q

DOC for trichomoniasis

A

Metronidazole!

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8
Q

Toxoplasmosis

A

Common in many animals, especially cats

Mild infection in most but fetal infection —> heart problems, hydrocephalus, retinochorioiditis

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9
Q

Pneumocystosis jirovecii/carina

A

Not a Protozoa but a yeast like fungi
Major cause of death for AIDS patients (PCP)
HIV therapy may include prophalaxis (Bactrim) against this

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10
Q

Tissue amebicides

A

***Metronidazole
Tinidazole
Emetine and Dehydroemetine

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11
Q

DOC for toxoplasmosis

A

Pyrimethamine (Daraprim) plus sulfadiazine plus folinic acid

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12
Q

Luminal Amebicides

A

Iodoquinol
Paromomycin
Tetracycline and Erythromycin

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13
Q

Metronidazole

A

DOC for Invasive Amebiasis (symptomatic) + luminal amebicide, Giardiasis and trichomoniasis

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14
Q

MOA for Metronidazole

A

Prodrug, non-enzymatically reduced by reacting with reduced ferredoxin (only found in anaerobes)

Kills amoeba in tissues but not cysts - combine with a luminal amebicide for amebiasis

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15
Q

Metronidazole adverse side effects

A

Metallic taste

Disulfiram like reaction to alcohol

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16
Q

Tinidazole

A

Newer drug derived from metronidazole
Same indications as metro
Same use and adverse side effects

17
Q

Emetine and Dehydroemetine

A

Alternative to those who don’t respond to metro to tinidazole but super toxic

Cardiotoxic, serious GI effects, teratogenic***

Only used under compassionate investigational new drug protocol

18
Q

Iodoquinol

A

Luminal amebicide used against asymptomatic amebiasis (or given together with Metro for symptomatic)

High iodine content —> iodine-induced thyroid enlargement and some serious adverse eye effects (remove immediately if affected)

19
Q

Paromomycin

A

Aminoglycoside that can be used for trichomoniasis, giardiasis, or as a luminal amebicide (because not well absorbed but we don’t need it to be)

NOT oto/nephrotoxic like other aminoglycosides because NOT absorbed

20
Q

Alternative Abx treatment for amebiasis/giardiasis (luminal)

A

Tetracycline and Erythromycin

Used in conjunction with metronidazole for symptomatic patients

21
Q

Pyrimethamine (Daraprim) plus Sulfadiazine

A

DOC for toxoplasmosis
High dose so some problems with bone marrow
Administer with folinic acid (leucovorin) to counteract bone marrow side fx

22
Q

DOC for pneumocystis pneumonia (PCP)

A

Trimethoprim plus Sulfamethoxazole (Bactrim)
Also useful against toxoplasmosis but not as good as Daraprim
Can be used as prophylaxis in AIDS patients but often not tolerated
MOA: inhibits folate synthesis
Toxicity: rash

23
Q

Pentamidine

A

Effective against PCP (Bactrim better but this can be used when Bactrim contraindicated)
Can be used in nebulizer for prophylaxis but IM is better
Toxicity: HYPOGLYCEMIA

24
Q

Most antihelmintic interfere with:

A

Energy metabolism**
Neuromuscular coordination
Microtubular function
Cell permeability

25
Q

What is the cause of most side effects from antihelminth drugs?

A

Immune response (allergic) to the dying worms

26
Q

Albendazole/Mebendazole

A

DOC for mixed roundworm infections

MOA - inhibit microtubule polymerization by binding to ß-tubulin—> effects worms’ energy metabolism

Little toxicity because not highly absorbed
SOME teratogenicity/embryotoxicity

27
Q

Pyrantel Pamoate

A

OTC drug, useful against a variety of nematodes (roundworm, pinworm, and hookworm)

MOA: cholinesterase inhibitor; produces depolarize great neuromuscular blockage in the worm

Few side fx because little is absorbed

28
Q

Ivermectin

A

Effective against lots of nematodes

MOA: paralyzes the parasite, intensifies GABA-mediated transmission of signals in the peripheral nerves

Minimal side fx

29
Q

Praziquantel

A

DOC for schistosomes

MOA: increasing the worm’s permeability to Ca2+ —> paralysis—>release

30
Q

Bithionol

A

Uncoupled oxidative phosphorylation

Only available from the CDC, for use against flukes

Pharm I Final Review (8 decks)

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