Antiprotozoal Drugs Flashcards
the Drug of choice for Pneumocystis jirovecci
Trimethoprim-sulfamethoxazole
inhibitor of plasmodial hydrolfolate
Proguanil
destroys secondary exoerythrocytic schizonts
Primaquine
Plasmodial resistance to chloroquine is due to
Decreased accumulation of the drug in the food vacuole
recommended drug fro prohlyxis in regions of the world where chloroquine resistant P. falciparum is endemic
Mefloquine
Alternative drug for prophylaxis but must be given daily
Doxycycline
Parenteral artemisinin
Artesumate
drug of choice in eradication of P. vivax
Primaquine
the treatment of choice in mild to moderate amebic colitis
Metronidazole plus a luminal amebicide (diloxanide fuorate)
- Diloxanide furoate (or iodoquinol or paromomycin) can be used as the sole agent in aymptomatic intestinal infection
effective in kmost cases of hepatic abscess due to the dual advantage of being both amebicidal and active against anaerobic bacteria
Metronidazole given for (10d) or Tinidalzole for (5d) plus a luminal agent
Possible treatment for Giardiasis
Metronidazole or tinidazole
A drug that can clear trypanosomes from the blood and lymph nodes and is active in the late CNS stages of african sleeping sickness
Melarsopol
Chloroquine
Prevents heme - >hemozoin
Blood schintozide
Oral, All nonresistant malarials. Autoimmune diseases
SE: GI upset, rash, headache
Artemisinins
Metabolism to toxic free radicals in protozoa
Blood schizonticides
Oral. IB. Combined with lumefantrine for prophylaxis and treametn of falciparum malaria, including resistant forms
GI upset
Mefloquine
MOA; unknown
Blood schizonticide
Oral. Weekly for prophylaxis, daily for infection
SE: GI upset, rash, cardiac abdnomalities, psychiatric disturbance, seizures
Primaquine
MOA: unknown
Active against liver forms of P. vivax and P. ovale. P. jirovecii pneumonia
Oral
SE: Blood cytopenias, hemolysis in G6PD deficiency
Atovaquone
Disrupts mitochondrial metabolism
As Malarone (with proguanil) for falciparum. Alternate for PCP
Oral
SE: rash, Fever, GI upse
Antifolates
(Pyrimethamine, proguanil, Fansidar (pyrimethamine + sulfadoxine)
Inhibit folate synthesis
Mostly blood schizonticide
Oral
GI upset, rashes (sometimes severe), cytopenias
Metronidazole, tinidazole
Reactive metabolic producs in organisms
Luminal and extraintestinal amebiasis, giardiasis, trichomoniasis
Oral. rapid diffusion into all tisues
Nause, headache, parestheisa, disulfiram effect; tinidazole less toxic
Diloxanide
MOA unknown
Luminal amebiasis
Oral. Short duration
Mild GI upset; avoid inpregnancy
Iodoquinol
MOA unknown
Luminal amebiasis
Oral
GI upset, rash, headache, iodine toxicity
Paromycin
Aminoglycoside
Luminal amebiasis. Lesihmaniasis
Oral for amebiasis, parenteral for leishmaniasis
Minimal toxicity with oral use. mild GI upset
Pentamidine
MOA unknown
PCP, african trypanosomiasis, leishmaniasis
Parenteral, inhalation
Hypotension, injection pain, pancratic toxicity, thrombocytopenia, hallucinations
Melarsopol
Trivalent arsenical: enzyme inhibition
African trypanosomiasis
PArenteral
Fever, GI upset and encephalopathy, renal and cardiac damage
Nifurtimox
MOA unkown
American typanosomiasis
Oral
Allergies, GI upset, CNS abnormalities
Suramin
MOA unknown
African trypanosomiasis
Parenteral
Rash, GI upset, neurologic dysfunction
Eflornithine
Inhibits ornithine decarboxylase
African trypanosomiasis
Oral and parenteral
GI upset, liver abnormalities, seizures
Sodium stibogluconate
Inhibits glycolysis, nucleic acid metabolism
Lesimaniasis, all forms
PArenteral
Cardiac toxicity
______may decrease oral absorption of chloroquine
Antacids
the only drugs reliably effective against quinine resistant strains
Artemisinins
May precipitate porohyria attacks
Chloroquine
Quinine is commonly used with _________ or _________ to shorten duration of therapy
Doxycycline
Clindamycin
______commonly causes cinchonism
Quinine
forms quinoline-quinone metabolites,, which are electron transferring compounds that act as cellular oxidants
Primaquine
a suicide substrate of ornithine decarboxylase
Eflornithine
Inhibits the parasitic unique enzyme trypanothione reductase
Nifurtimox