Antiprotozoals

Question 1

Metronidazole , Tinidazole

Answer 1

Nitroimidazole Systemic agents (intestinal wall & liver)

Question 2

Metronidazole , Tinidazole (MeTin) Uses

Answer 2

Protozoal infections: Trichomoniasis, Amebiasis, Giardiasis (MeTin TAG)
Anaerobic + H. Pylori infection

Question 3

Metronidazole , Tinidazole MOA

Answer 3

Enters protozoa , reduced by ferredoxin-like molecule : activated , binds to protozoal DNA = FR = DNA breakage = cell death

Question 4

Metronidazole , Tinidazole PK

Answer 4

oral , IV , rectal ; T1/2=8hr ; liver metabolism ; urine excretion
M has a shorter half life and is less expensive than T

Question 5

Metronidazole , Tinidazole Side Effects

Answer 5

NVD , metallic taste , anorexia , neurotoxicity, seizures + disulfiram-like reaction ( w/ alcohol) = Flushing, tachycardia, palpitations

Question 6

Metronidazole , Tinidazole CI

Answer 6

Cimetidine (prolongs half life = toxicity) Phenobarbital (enhances metabolism)
Hepatic disease
Seizure disorder (neurotoxicity)

Question 7

Paromomycin

Answer 7

Aminoglycoside antibiotic (intraluminal :lumen of bowel)

Question 8

Paromomycin MOA

Answer 8

Bind30S subunitof the bacterialribosome→ inhibition of bacterialprotein synthesis→cell death(bactericidaleffect)

Question 9

Paromomycin PK

Answer 9

poor oral absorption (100% excreted in feces)
Safe in pregnancy (amebic colitis)

Question 10

Pyrimethamine , Sulfadiazine MOA

Answer 10

inhibit FA synthesis (bc together)

Question 11

Pyrimethamine , Sulfadiazine Uses (toxic meth = die)

Answer 11

Toxoplasmosis (+ leucovorin / FA)

Question 12

Pyrimethamine , Sulfadiazine CI

Answer 12

Pregnancy ( before 18 weeks give Spiramycin : macrolide)

Question 13

Pyrimethamine , Sulfadiazine Adverse Effects

Answer 13

P: Megaloblastic anemia , arrhythmia
S: aplastic anemia , thrombocytopenia , headache , hemolytic anemia “G6PD”

Question 14

Drugs used for leishmania

Answer 14

Amphotericin B , Miltefosine , Paromomycin , Sodium stibogluconate , Meglumine antimoniate , ( Pentamidine , azoles = cut.)

Question 15

Amphotericin B , Miltefosine ,Paromomycin

Answer 15

visceral leishmaniasis (cut. w/ azoles) “leish Am Mi)

Question 16

Amphotericin B (liposomal)

Answer 16

IV antifungal

Question 17

Amphotericin B MOA

Answer 17

disrupts wall synthesis by binding to ergosterols = pore formation = leakage

Question 18

Amphotericin B Adverse effects

Answer 18

Nephrotoxicity (liposomal is better) , bm suppression , arrhythmias , hypotension , impaired renal tubule permeability =hypokalemia & hypomagnesemia

Question 19

Miltefosine PK

Answer 19

oral agent for leishmania , DON’T give to pregnant women (contraception after 5 months of therapy)

Question 20

Miltefosine Adverse

Answer 20

Increased transaminases (ALT & AST) , thrombocytopenia , upset GI

Question 21

Sodium stibogluconate , Meglumine antimoniate Adverse effects

Answer 21

myalgia,arthralgia, anorexia, nausea, vomiting, elevated serumtransaminases, cardiotoxicity, pancreatitis

Question 22

Pentamidine MOA + AE

Answer 22

inhibits oxidative phosphorylation causes Increased creatinine , leukopenia , hypotension