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Pharmacology > Antiprotozoals > Flashcards

Antiprotozoals Flashcards

1
Q

what are the 2 forms that E. histolytica can be

A

trophozoite- can’t survive outside the body
cyst- can be passed in feces, can survive outside the body

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2
Q

what is the difference between luminal amebicides and systemic amebicides

A

luminal- act only on luminal parasites, not absorbed from GIT
systemic- act only on tissue amoebas, completely absorbed from GIT

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3
Q

what are the most commonly used anti-amebic drugs

A

metronidazole
tinidazole

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4
Q

what type of effect do mixed anti-amebic drugs such as metronidazole and tinidazole have

A

mixed- effect in luminal and tissue forms

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5
Q

is metronidazole or tinidazole longer acting

A

tinidazole

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6
Q

what is the mechanism of action of metronidazole

A

it accepts electrons from ferredoxin in anaerobic conditions and converts it to reduced cytotoxic intermediates

the reduced form causes breaks in DNA

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7
Q

metronidazole is the drug of choice in what 2 protozoal infections

A

amebiasis
giardiasis

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8
Q

metronidazole is the drug of choice in what 3 bacterial infections

A

B. fragilis
C. difficile (has been replaced by vancomycin)
H. pylori

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9
Q

what are the 5 main adverse effects of metronidazole

A

peripheral neuropathy
seizures
pancreatitis
thrush
disulfiram like reaction

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10
Q

__ can alter the effect of metronidazole

A

enzyme inducers and inhibitors

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11
Q

what are the advantages of tinidazole over metronidazole (2)

A

longer acting
less adverse effects

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12
Q

can tinidazole only be used in protozoal or anaerobic bacterial infections, unlike metronidazole which can be used for both

A

protozoal

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13
Q

Paromomycin is effective in __ infection and useful as an alternative

A

Giardia lamblia

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14
Q

is idodquinol luminal or systemic

A

luminal

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15
Q

what are the adverse reactions of iodoquinol

A

nausea/vomiting
optic neuritis

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16
Q

what is the mechanism of action of nitazoxanide

A

inhibits pyruvate ferredoxin oxidoreductase

17
Q

nitazoxanide is most effective for what 2 types of infection

A

giardiasis
cryptosporidiosis

18
Q

chloroquine is used in amoebic __

A

liver abscess

19
Q

chloroquine is combined with what 2 other medications

A

metronidazole
paromomycin/idoquinol

20
Q

why is chloroquine not useful to treat luminal amebiasis

A

it is completely absorbed from the upper GIT

21
Q

what is the mechanism of action of emetine

A

inhibition of protein synthesis by blocking AA elongation

22
Q

is emetine luminal or systemic amebicide

A

systemic

23
Q

emetine is only used if other drugs are not effective or in severe __

A

intestinal, hepatic, and extraintestinal amebiasis

24
Q

what is the main adverse effect of emetine

A

cardiotoxicity

25
Q

emetine should be avoided in patients with what condition

A

cardiac arrhythmias

26
Q

what is the drug of choice for toxoplasmosis

A

pyrimethamine and sulfadiazine combo

27
Q

pyrimethamine and sulfadiazine combo used to treat toxoplasmosis can lead to what adverse effect

A

megaloblastic anemia

28
Q

pyrimethamine and sulfadiazine combo can be used for prophylaxis and treatment for what infction

A

toxoplasmosis (T. gondii)

29
Q

what is the drug alternative used to treat toxoplasmosis in those pregnant

A

spiramycin

30
Q

what are the 3 drug options for use in those with cryptosporidiosis

A

nitazoxanide
paromomycin
azithromycin

31
Q

what is involved in the clinical first vs second stage of Chages disease (American trypanosomiasis)

A

first- multiply in subcutaneous tissue, blood, and lymph
second- cross BBB and infect CNS

32
Q

what is the main adverse effect of pentamidine

A

renal dysfunction

33
Q

what is the drug of choice for hemo-lymphatic (first) stage of T. brucei/W. African trypanosomiasis

what else can be used

A

pentamidine

suramin

34
Q

why is suramin not used for the second stage African trypanosomiasis

A

it does not cross the BBB

35
Q

what drug is used in the late stages (CNS/meningoencephalic stage) of East African trypanosomiasis

A

melarsoprol

36
Q

what is the main adverse effect of melarsoprol

A

fatal reactive encephalopathy

37
Q

what is used as the first line drug for west african trypanosomiasis

A

eflornithine or eflornithine in combination with NECT

38
Q

what is the mechanism of action of nifurtimox and benznidazole

A

form ROS and inhibit trypanothione reductase and DNA synthesis

Pharmacology (16 decks)

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