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Pharm > Antiprotozoals > Flashcards

Antiprotozoals Flashcards

1
Q

Mixed amebicide (luminal + systemic activity)

A

Metronidazole
Tinidazole

They are completely absorbed in the GI however, so least effective at luminal level.

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2
Q

Chloroquine
Dehydroemetine & Emetine
Part of what class of antiprotozoals ?

A

Systemic amebicides

Totally absorbed in GIT, no action in the lumen.

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3
Q

Examples of luminal amebicides ?

A

Paromomycin
Iodoquinol

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4
Q

Systemic amebicides are effective at what level ?

A

Tissue level (interstinal wall, liver mostly)

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5
Q

Effective both against protozal infections and anaerobic bacterial infections ?

A

Metronidazole

Achieves high concentration in the liver & CNS

Bacterial use : fragilis, c diff and h pylori
* Metronidazole no longer DOC for c diff ; replaced by Vancomycin

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6
Q

DOC for treatment of Entamoeba histolytica, Giardia lambia and Trichomonas vaginalis ?

A

Metronidazole

x 7-14 days

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7
Q

Main side effects of Metronidazole ?

A

GI (alteration of microbiome)
Metallic taste
Peripheral neuropathy
Disulfiram-like reactions
Teratogenic

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8
Q

Short acting version of Metronidazole ?

A

Tinidazole

Better tolerance ; single dose daily for shorter duration - 5 days

ONLY FOR PROTOZOAL INFECTIONS
NOT USEFUL IN ANAEROBIC BACTERIAL INFECTIONS UNLIKE METRONIDAZOLE

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9
Q

What is the basis of treatment for asymptomatic protozoal infections ?

A

Luminal amebicides

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10
Q

Tissue amebicidal drugs (e.g. metronidazole) should always be combined with what to prevent relapse ?

A

Luminal amebicides

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11
Q

Paromomycin (aminoglycosides) is a :

A

Luminal amebicide

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12
Q

Luminal amebicide useful in the treatment of Giardia lambia when Metronidazole is contraindicated ; in AIDS pts with cryptosporidiosis or cutaneous leishmaniasis ?

A

Paromomycin

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13
Q

Luminal amebicide that can cause NoVo, thyroid enlargment and optic neuritis (blindness) as side effects ?

A

Iodoquinol

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14
Q

Nitazoxanide antiprotozoal effective in treatment of giardiasis and cryptosporidiosis MAO ?

A

Inhibits PFOR pathway of electron transport

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15
Q

Systemic amebicide that highly concentrated in the liver & kills trophozoites, used in amebic liver abscess in combination with Metronidazole and Paromomycin/Iodiquinol ?

A

Chloriquine

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16
Q

Last resort systemic amebicides (cardiotoxicity, contraindicated in arrythmias) if other drugs are ineffective or in treatment of severe intestinal hepatic/extraintestinal amebiasis :

A

Emetine & Dehydroemetine

IM injection

17
Q

Treatment of Entameba histolytica infection :

18
Q

DOC for toxoplasmosis?

A

Perimethamine & sulfadiazine in combination.

Blocks steps of folic acid synthesis and together synergistic effect

Megaloblastic anemia –> prevent with leucovorin (folinic acid)

19
Q

DOC for prophylaxis & trx of T toxoplasmosis as well as lifelong prophylaxis for pneomocystitis pneumonia (jerovecii) in AIDS pts ?

A

Pyrimethamine & Sulfadiazine combination

20
Q

Toxoplasmosis during pregnancy treat with ?

A

Spiramycin (macrolide)

21
Q

Nitazoxanide, Paromomycin & Azithromycin are useful in treatment of :

A

Cryptosporidiosis

22
Q

Treatment of tyrpanosomiasis
Aerosol or IM, not IV (hypotension, tachy)
Can cause severe renal dysfunction & hypoglycemia

A

Pentamidine

23
Q

DOC in early hemo-lymphatic stage of West African trypanosomiasis ?

DOES NOT CROSS BBB

A

Pentamidine

24
Q

Alternate drug to sitbogluconate in treatment of visceral Leishmaniasis & inhalation form once of month for prophylaxis of Pneumocystosis (jirovecii) in AIDS pts ?

A

Pentamidine

25
Q

Used in African trypanosomiasis
IV route
Does not cross BBB so not usefull in advanced stages
Can cause proteinuria/hematuria

26
Q

DOC in advanced CNS meningo-encephalitic stage of East African trypanosomiasis (sleeping sickness) ? second line in West African ?

A

Melarsoprol

27
Q

Side effects of Melarsoprol:

A

Highly toxic & morbidity
Immediate : HSR & GI disturbances
CNS toxicity : fatal reactive encephalopathy
Later : renal & cardiac diseases

28
Q

Used in West African TP in combination with Nifurtimox

A

Eflornithine

Suicide substrate

29
Q

DOC in T cruzii (Chagas disease) which MAO is inhibition of trypanothione reductase thus DNA synthesis ?

American trypanosomiasis

A

Nifurtimox & Benznidazole

DECREASE THE SEVERITY OF THE PARASITE, BUT NOT EFFECTIVE FOR ERADICATION

30
Q

DOC for West African TP early & advanced stages

A

Fexinidazole

Early : Fexinidazole
Late CNS : Fexinidazole + Eflornithine + Nifurtimox

Pharm (3 decks)

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