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Pharmacology Exam 3 (Lauren) > Antoprotozoals And Antihelmintic Agents > Flashcards

Antoprotozoals And Antihelmintic Agents Flashcards

1
Q

What is the etiology of amebiasis?

A

Entamoeba histolytica

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2
Q

What are the two forms of E. Histolytica and which one is the infective one?

A

Cysts = infective

Trophozoites

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3
Q

What are the two phases of E histolytica, and which one is symptomatic?

A

Liver phase=symptomatic

Lumen phase =asymptomatic

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4
Q

If one person in the household has e. Histolytica, do you need to treat the rest of the household?

A

Yes, it is spread via food, water, and contact, and is a “population” disease. Usually the whole household is infected

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5
Q

What is the etiology of giardiasis?

A

Giardia lamblia

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6
Q

How is trichomoniasis spread?

A

Sexually

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7
Q

If one person has trichomoniasis, does their partner?

A

Yes you need to treat both partners. Men are usually asymptomatic though.

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8
Q

What is the characteristic symptom of trichomoniasis in women?

A

Vaginitis

Frothy yellow discharge 🤮

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9
Q

Is toxoplasmosis a big deal for healthy people?

A

No, it is a mild infection in people with good immune systems

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10
Q

Is toxoplasmosis a big deal for pregnant women and immunocompromised peopel
/

A

Yes, can cause major problems to the fetus and can be life threatening to someone with an incompetent immune system

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11
Q

What is the etiology of pneumocystis aka PCP?

A

Pneumocystis jirovecii

Pneumocystis carinii

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12
Q

For what population is pneumocystosis a big deal?

A

AIDS patients

MAJOR cause of death for them via pneumocystis pneumonia

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13
Q

What drugs are the tissue amebicides for entamoeba histolytica?

A

Metronidazole

Tinidazole

Emetine + Dehydroemetine

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14
Q

What are the luminal amebicides used for asymptomatic luminal phases of entamoeba histolytica?

A

Iodoquinol

Paromomycin

Tetracycline and erythromycin

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15
Q

What is the drug of choice for entamoeba histolytica?

A

Metronidazole (with or without a luminal amebicide)

You would give just the luminal amebicide if they were asymptomatic- no metronidazole

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16
Q

What is the DOC for giardia?

A

Metronidazole

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17
Q

What is the DOC for trichomonas vaginalis?

A

Metronidazole

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18
Q

What are the DOCs for toxoplasma gondii (toxoplasmosis)?

A

Pyrimethamine-sulfadiazine + leucovorin

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19
Q

What are the DOCs for pneumocystis jirovecii/carinii?

A

Bactrim + leucovorin

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20
Q

How many treatments of metronidazole do we give for giardiasis or trichomoniasis?

A

Single treatment

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21
Q

How does metronidazole get activated?

A

It gets reduced by ferredoxin, which is only in anaerobes

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22
Q

What is the MOA of metronidazole?

A

Its metabolites are taken up into DNA where they form unstable molecules

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23
Q

Will metronidazole kill amoebas in luminal phase?

A

No, must combine with luminal agent

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24
Q

What are the side effects of metronidazole?

A

Metallic taste

Disulfiram-like reaction

Nervous system toxicity with prolonged use, but we don’t use metronidazole for long periods

GI upset, superinfection

25
Q

What is the main point about tinidazole?

A

It’s a metronidazole alternative

26
Q

When would we use emetine + dehydroemetine (Mebadin)?

A

Severe amebiasis infections in which metronidazole didn’t work

(Last resort, very toxic)

27
Q

What are the side effects of emetine+dehydroemetine (mebadin)?

A

Cardiotoxicity**

Serious GI upset

Teratogenicity**

28
Q

If someone is pregnant and metronidaozle didn’t work for their amebiasis infection, can we give them an injection of emetine+dehydroemetine(Mebadin)?

A

NO VERY TERATOGENIC

29
Q

Who can NOT have emetine+dehydroemetine (Mebadin)

A

Heart disease

Kidney disease

Pregnant women

30
Q

What is the main use of iodoquinol?

A

Luminal phase of e. histolytica aka asymptomatic amebiasis

31
Q

What are the toxicities of iodoquinol?

A

Iodine-induced thyroid enlargement

Eye problems, possible blindness

32
Q

What do we use paromomycin for?

A

Asymptomatic amebiasis

Giardiasis

Trichomonas vaginalis

33
Q

What are the side effects of paromomycin?

A

GI upset!

Even though it is an aminoglycoside, you don’t get ototoxicity/nephrotoxicity since it is not significantly absorbed

34
Q

What kind of medication is paromomycin?

A

Aminoglycoside

35
Q

What are tetracycline and erythromycin used for?

A

Alternative treatments for amebiasis and giardiasis after paromomycin didn’t work either

36
Q

What other drug will be given with tetracycline/erythromycin for symptomatic amebiasis patients?

A

Metronidazole

37
Q

What is the drug of choice for toxoplasmosis?

A

Pyrimethamine + sulfadiazine

38
Q

What kind of infection is toxoplasmosis (toxoplasma gondii)?

A

Opportunisitic infection

39
Q

Is pyrimethamine + sulfadiazine static or cidal?

A

It is static,

So, it can be given prophylactically for toxoplasmosis, as well as can be given for active infection, but will not clear the infection.

40
Q

What should you give with pyrimethamine+sulfadiazine?

A

Leucovorin**

41
Q

What is the drug of choice for pneumocystis pneumonia (caused by P. jirovecii/P. carinii)?

A

Bactrim

Don’t forget it is a sulfa

42
Q

30% of AIDS patients can not tolerate Bactrim :(

And since pneumocystis pneumonia is one of the biggest killers of AIDS patients, what are they supposed to take?

A

Pentamidine

43
Q

What is pentamidine usually reserved for?

A

Patients who can’t tolerate bactrim

Not as effective and more toxic though

44
Q

What microbe causes pneumocystis pneumonia (PCP)?

A

Pneumocystis jirovecii
Or pneumocystis carinii

(It is a yeast like fungus)

45
Q

What is the mechanism of action of bactrim? I forgot

A

Inhibition of folate metabolism

Synergy between trimethoprim and sulfamethoxazole

46
Q

What are the main toxicities of bactrim? I forgot

A

Hypersensitivity

Stevens Johnson syndrome

Photosensitivity

Aplastic anemia for G6PD

47
Q

When you treat someone with an antihelminthic drug, what usually causes the side effects?

A

The worms dying. Not the drug

It’s usually just some flu-like symptoms

48
Q

What are the DOCs for roundworms (nematodes)?

A

Albendazole

Mebendazole

Pyrantel pamoate

49
Q

What is the MOA of albendozole and mebendazole?

A

Binds to B-tubulin and inhibitis the microtubule-dependent uptake of glucose

(Starves the worms)

50
Q

What is an alternative treatment for roundworms(nematodes)?

A

Ivermectin

DOCs were albendazole, mebendazole, or pyrantel pamoate

51
Q

What are the adverse effects of albendazole and mebendazole?

A

Kills fetuses

Do not use in pregnant women

52
Q

What is the MOA of pyrantel pamoate?

A

Its a cholinesterase inhibitor that produces a depolarize game neuromuscular blockade

53
Q

What is the MOA of ivermectin?

A

Paralyzes the worm by intensifying GABA-mediated transmission of signals in peripheral nerves

54
Q

What is the DOC for flukes and tapeworms?

A

Praziquantel

55
Q

What is an alternative treatment for flukes?

A

Bithionol

DOC is praziquantel

56
Q

What is an alternative treatment for tapeworms?

A

Niclosamide

DOC is praziquantel

57
Q

What is the MOA of praziquantel?

A

Increasing worm’s permeability to Ca++, resulting in contraction and paralysis of the worms muscles

(Dislodges the worm)

58
Q

What is the MOA of bithionol?

A

Uncoupled oxidative phosphorylation= no ATP synthesis

59
Q

Paromomycin is an aminoglycoside, so will we see the same ototoxicity and nephrotoxicity we see with other aminoglycosides?

A

No, because it is not well absorbed from GI tract

Pharmacology Exam 3 (Lauren) (8 decks)

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