Ch. 12 Antiprotozoal Agents Flashcards

1
Q

What are risk factors for protozoal infections? And what is a protozoa?

A
  1. Unsanitary and crowded conditions
  2. Third world countries
  3. Poor hygienic practices

Protozoa is a single celled organism that pass through several stages in their lifecycle, including at least one phase as a human parasite;

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2
Q

Other causes of protozoal infections

A

Insect bites which cause
Malaria
Trypanosomiasis - causes African sleeping sickness, transmitted by Tsetse fly.
And Chagas’ disease caused by Trypanosoma Cruzi, caused by common house fly.

Leishmaniasis- passed by sand flies

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3
Q

Protozoa thrive in

A

Tropical climates
These are caused by trypanosomes and typically transmitted by biting insects, especially sleeping sickness and Chagas disease.

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4
Q

Define Trypanosomiasis

A

African sleeping sickness, which is caused by a protozoan that inflames the CNS and is spread to humans by the bite of the tsetse fly, Also, Chagas disease, which causes a serious cardiomyopathy after the bite of the housefly

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5
Q

TAG

Other causes of protozoal infections

A

Ingestion Or contact with the causal organism anebiadis, giardiasis, trichomoniasis

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6
Q

Malaria is caused by

Hint: genus is plasmodium

A

Anopheles mosquito

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7
Q

Amebiasis is

A

Amebic dysentery (type of gastroenteritis that results in bloody diarrhea) which is caused by intestinal invasion of the trophozoite stage of the protozoan Entamoeba histolytica

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8
Q

Amebiasis - symptoms of

A

Severe diarrhea with abdominal pain

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9
Q

Trichomoniasis is

Hint: sex

A

A sexually transmitted infection caused by a parasite. That causes vaginitis in women, which may cause foul smelling vaginal discharge in women and no symptoms in men.

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10
Q

Giardiasis is and what does it cause?

A

Protozoal intestinal infection that causes severe diarrhea and epigastric distress, may lead to serious malnutrition

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11
Q

Plasmodium is a protozoan that causes….

A

malaria in humans; its lifecycle includes the Anopheles mosquito, which injects protozoa into humans

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12
Q

Antiprotozoal Agents effects in older adults

A

Older patients may be more susceptible to the adverse effects they should be monitored closely. Patients with hepatic dysfunction are at increased risk for worsening hepatic problems and toxic effects of many of these drugs if hepatic dysfunction is expected extreme age alcohol abuse use of other hepatotoxic drugs the dose may need to be Lowered and the patient monitoring more frequently

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13
Q

Antiprotozoal Agents (meds) effects on children

A

Children are very sensitive to the effects of most antiprotozoal drugs and more severe reactions can be expected. Many of these drugs do not have proven safety and efficacy in children and extreme caution should be used.

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14
Q

Antiprotozoal effects in adults

Hint: prophylactic and when else to take?

A

Adults should be well advised about the need for prophylaxis against various protozoal infection and the need for immediate treatment if the disease is contracted. Pregnant and nursing women should not use these drugs unless the benefit clearly outweighs the potential risk to the fetus or neonate women should be advised to use barrier contraceptives if these drugs are used.

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15
Q

Actions of Antiprotozoal Drugs

A

Inhibit protein DNA synthesis in susceptible protozoa pharmacokinetics – readily absorbed and highly protein bound in circulation or metabolized in the liver and excreted in the urine and feces generally nephrotoxic and

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16
Q

Which organ do these parasites invade?

A

They lay dormant until they eventually find their way to the liver, or they multiply and then invade more red blood cells, again causing the acute cycle

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17
Q

Antiprotozoal drugs contraindications

A

Known allergy
Pregnancy
CNS
HEPATIC (liver disease) monitor patients who are on these meds

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18
Q

Antiprotozoal Adverse Effects Chloroquine

A

Chloroquine- seizures, confusion, CNS

Headache, dizziness, ataxia, nausea, vomiting, diarrhea

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19
Q

Is the mainstay of antimalarial therapy for infections.

A

Chloroquine (Aralen)

Prevention and tx of Plasmodium malaria; tx of extra intestinal amebiasis

20
Q

Antiprotozoal Drug-drug interaction

Hint: A, A, D

A

Alcohol

Anticoagulants (Warfarin, Coumadin)

Disulfiram is a drug to help alcoholics quit drinking. If taken with Antiprotozoal drug will make them sick such as N/V, chest pain, mental confusion, weakness, choking, breathing difficulty, anxiety

21
Q

Malaria signs and symptoms

A

Related to the destruction of red blood cells and toxicity to the liver

22
Q

Malaria treatment

A

Aims at attacking the parasite at the various stages of its development inside and outside the human body

23
Q

How does malaria occur and spread?

A

Mosquito bite injects plasmodium falciparum into your blood. They travel to the liver, evolve into merozoite and get into the RBC’s. The next mosquito sucks this from your blood and then injects the plasmodium falciparum to the next customer, thus Malaria circle of life

24
Q

Plasmodium falciparum is

A

The most dangerous type. Infection with this protozoan results in an acute, rapidly fulminating disease with high fever, severe hypotension, swelling and reddening of the limbs, loss of RBC’s, and even death. Also causes cancer.

25
Q

Antimalarial contraindications and cautions

A

Check for allergies
Liver disease or alcoholism bc of the parasitic invasion of the liver
Hepatic metabolism is needed to prevent toxicity
Pregnancy
Use caution in retinal disease can affect vision and retina esp. if already damaged
Psoriasis or porphyria bc of skin damage or with damage to mucus membranes

26
Q

Antimalarial (meds) adverse effects

A

CNS: headache and dizziness

GI: Nausea and vomiting, dyspepsia and anorexia

Hepatic dysfunction

27
Q

First drug found effective in tx of malaria

A

Quinine (Qualaquin)

28
Q

cinchonism is

A

Nausea, vomiting, tinnitus, and vertigo

May occur with high levels of quinine or primiquine

29
Q

Antibiotics used to treat malaria
Hint: C, D, T
Hint: 2 end in cycline

A

Doxycycline
Tetracycline
Clindamycin
Used bc of the emergence chloroquine-resistant strains of Plasmodium

30
Q

Prophylaxis for malaria

A

CDC recommends prophylaxis when traveling to places with high incidence of malaria.
CDC has different guidelines for prophylaxis based on location.

31
Q

Nursing considerations for patients on Antiprotozoal agents

A
  1. Assess for contraindications and cautions, such as liver dysfunction
  2. Pregnancy and lactation
  3. CNS disease
  4. Candidiasis
  5. Examine skin and mucous membranes to check for lesions, color, temp., texture
  6. Obtain lab cultures to determine the exact protozoal species causing the disease.
32
Q

True or False:
Chlorquine (Aralen) is an antimalarial drug used in the treatment of plasmodial malaria. It is typically used in combination with other drugs.

A

True

33
Q

Other protozoal infections

A
Amebiasis
Leishmaniasis 
Trypanosomiasis 
Trichomoniasis 
Giardiasis 
Pneumocystic jiroveci pneumonia
34
Q

Atovaquone (Mepron)

Hint: given to patients with AIDS

A

Especially active against PCP

Pneumocystic jiroveci pneumonia. Used in combination with proguanil for tx of chloroquine-resistant malaria

35
Q

PCP is a type of pneumonia that only AIDS patient get? True or False?

A

True.

They don’t get the treatments ending in “myocin” bc of the specific pneumonia strain that they get

36
Q

Metronidazole (Flagyl) treats

A

Amebiasis
Trichomoniasis
Giardiasis

37
Q

Tinidazole, benznidazole, and metronidazole (Antiprotozoal meds) should not be combined with?

A

Alcohol
Metro and tinidazole combined with oral anticoagulants can lead to increased bleeding. 🩸

Psychotic reactions tini and metro combined with disulfiram

38
Q

Metronidazole (Antiprotozoal med) adverse effects

A

Headache, dizziness, ataxia, nausea, vomiting, metallic taste, diarrhea, darkening of the urine.

39
Q

Pentamidine, is an anti infective, most commonly used in the hospital for nebulized Antiprotozoal tx

AIDS patients

A

Treats PCP (inhalation tx), as a systemic agent in the tx of trypanosomiasis, and leishmaniasis

40
Q

Tinidazole (Tindamax)

A

Treats
trichomoniasis
Giardiasis
Amebiasis

41
Q

Tinidazole treats

A

Bacterial vaginosis- a sexually transmitted infection caused by a parasite. This may cause foul smelling vaginal discharge in women and no symptoms in men. Lowers fertility males.

42
Q

What is giardiasis?

A

Is caused by Giardia lamblia, is the most commonly diagnosed intestinal parasite in the U.S..
This protozoan forms cysts, which survive outside the body and allow transmission through contaminated water, or food.
S/S diarrhea, rotten egg smelling stool, and pale and mucus-filled stool are commonly seen.

43
Q

Benznidazole 9 treats

A

An Antiprotozoal agent that treats pediatric patients with Chagas disease caused by Trypanosoma cruzi

44
Q

Chagas disease

A

A vector-borne parasitic disease caused by the bite of the triatomine bug

45
Q

When are Antiprotozoal medications contraindicated?

A

CNS Disease

46
Q

When are antimalarial medications contraindicated?

A

Alcoholism

Rationale: bc of the need for hepatic metabolism to prevent toxicity