DLA9- Antiparasitics

Question 1

list the common drugs used to treat protozoal infections, separate by type

Answer 1

Luminal: diloxanide furoate, iodoquinol, paromycin

Systemic: chloroquine, emetine/dehydroemetine

Mixed: metronidazole, tinidazole

Question 2

list the goals for anti-protozoal therapy

Answer 2

• eliminate invader: trophozoites

- eradicate intestinal carriage of organism

Question 3

Asymptomatic intestinal protozoal infection:

• (1) DOC
• (2) alternatives

Answer 3

1- diloxanide furoate

2- iodoquinol, paromomycin

Question 4

Mild-Moderate intestinal protozoal infection:

• (1) DOC
• (2) alternatives

Answer 4

1- diloxanide furoate + metronidazole

2- diloxanide furoate + tinidazole / tetracycline / erythromycin

Question 5

Severe intestinal protozoal infection:

• (1) DOC
• (2) alternatives

Answer 5

1- diloxanide furoate + metronidazole/ tinidazole

2- diloxanide furoate + emetine, dihydroemetine / tetracycline

Question 6

Hepatic Abscess / other extraintestinal protozoal infection:

• (1) DOC
• (2) alternatives

Answer 6

1- diloxanide furoate + metronidazole/ tinidazole

2- diloxanide furoate + emetine / dihydroemetine + Chloroquine

Question 7

______ is useful in Giardiasis Tx

Answer 7

(giardia lambia)

Nitroimidazoles: metronidazole, tinidazole

Question 8

______ is useful in Trichomoniasis

Answer 8

(trichomonas vaginalis)

Nitroimidazoles: metronidazole, tinidazole

Question 9

PCP Tx

Answer 9

• *Cotrimoxazole: trimethoprim + sulfamethoxazole
• pentamidine
• dapsone
• atovaquone

Question 10

list the luminal anti-protozoal agents

Answer 10

• diloxanide furoate
• iodoquinol
• paromycin

Question 11

list the systemic anti-protozoal agents

Answer 11

• chloroquine

- emetine / dihydroemetine

Question 12

list the mixed anti-protozoal agents

Answer 12

(treats luminal and systemic diseases)

Nitroimidazoles: metronidazole, tinidazole

Question 13

list general anti-helminthic agents

Answer 13

• benzimidazoles
• ivermectin
• diethylcarbamazine
• pyrantel pamoate
• praziquantel
• niclosamide

Question 14

Benzimidazoles:

• (1) agents — * the most toxic
• (2) MOA
• (3) contraindications

Answer 14

1- albendazole, mebendazole, *thiabendazole

2- inhibits MT synthesis and glucose uptake

3- pregnancy, children <2y/o

Question 15

______ is the anti-helmithic agent that is a GABA agonist:

• explain MOA
• include contraindications

Answer 15

Ivermectin:

• GABA agonist –> Cl- influx –> hyperpolarization and death of parasite
• Contraindicated in pregnancy, meningitis

Question 16

______ is the anti-helmithic agent that immobilizes microfiliariae

Answer 16

diethylcarbamazine

Question 17

______ is the anti-helmithic agent that inc Ca permeability

• explain MOA
• include contraindications

Answer 17

Pyrantel Pamoate:

• inc Ca cell permeability –> prolonged contraction –> eventual paralysis –> detachment of suckers from tissue wall
• Contraindicated in pregnancy, lactation

Question 18

______ is the anti-helmithic agent that inhibits mitochondrial phosphorylation of ADP

• explain MOA
• include possible contraindications

Answer 18

Niclosamide:

• inhibits ADP phosphorylation
• inhibits anaerobic metabolism
• lethal for scolex, not ova

-maybe contraindicated in pregnancy, children <2y/o

Question 19

______ are the main Nematode drugs, list in order of most used

Answer 19

1) Benzimidazoles: albendazole, mebendazole
2) pyrantel pamoate
3) ivermectin, diethycarbamazine

Question 20

______ are the main Trematode drugs

Answer 20

Schistoma spp.: Praziquantel

Clonorchis sinesis: Praziquantel, albendazole

Question 21

______ are the main Cestode drugs, list in order of most used

Answer 21

1) praziquantel
2) niclosamide
3) Benzimidazoles: albendazole, mebendazole