Drugs: Anti-malaria, Anti-protozoal, Anti-Helminths Flashcards

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1
Q

Chloroqiune
(Hydroxychloroqione)
MOA

A

Anti-Malaria: Prevents heme polymerization to hemozoin leading to malaria and RBC lysis via oxidative damage

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2
Q

Chloroqiune
(Hydroxychloroqione)
Used For

A

Anti-Malaria Prophlyaxis, Autoimmune disorders

Amebiasis

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3
Q

Chloroqiune
(Hydroxychloroqione)
Resistance

A

Common in P. falciparum

Increasing in P. vivax -> adminster with Verapamil or Despiramine to prevent drug efflux!

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4
Q

Chloroqiune
(Hydroxychloroqione)
Interactions

A

CYP450 2D6 inhibitor

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5
Q

Chloroqiune
(Hydroxychloroqione)
Adverse Rxns

A

GI, Rash, Pruritis, Exfoliatve dermatitis

Ototoxicty
Retinopathy
Neuropathy

Hemolysis (G6PD)

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6
Q

Quinine
Quinidine
MOA

A

Anti-Malaria: Rapdily acting blood schiontocide, blooks DNA replication and RNA tx

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7
Q

Quinine
Quinidine
Used For

A

1 Anti-Malaria for Severe falciparum malaria, can use with doxy of clinadmycin to shorten therpay

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8
Q

Quinine
Quinidine
Adverse Rxns

A

** “Cinchonsim” - tinnitus, headache, dizziness, flushing, visual disturbances
**Hypersensitivity rxn
Hematologic abnormalities
**Hemolysis->Anemia (G6PD)
Thrombophlebitis, EKG changes, hypotension with IV administration

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9
Q

Mefloquin MOA

A

Anti-Malaria: Induces distruption of Ca2+ homeostasis

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10
Q

Mefloquin Used For

A

Anti-Malaria Prophylaxis in Chloroquine resistant area

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11
Q

Mefloquin Adverse Rxns

A
GI
 Sleep disturbance,
 Neurospychiatric seizure
 Rash
** QT PROLONGATION
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12
Q

Primaquine MOA

A

Anti-Malaria: oxidzes GSH->GSSG make cell more susceptible to oxidative damage

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13
Q

Primaquine Activity

A

Tissue schizonticide
Gametocide
Dormant hynozoite (vixax, ovale)

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14
Q

Primaquine Used For

A

vivax and ovale endemic areas
** ERADICATION OF DORMANT LIVER FORMS
Relapse prevention and limits transmission

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15
Q

Primaquine Adverse Rxns

A

Contraindicated in Pregnancy!!!!!!

  • Leukopenia
  • Hemolytic anemia (G6PD)
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16
Q

Sulfadoxine and Pyrimethamine MOA

A

Anti-Malaria (anti-metabolite): Inhibits dihydropteroate reductase and tetrahydrofolate reductase.
SLOW acting, Blood schizonticide

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17
Q

Sulfadoxine and Pyrimethamine Used For

A

prophylaxis
rx falciparum
AND Toxoplasmosis

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18
Q

Sulfadoxine and Pyrimethamine Adverse Rxns

A
  • Bone marrow suppression
    Stevens Johnsons
    CNS, GI, Renal toxicity
  • REVERSIBLE MEGALOBLASTIC ANEMIA (Pyrimethamine)
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19
Q

Doxycycline MOA

A

Abx and Anti-Malaria: Protein synthesis inhibitor (30s ribo subunit)

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20
Q

Doxycycline Used For

A

Malaria Porphylaxis in highly resistant areas

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21
Q

Doxycycline Adverse Rxns

A

GI

*Photosensitivity

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22
Q

Atovaquone MOA

A

Anti-Malaria: Disrupts mitochondrial electron transport

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23
Q

Artemisinin Uses

A

MOA: Free radical killing
Use: * Severe MDR (multi drug resistant) falci
AE: QT prolongation

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24
Q

Metronadizole MOA

A

Anti-Protozoal: forms reactive cytotoxic products to interfere with pathogen’s energy metabolic pathways

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25
Q

Metronadizole Activity

A

Tissue amebicide against trophozoites (not cysts)

26
Q

Matronadizole Uses

A

Amebiasi, Giardia, Trichomonas

27
Q

Metronadizole Adverse Rxns

A

*ALCOHOL (disulfiram-like rxn)

Nausea, Headache, CNS toxicity

28
Q

Emetine
Dehydroemitine
MOA

A

Anti-Amebicide: Irreversible protein synthesis inhibitors (trophozoites)

29
Q

Emetine
Dehydroemitine
Uses

A

Back up for very severe Amebiasis

30
Q

Emetine
Dehydroemitine
Adverse Rxns

A

NVD, Weakness

  • CARDIAC ARRHYTHMIA
  • Heart failure, hypotension
  • ONLY available at CDC bc of HIGH TOXICITY
31
Q

Chlorquine MOA

A

Amebicide: Irreversible protein synthesis inhibitor. works in tissue (concentrates in liver)

32
Q

Chlorquine Uses

A
Extraluminal Amebiasis (after metronadizole)
Given with luminal agent (Diloxanide furoate or Iodouinol)
33
Q

Diloxanide furoate MOA

A

Luminal Amebicide: Inhibits protein synthesis

34
Q

Iodoquinol MOA

A

Luminal Amebicide: Mutagenic activity to inihbit amebic growth. 90% NOT absorbed in GI

35
Q

Iodoquinol Adverse Rxns

A

Diarrhea

  • *Iodine toxicity
  • > limit by taking with food
36
Q

Pentamidine MOA

A

Anti-Protozoal: Protein synthesis inhibitor (does NOT cross BBB)

37
Q

Pentamidine Uses

A

** T. cruzi, Leichmaniasis Pneumocystis

38
Q

Pentamidine Adverse Rxns

A
Hypotension
 Arrhythmias
 Pancreatitis
 Hypoglycemia
 Nephtotoxicity
 Electrolyte abormalities
39
Q

Melarsoprol MOA

A

Anti-Protozoal: Prevents ATP synthesis (& crosses BBB)

40
Q

Melarsoprol Uses

A
  • trypanosomiasis cruzi, especially CNS disease
41
Q

Melarsoprol Adverse Rxns

A

Fever, GI, Arthralgia, cardiac effects
Enchepalopathy
Nephrotoxicity
Hypersensitivity

42
Q

Nifurtimox MOA

A

Anti-Protozoal: inhibits trypanothione reductase (essential for thiol metabolism)

43
Q

Nifurtimox Uses

A

** Drug of choice for: African and American Trypanosomiasis

44
Q

Albendazole/Mebenazole MOA

A

(luminal) Binds to beta tubulin to prevent polymerization of microtubules, and inhibits glucose uptake by wormsn

45
Q

Albendazole/Mebenazole Uses

A
  • *Nematode treatment (hydatid disease, neurocysticercosis).
  • *Thiabendazole (systemic) or Ivermectin used for Strongyloides.
46
Q

Albendazole/Mebenazole Adverse Rxns

A

well tolerated. Albendazole may cause long term GI problems, alopecia, elevated LFTS. (Thiabenazole is not well tolerated)

47
Q

Pyrantel Pamoate MOA

A

(luminal) depolarizes NMJ -> AchR always on = Spastic paralysis

48
Q

Pyrantel Pamoate Uses

A

Nematode treatment. NOT effective for cestodes or trematodes.

49
Q

Diethylcarbamazine MOA

A

(systemic) Immobilizes microfilariae and alters surface structure displacing them from tissues and making them more susceptible to host defenses

50
Q

Diethylcarbamazine Uses

A

(Wuchereria bancrofti) Lymphatic Filariasis

51
Q

Diethylcarbamazine Adverse Rxns

A

Headache, weakness, dizziness RXN TO DYING WORMS (min with steroids, antihistamines) Fever, rash, GI, pain, proteinuria, retinal hemorrhage, encepalopathy

52
Q

Ivermectin MOA

A

(systemic) Tonic paralysis of nematodes and arthropods by intensifying GABA-mediated transmission of signals in peripheral nerves

53
Q

Ivermectin Uses

A

Strongyloides (threadworm) (dog heart worm medication)

54
Q

Ivermectin Adverse Rxns

A

MAZZOTTI RXN= Reactions due to dying worms. Fever, headache, dizziness.

55
Q

Praziquantel MOA

A

(systemic) Spastic paralysis by increasing the permeability of trematode and cestode cell membranes to calcium.

56
Q

Praziquantel Uses

A

Flukes (schistomiasis) and cestodes

57
Q

Praziquantel Adverse Rxns

A

Due to dying worms-> Rash, fever, eosinophilia Don’t use for Ocular cysticerosis bc of potential for irreversible damage

58
Q

Niclosamine MOA

A

(luminal) Depletes ATP in worms, possibly by interfering with oxidative phosphoylation

59
Q

Niclosamine Uses

A

Second line for tapeworms

60
Q

Niclosamine Adverse Rxns

A

Avoid alcohol (minimal absoprotion, not available in the US)

61
Q

Oxamniquine MOA/Use

A

paralysis (moa unknwn), Effective only for Schistosoma mansoni, all stages of disease

62
Q

Sodium Stibogluconate

A

** Drug of choice for: Leishmaniasis (ROS and NOS dependent killing of parasite)