Exam 4 - Anti-Malarials Flashcards

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1
Q

DRUG LIST

Artemisinins

A
  • Artemether (asexual/gametocyte

- Combo w/ Lumefantrine

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2
Q

DRUG LIST

Quinilones

A
  • Quinine Sulfate (blood)
  • Chloroquine Phosphate (blood)
  • Primaquine (Hypnozoite Liver/Gametocyte blood)
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3
Q

DRUG LIST

Quinolone Adjuncts

A
  • Doxycycline
  • Tetracycline
  • Clindamycin
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4
Q

Drug List

Other

A

Atovaquone-Proguanil

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5
Q

Artemisinins

Artemether

A
  • P falciparum
  • P vivax asexual blood stage
  • toxic adducts, free radicals kill bug
  • not useful for prophylaxis
  • use combo therapy with Lumefantrine
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6
Q

Artemisinins

Adverse

A
  • drug-drug interx’ns w/ antiretrovirals
  • decrease RBCs and neutrophils
  • not for children or 1st trimester preggos
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7
Q

Quninolones

Quinine

A
  • P. falciparum asexual blood stage
  • P vivax and ovale gametocyticidal
  • interferes w/ heme digestion
  • use for chloroquinine resistant P falciparum
  • Resistance in SE Asia, South America
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8
Q

Quinolones
Quinine
Adverse

A
  • fatal dose 2-8 g
  • cinchonism: tinnitus, deafness, visual disturbance, headache, flushing
  • increased hemolysis with G6PD deficiency
  • contra’d with: hypersens, tinnitus, optic neuritis, dysrhythmias, warfarin, digoxin, renal insufficiency
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9
Q

Quinolones
Quinine
Adjuncts

A

Inhibition of protein translation for protozoa:

  • Doxycycline
  • Tetracycline
  • Clindamycin
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10
Q

Quinolones
Chloroquine
Mechanism

A
  • interferes with heme digestion
  • mainly oral admin (IV can be lethal)
  • resistance since the 60s!
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11
Q

Quinolones
Chloroquine
Adverse

A
  • CV and CNS toxicities
  • fatal for parenteral > 5g
  • pruritius in black people
  • hemolysis with G6PD deficiency
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12
Q

Quinolones
Primaquine
Mechanism

A

-primary and latent hepatic stages (P vivax, ovale)
-gametocyticidal against P falciparum
-elelctrophilic intermediates disrupt parasite mitochondrial ETC
(oxidative stress)
-oral administration

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13
Q

Quinolones
Primaquine
Adverse

A

-hemolytic anemia w/ G6PD deficiency
(African, Sephardic, Sardinian, Iranian descent)
-Contra’d in preggo, breast-feeding

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14
Q

Atovaquone
(Proguanil Combo)
Mechanism

A
  • P falciparum asexual blood and liver stagez
  • inhibits mitochondrial ETC
  • combo with Proguanil
  • Proguanil inhibits dihydrofolate reductase
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15
Q

Atovaquone-Proguanil

Adverse

A

Atovaquone: Rifamp/tetracycline plasma interactions

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