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GI 2 Final > GI Pharmacology For Parasitic Infections > Flashcards

GI Pharmacology For Parasitic Infections Flashcards

1
Q

What is the MOA of Benzimidazoles?

A

-Bind to parasitic beta-tubulin, disrupt microtubular polymerizaion and microtubular depentdent processes (attachment and transport).

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2
Q

What are the three Benzimidazoles used in anti-helminthic treatment?

A
  • Albendazole
  • Mebendazole
  • Thiabendazole (cutaneous only)
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3
Q

What is the absorption and bioavabiltiy of medendazole?

A
  • Poor absorption and efficient metabolism.
  • Low systemic exposure.
  • Safe medication >2 y/o.
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4
Q

What is the absorption and bioavailability of Albendazole?

A
  • Modest absorption, efficient metabolism.
  • Low systemic exposure to parent drug, exposure to metabolites make it effective against tissue dwelling helminths and hydatid cysts.
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5
Q

What is the absorption and bioavaibility of Thiabendazole?

A

Systemic toxicity limits its use to cutaneous only for larval migrans.

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6
Q

What medication is indicated for infection with Enterobius Vermicularis (pinworm)?

A

Mebendazole.

Common infection in kids

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7
Q

What medication is indicated for infection with Necator americanus and Ancylostoma duodenale (hookworms)?

A

Albendazole

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8
Q

What medications are indicated for infections with Ascaris lumbricoides?

A

Albendazole or Mebendazole

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9
Q

What medication is indicated for infection with Trichuris trichirua (whipworm)?

A

Mebendazole (3 day course) or Albendazole

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10
Q

what medication is indicated for treatment of infection with Toxocara species (larval migrans)?

A

Albendazole

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11
Q

What are the side effects of albendazole and medendazole?

A

Both are teratogenic. Pregnancy class C medications

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12
Q

What medication is affective against hookworms, pinworms, and round worms but ineffective against Trichuris trichiura?

A

Pyrantel pamoate.

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13
Q

What is the MOA of pyrantel?

A

Depolarizing NM blocking agent. Causes persistent activation of nAChr and spastic paralysis of the worm.

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14
Q

What agent can be given for heavy ascaris infections because it paralyzes the worms prior to treatment with second agent?

A

Pyrantel pamoate

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15
Q

What is the bioavability and absorption of pyrantel pamoate?

A

Poorly absorbed from the GI tract, confines action to intraluminal GI nematodes only.

Can be used with caution in pregnant women and children <2.

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16
Q

What medication can be used in the treatment of intestinal Strongyloides and Onchocerciasis?

A

Ivermectin

17
Q

What is the MOA of Ivermectin?

A

Activates Glurtamate gates chloride channels causing hyperpolarization and paralysis.

18
Q

What is a contraindication to the use of Ivermectin?

A

In patients with a disruptive BBB (meningitis, trypanosomiasis) due to the fact that ivermectin can act on GABA-gated Cl channels.

19
Q

What drug is used in the treatment of lymphatic filariasis?

A

Diethylcarbamazine.

Can only be obtained via CDC

20
Q

What is the drug of choice for infections of adult tapeworms (taenia species and diphyllobothrium)?

A

Praziquantel

21
Q

What is the drug of choice for larval forms of tapeworm infections (cysticercosis, echinococcus)?

A

Albendazole

22
Q

What is a contra-indicated use for treatment of Praziquantel?

A

Ocular cysticercosis due to destruction of the organism in the eye leading to damage.

23
Q

What is the drug of choice in the treatment of cystic hydatid disease due to echinococcus granulosus (dog tapeworm in humans)?

A

Albendazole.

24
Q

What is a finding on microscopy of the schistomiasis eggs?

A

Pointed structure sticking out of the surrounding membrane

25
Q

What is the drug of choice for all forms of schistomiasis?

A

Praziquantel

26
Q

What is the bioavability of praziquantel?

A

Rapidly absorbed, distributes into the CSF, metabolized with short half life (1-3hrs).

27
Q

What is the MOA of praziquantel?

A

Interferes with calcium homeostasis and causes flaccid paralysis in adult flukes.

28
Q

What are the indications for treatment with metronidazole?

A

Protozoa:Entamoeba histolytica and Giardia lamblia infections

Bacteria: (anaerobic) clostridium and enterococcus species

29
Q

What activates metronidazole within its host?

A

Pyruvate-ferredoxin oxidoreductase complex.

30
Q

What is the approved treatment for Giardiasis?

A

Tinidazole. There is resistance to metronidazole

31
Q

What are the adverse effects off tinidazole and metronidazole?

A
  • Metallic taste

- Disulfiram-like reaction (severe symptoms with intake of etoh).

32
Q

What is the treatment protocol for E. Histolytica infection?

A

Metronidazole followed by a luminal amebicide (paromomycin, diiodohydroxyquin, or diloxanide furoate).

33
Q

What type of drug is paromomycin?

A
  • member of aminoglycoside family.

- binds 30s ribosome

34
Q

What is a medication that can be used as an alternate to metronidazole for E. Histolytica infection during pregnancy?

A

Paromomycin

35
Q

What is the drug of choice for treatment of colonized intestine with E. Histolytica?

A

Paromomycin

36
Q

What are the three drugs that can be used to treat Giardiasis?

A

Tinidazole, metronidazole, nitazoxanide.

Tinidazole if fist choice

GI 2 Final (9 decks)

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