Malaria Flashcards
Name the quinoline derivatives
quinine/quinoline, chloroquine, mefloquine, primaquine
Mechanism of quinolines?
believed to accumulate in parasite’s food vacuoles and disrupt heme polymerization to hemozoin, causing oxidative damage to membranes and digestive proteases
What helps get the quinolines to accumulate in food vacuoles?
Increasing acidity traps them as the travel from plasma, to red cell cytoplasm, to parasite cytoplasm, to food vacuole
Are chloroquine and mefloquine used for prophylaxis or treatment of acute attacks?
Both!
Name the two DHFR inhibitors used in malaria treatment? What makes them kind of special?
pyrimethamine and chloroguanide (proguanil)
they only affect the parasitic DHFR, not human
What does atovaquone do and how is it used?
depolarizes parasitic mitochondria, inhibits their ETC
used in combo with proguanil for prophylaxis and treatment of P. falciparum (including chloroquine resistant)
What are the two artemisinins?
artemether and artesunate
What’s the mechanism of the artemesinins?
specifically and selectively inhibit the SERCA of P. falciparum
Primaquine is kind of different than the others. How? What’s its use?
action during hepatic stage! probably oxidizes schizont membranes
used for prophylaxis and prevention of relapses
What are the four important parts of malaria prevention?
Assess risk, discuss antimosquito measures, chemoprophylaxis, review symptoms of malaria
Treatment of uncomplicated falciparum, malariae, knowlesi
chloroquine
What needs to be added in treatment of chloroquine sensitive vivax and ovale?
primaquine
Which parasites are likely to be chloroquine resistant?
falciparum and vivax
What can be used in place of chloroquine for resistant strains?
atovaquone+proguanil, quinine+doxycycline, tetracycline or clindomycin (kids), or mefloquine
(add primaquine for vivax)
Side effects of chloroquine?
itching (africans), retinitis (rare)
