Malaria

Question 1

Quinine/ Quinidine

Answer 1

Class: Quinolone derivitive
MOA: Accumulate in parasite’s food vacuole, disrupt heme polymerization to hemozoin, yielding oxidative damage to membranes and digestive proteases
Uses: Prophylaxis, treatment of acute malarial attacks
SE: Cinchonism, hypotension, hypoglycemia, abortion, arrhythmias

Question 2

Chloroquine (Aralen)

Answer 2

Class: Quinolone derivitive
MOA: Accumulate in parasite’s food vacuole, disrupt heme polymerization to hemozoin, yielding oxidative damage to membranes and digestive proteases
Uses: Prophylaxis, treatment of acute malarial attacks
SE: Itching (Africans), retinitis (rare)

Question 3

Hydroxychloroquine (Plaquenil)

Answer 3

Class: Quinolone derivitive
MOA: Accumulate in parasite’s food vacuole, disrupt heme polymerization to hemozoin, yielding oxidative damage to membranes and digestive proteases
Uses: Prophylaxis, treatment of acute malarial attacks

Question 4

Mefloquine (Lariam)

Answer 4

Class: Quinolone derivitive
MOA: Accumulate in parasite’s food vacuole, disrupt heme polymerization to hemozoin, yielding oxidative damage to membranes and digestive proteases
Uses: Prophylaxis, treatment of acute malarial attacks

Question 5

Primaquine (Primaryl)

Answer 5

Class: Quinolone derivitive
MOA: Forms quinolone-quinone intermediates that oxidize schizont membranes
Uses: Prophylaxis, treatment of acute malarial attacks
SE: Hemolysis (G6PD), methemoglobinemia; Fever, nausea, vomiting
Misc: Only drug that inhibits exoerythrocytic schyzogony

Question 6

Atovaquone (Mepron)

Answer 6

Class: Napthalene
MOA: Depolarizes parasitic mitochondria and inhibits their electron transport
Uses: Used in combination w/proguanil

Question 7

Proguanil/ Chloroguanide (Malarone)

Answer 7

Class: Antifolate
MOA: Dihydrofolate reductase inhibitors (human and parasite pathway)
SE: Rare

Question 8

Pyrimethamine (Daraprim)

Answer 8

Class: Antifolate
MOA: Dihydrofolate reductase inhibitors (human and parasite pathway)

Question 9

Tetracycline (Tetracyn)

Answer 9

Class: Antibiotic
Uses: Severe malaria & chloroquine-resistant uncomplicated malaria

Question 10

Clindamycin (Cleocin)

Answer 10

Class: Antibiotic
Uses: Severe malaria & chloroquine-resistant uncomplicated malaria

Question 11

Doxycycline (Adoxa)

Answer 11

Class: Antibiotic
Uses: Severe malaria & chloroquine-resistant uncomplicated malaria
SE: Photosensitivity

Question 12

Amantadine (Symmetrel)

Answer 12

MOA: Positive charge helps chloroquine overcome chloroquine-resistant malaria vacuoles; point mutations against amantadine return bacteria to chloroquine-sensitivity

Question 13

Artesunate

Answer 13

Class: Artemisinin compound
MOA: Specifically and selectively inhibit SERCA of P. falciparum

SE: Neurotoxicity, prolongation of QT interval

Question 14

Artemether

Answer 14

Class: Artemisinin compound
MOA: Specifically and selectively inhibit SERCA of P. falciparum

Question 15

Lumefantrine

Answer 15

Class: Aminoalcohol

Uses: Used in combination w/artemether (called Coartem)