Malaria Flashcards
What are the 5 quinolone derivatives used for the treatment of acute malarial attacks?
Quinine Chloroquine Hydroxychloroquine Mefloquine Primaquine
What is the mechanism of action for the quinolone derivatives, except for primaquine?
Accumulate in parasite’s food vacuole, disrupt heme polymerization to hemozoin, yielding oxidative damage to membranes and digestive proteases
What is the mechanism of action for primaquine?
Forms quinolone-quinone intermediates that oxidize schizont membranes
Which of the malarial drugs is the only one that inhibits exoerythrocytic schizogony?
Primaquine
What are the side effects of quinine?
Cinchonism Hypotension Hypoglycemia Abortion Arrhythmias
What are the side effects of chloroquine?
Itching (Africans)
Retinitis (Rare)
What are the side effects of Primaquine?
Hemolysis (G6PD)
methemoglobinemia
Fever
N/V
The positive charge of this drug helps chloroquine overcome chloroquine-resistant malaria vacuoles…
Amantadine
What drug is given for chloroquine-resistant malaria that creates a positive charge?
Amantadine
What are the 2 artemisinin compounds that specifically and selectively inhibit SERCA of P. Falciparum?
Artesunate
Artemether
What is the aminoalcohol used in combination with artemether?
Lumefantrine
What are the side effects of artesunate?
Neurotoxicity
Prolongation of QT interval
What class is atovaquone in?
Napthalene
What is the mechanism of action for atovaquone?
Depolarizes parasitic mitochondria and inhibits their electron transport
What is used in combination with atovaquone?
Proguanil
What class is chloroguanide (proguanil) in?
Antifolates
What is the mechanism of action for chloroguanide (proguanil)?
Dihydrofolate reductase inhibitor
What are the three antibiotics used with severe malaria and chloroquine-resistant uncomplicated malaria?
Tetracycline
Clindamycine
Doxycycline
What are the treatment options for severe malaria?
IV quinidine gluconate + tetracycline, doxycycline, or clindamycine
or
IV arsenate followed by atovaquone-proguanil, doxycycline or mefloquine
Treatment of uncomplicated malaria–Chloroquine sensitive strains?
Falciparum, Malariae, knowlesi
Chloroquine phosphate or hydroxychloroquine
Treatment of uncomplicated malaria—Chloroquine sensitive strains
Vivax and ovale
Chloroquine phosphate + Primaquine phosphate
OR
Hydroxychloroquine + Primaquine phosphate
Treatment of uncomplicated malaria—Chloroquine-resistant strains
Falciparum
Atovaquone-proguanil
OR
Artemether-lumefantrine
Quinine sulfate + doxycycline, tetracycline or clindamycin
Mefloquine
Treatment of uncomplicated malaria—Chloroquine-resistant strains
Vivax
Quinine sulfate + either Doxycycline or Tetracycline + Primaquine phosphate
OR
Atovaquone-proquanil + primaquine phosphate
Mefloquine + Primaquine phosphate
ACUTE ATTACKs by Vivax or Ovale treatment
Primaquine phosphate
