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Pharm 4 > Malaria > Flashcards

Malaria Flashcards

1
Q

Artesunate - target

A 
Blood stage (asexual + gamete) of falciparum
Asexual of vivax
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2
Q

Artemisins - mechanism

A

peroxide bridge - endoperoxide moiety

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3
Q

Artemisins - excretion

A

biliary excretion

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4
Q

Artemisins - prox?

A

NO

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5
Q

Artemisins - in pregnancy?

A

NOT in 1st trimester or kids <5kg

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6
Q

Artemisins - TOX

A

Decreased RBCs/neutrophils + heart block (REV)

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7
Q

Artemether + Lumefantrine - administration?

A

Fat meal increases absorption

if vomit in 30 mins, retake

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8
Q

Artemether + Lumefantrine - drug drug rx?

A

Antiretrovirals/PI

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9
Q

Artemether + Lumefantrine - contraindicated in?

A

Cardiac disease, arrhythmias

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10
Q

Chloroquine - target?

A

Drug of choice for falciparum (asexual + gamete)

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11
Q

What is the drug of choice for falciparum?

A

Chloroquine

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12
Q

Chloroquine - mechanism?

A

Blocks heme digestion

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13
Q

Chloroquine - administration?

A

PO (parenteral is dangerous)

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14
Q

Chloroquine - excretion?

A

Renal

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15
Q

Chloroquine - resistance?

A

increased PfCRT (chloroquine efflux)

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16
Q

Chloroquine - in pregnancy?

A

YES

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17
Q

Chloroquine - TOX

A

visual disturbances, pruritis in Africans, G6PD - hemolysis, nail+mucous - discolor, parenteral > 5 gm =dead (CV + CNS tox)

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18
Q

Chloroquine - CI?

A

Epilepsy, myasthenia gravis

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19
Q

Chloroquine - caution?

A

Liver, GI, neuro, blood disorders

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20
Q

Chloroquine - Avoid

A

kaolin, antacids, CYP2D6 (decreases yellow fever immunization)

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21
Q

Quinine - target

A 
asexual falciparum (resist to chloroquine)
gemetocidal vivax + ovale
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22
Q

Quinine - mechanism

A

Inhibits heme digestion

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23
Q

Quinine - administration

A

PO (IV is more toxic)

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24
Q

Quinine - excretion

A

Renal

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25
Q

Quinine - resistance

A

increased Pfmdr1

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26
Q

Quinine - TOX

A

tinnitus, deafness, visual disturbance, HA, N/V, dizziness, postural hypotension (REV), blackwater fever (stop TX)

27
Q

Quinine - CI

A

Tinnitus, optic neuritis, renal

28
Q

Quinine - in pregnancy?

A

YES

29
Q

Quinine - overdose?

A

PO 2-8 gm - pulmonary edema, thrombocytopenia

30
Q

Quinine - drug drug rx

A

Inhibits CYP3A4 - (warfarin, digoxin)

Antacids decrease absorbption

31
Q

Primaquine - target

A

Primary and latent hepatic (ovale + vivax)
Gametocidal (falciparum)
NOT asexual blood stage

32
Q

Primaquine - caution

A

G6PD hemolytic anemia

33
Q

Primaquine - mechanism

A

electrophilic intermediate - mitochondrial ETC interference

decrease GSH antioxidant

34
Q

Primaquine - administration

A

PO

35
Q

Primaquine - CI

A

RA, Lupus

36
Q

Primaquine - in pregnancy

A

NO

37
Q

Atovaquone - target

A 
Asexual falciparum
Primary liver (no vivax)
38
Q

Atovaquone - mechanism

A

blocks mitochondrial ETC

39
Q

Atovaquone - caution

A

not MONO (+Proguanil - Malarone)

40
Q

Malarone

A

Prophylaxis and cure (falciparum)

41
Q

Atovaquone - excretion

A

Biliary

42
Q

Atovaquone - resist

A

Cyt b

43
Q

Atovaquone - pregnancy

A

NO

44
Q

Atovaquone - drug drug rx

A

Rifampin/tetracycline decrease levels

45
Q

Proguanil - target

A

asexual falciparum
Primary liver falciparum
Acute vivax

46
Q

Proguanil - drug or prodrug

A

Prodrug

47
Q

Which malaria drug is a prodrug?

A

Proguanil

48
Q

Proguanil - mechanism

A

inhibits dihydrofolate reductase

49
Q

Proguanil - pregnancy?

A

NO

50
Q

Mefloquine - target

A 
asexual blood (good for resistsant falciparum)
prophylaxis
51
Q

Mefloquine - excretion

A

Biliary

52
Q

Mefloquine - caution

A

vivid dreams

53
Q

Mefloquine - in pregnancy?

A

YES

54
Q

Mefloquine - blackbox

A

Neuro and psych

55
Q

Which malaria drug has a black box warning about neuro and psych problems?

A

Mefloquine

56
Q

Babesiosi - treatment

A

Quinine + Clinda

Atovaquone + azithro

57
Q

Amebiasis - treatment

A

Metron

Chloroquine

58
Q

PJP - treatment

A

Bactrim

Primaquine + clinda

59
Q

Malaria drugs ok in pregnancy?

A

Chloroquine
Quinine + Clinda
Mefloquine

60
Q

Malaria prophylaxis?

A 
Chloroquine
Atovaquone - proguanil
Mefloquine
Doxycycline (MDR)
Primaquine (liver)
61
Q

Which malaria drugs are gametocytal?

A

Artemisinins

Primaquine

62
Q

Which malaria drug targets BOTH liver stages?

A

Primaquine

63
Q

Which malaria drug targets the primary liver stage?

A

Malarone

Pharm 4 (5 decks)

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