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Phar 506 > Malaria > Flashcards

Malaria Flashcards

1
Q

What is malaria

A

infectious disease affecting humans and other animals caused by parasitic protazoans (plasmodium type)

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2
Q

What is the vector for malaria

A

Female anopheles mosquito

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3
Q

What are the four plasmodium genes that causes marlaria, what type of malaria does each genus cause

A

Plasmodium falciprium -> tropica, Plasmodium vivax -> tertiana, plasmodium ovale -> tertiana, Plasmodium malariae -> quartana

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4
Q

Which malaria is the most aggresive

A

tropica

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5
Q

Which malaria is able to relapse, why

A

vivax, can stay dormant in liver cells

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6
Q

T/F: Plasmodium knowlesi is a plasmodium genus that can cause malaria through transmission from monkeys to humans but needs a mosquito vector

A

True

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7
Q

Where are malaria cases usually found

A

Around the equator

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8
Q

When a mosquito bites a human where does the parasite reside to survive and spread, what is the purpose for this fluid in mosquito, what form is the parasite at

A

Saliva, used to prevent the blood from coagulating, sporozoites

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9
Q

Once in the human blood stream where does the sporozoites go to take refuge, what happens once it has found refuge

A

The liver, multiply within hepatocytes until it bursts

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10
Q

What is the parasite form that is released from the liver

A

Merozites

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11
Q

Once the liver cell has been destroyed what form of the parasite looks for refuge in the blood stream, where does it take refuge

A

Merozites, RBCs

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12
Q

When does the patient first start to feel the symptoms of having malaria

A

When the merozites have reproduced and burst the RBC and re-infect other RBCs

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13
Q

What is a separate fate for RBCs if they do not burst

A

Become male or female gametocytes

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14
Q

What happens to the gametocytes in a patient’s blood that has malaria that is ingested by a mosquito

A

Instead of being digested the mature to gametes and become a zygote

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15
Q

What is the name of a mosquito zygote that becomes mobile

A

ookinete

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16
Q

Where does a ookinete migrate to and what does it mature into

A

Cell wall of a mosquito’s gut, oocyst

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17
Q

What happens when a oocyst bursts, what is the fate of the contents

A

Sporozoites are released and travel to the saliva glands of mosquitoes

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18
Q

What are hypnozoites

A

Dormant liver form of malaria

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19
Q

T/F: Liver schizonts are the liver cells infected that allow for sporozoites to mature to merozoites and eventually burst. Blood schizonts are infected blood cells that allow merozoites to reproduce and eventually burst

A

True

20
Q

What are the three human drug targets to fight malaria

A

Hypnozoites, Schizonts, Gametocytes

21
Q

What are the classes of drugs for fighting malaria

A

4-substituted quinolones, 8-substituted quinolones

22
Q

What are the four different 4-sub quinolines

A

Quinine, Chloroquine, Mefloquine, Halofantrine

23
Q

What are the two components of the drug quinine

A

quinoline and quinuclidine

24
Q

What are the essential components of quinine to make it active

A

The two chiral carbons

25
Q

What are the two conformations quinine must be in order to be active, what is the name of each

A

8S, 9R (quinine) and 8R, 9S (quinidine)

26
Q

What are the unique subsitutions for mefloquine, halofantrine, and chloroquine

A

two fluorinated methyl groups, surronded by halogens, a single chlorine and a amino group

27
Q

What is the MOA of 4-sub quinolines

A

Binds thus preventing hemozoin synthesis allowing the heme to kill the RBCs and therefore the merozites

28
Q

What does the merozite use as sustenance while in a RBC, what is the consequence of this, how is this consequence dealt with

A

Hemoglobin, Heme has the potential to kill RBC, produces hemozoin to bind the heme and keep the RBC alive

29
Q

How do 4 sub quinolines get into where the digestion happens

A

Enter the acidic environment easily because they are weak bases (tertiary amines) through a ion gradient, once in the acidic enviornment they become ionized and can no longer leave thus allowing them do to their action

30
Q

T/F: 4-sub quinolines only work on blood schizonts

A

True

31
Q

What is the resistance against 4-sub quinolines

A

Efflux pumps, increased plasmodium metabolism

32
Q

What is the 8-substituted quinoline used in mylaria

A

Primaquine

33
Q

What do the 8-sub quinolines work on

A

Liver hypnozoites, liver schizonts, and blood gametocides

34
Q

T/F: Pregnant women can use both types of quinolines

A

False: 8-sub quinolines is not indicated to be used in pregnant women

35
Q

What is the antifolate used in malaria, what is the MOA, what is used in combination with

A

Pyrimethamine, significantly higher affinity for binding the DHFR receptor leading to inhibit folic acid synthesis, Sulfadoxine

36
Q

What do the DHFR- inhibitors target

A

Blood schizonts

37
Q

What is MOA of artemisins, what do they work on

A

free radical formations, blood schzoints and young gametocides

38
Q

What is the MOA of the dual product Atovaquone/Proguanil (Malarone)

A

Collapse of the mitochondrial membrane potential, inhibitor of dihydro folate reductase

39
Q

T/F: Malarone (Atovaquone/Prguanil) only works on blood schizonts

A

True

40
Q

T/F: If malaria infection occurs even though preventive drugs were used it is okay to keep the same regimen

A

False: If a malaria infection occurred despite the use of a preventative drug, that drug should not be used in the treatment regimen

41
Q

What should be done if there is suspiscion of malaria but it cannot be confirmed

A

treat against CQ- resistant malaria immediately

42
Q

What is the drug therapy if someone has CQ sensitive malaria)

A

CQ phosphate

43
Q

What is the drug therapy if someone has CQ resistance

A

Malarone OR Coartem OR Quinine Sulfate plus doxycycline or tetracyline

44
Q

What is the drug therapy if a patient has plasmodium Malariae or knowles

A

CQ phosphate

45
Q

What is the drug therapy if a patient has plasmodium vivax or ovale

A

CQ phosphate PLUS primaquine phosphate

46
Q

What is the drug therapy if a patient has severe malaria

A

Quinidine gluconate IV then Quinine OR Atovaquone-Guanil OR Artemether- Lumefantrine

47
Q

What do pregnant patients with malaria recieve

A

CQ OR mefloquine plus clindamycin

Phar 506 (37 decks)

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