Malaria Treatment

Question 1

Resistance readily occurs in which two species?

Answer 1

falciparum and vivax

Question 2

builds up in the food vacuole of the parasite

keeps cell “toxic” by preventing FPIX from converting to hemozoin

low doses for prophylaxis w/minimal side fx

high doses for acute disease tx can cause dizziness, HA, itching, vomiting, rash, BLINDNESS if prolonged

Answer 2

Chloroquine

Question 3

More toxic than Chloroquine but resistance not readily developed

• probably same MOA as Chloroquine
• side fx: Cinchonism (tinnitus, blurred vision, nausea, HA, decreased hearing acuity, permanent vision/balance/hearing damage

Answer 3

Quinine and Quinidine

Question 4

Anti-arrhythmic drug blocks Na and K currents

IV for malaria

side fx: cardiac problems!!!!

Answer 4

Quinidine

Question 5

• probably acts like Chloroquine

- may cause hallucinations and DEPRESSION

Answer 5

Mefloquine

Question 6

• depolarizes parasitic mitochondria and inhibits electron transport
• given with Proguanil

Answer 6

Atovaquone

Question 7

• inhibits Plasmodium DHFR
• enhances mitochondrial toxicity of atovaquone
• not active in liver
• concentrated in RBCs

Answer 7

Proguanil

Question 8

Slow onset

replacing mefloquine for prophylaxis

GI probs

Answer 8

Atovaquone-Proguanil

Question 9

• produces free radical to damage parasite proteins
• RAPID and potent against even multi-drug resistance
• DO NOT use alone (to avoid development of resistance)

Answer 9

Artemisinins

• Artesunate + mefloquine
• Artemether + lumefantrine

Question 10

• uknown MOA
• used with artemether
• rapid initial response and LONG HALF LIFE

Answer 10

Lumefantrine

Question 11

“Radical care” means what?

Answer 11

treating dormant vivax and ovale HYPNOZOITES in hepatocytes

Question 12

Which drug is first line for “radical care”?

Answer 12

Primaquine

**causes hemolytic anemia in pts w/G6PD def

Question 13

Abx that inhibits protein synthesis?

Answer 13

Doxycycline