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Module 1 > ORG: Anti-malaria > Flashcards

ORG: Anti-malaria Flashcards

1
Q

Most dangerous malaria species

A

Falciparum

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2
Q

What causes periodic episodes of fever in malaria

A

Synchronized rupture of RBC with release of merozoites and rise in concentration of tumor necrosis-factor alpha in the plasma

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3
Q

Erythrocytic cycle of falciparum (hours)

A

48 hours

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4
Q

What species causes malignant tertian malaria

A

Falciparum

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5
Q

What species causes benign tertian malaria

A

Vivax

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6
Q

Erythrocytic cycle of ovale (Hours)

A

48 hours

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7
Q

Erythrocyctic cycle of malariae

A

72 hours

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8
Q

Quinine is highly effective schizonticide agains what species of malaria?

A

All four species

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9
Q

Dextrorotatory isomer of quinine

A

Quinidine

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10
Q

Quinine is gametocidal to

A

Vivax and Ovale

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11
Q

MOA of Quinine

A

Inhibition of heme polymerase and acts as general protoplasmic poison

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12
Q

DOC for severe falciparum malaria

A

Quinine or Quinidine

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13
Q

First line therapy for Chloroquine resistant falciparum malaria

A

Quinine

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14
Q

Quinine is given with what drugs to shorten usage time and reduce toxicity

A

Doxycycline and Clindamycin (Children)

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15
Q

First line therapy for in the treatment of Babesia microti

A

Quinine + Clindamycin

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16
Q

A/E of quinine

A

Cinchonism
Hypoglycemia
ECG abnomalities (QT prolongation - IV Quinidine)
Blackwater fever

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17
Q

How does quinine cause hypoglycemia

A

Through stimulation of insulin release

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18
Q

Rare severe illness that includes marked hemolysis and hemoglobinuria

A

Blackwater fever

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19
Q

Contraindication of quinine

A

Visual or auditory problems

Cardiac Abnormalities

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20
Q

Mefloquine is a strong blood schizonticide against what malarial species?

A

Falciparum and Vivax

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21
Q

MOA of mefloquine

A

Inhibition of heme polymerase

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22
Q

Anti malarial drug effective in prophylaxis against most strains of falciparum and all other malarial species except for those with no chloroquine resistant strains

A

Mefloquine

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23
Q

A/E of Mefloquine

A

Neuropsychiatric toxicities
Arrhythmias and Bradycardia
Thrombocytopenia, Leukocytosis, Aminotransferase elevation
GI disturbance

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24
Q

C/I of Mefloquine

A

Pregnancy
Epilepsy or psychiatric disorders
Cardiac conduction defects (or with drugs that cause this)

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25
Q

Mefloquine should not be co-administered with

A

Quinine
Quinidine
Halofantrine
NOTE: Caution is required when administering Quinine/Quinidine after Mefloquine Prophylaxis

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26
Q

The two drugs under Quinoline-Methanols

A

Quinine

Mefloquine

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27
Q

Chloroquine is a highly effective blood schizonticide against what malarial species?

A

The four species

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28
Q

Chloroquine is a gametocide against

A

Vivax
Ovale
Malariae

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29
Q

MOA of Chloroquine

A

Prevent polymerization of heme to hemozoin.

Heme will then be toxic to the parasite.

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30
Q

DOC in the treatment of nonfalciparum malaria

A

Chloroquine

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31
Q

Preferred chemoprophylactic agent in malarious regions without resistant falciparum malaria

A

Chloroquine

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32
Q

Drug used for amebic abscesses that fail initial therapy with metronidazole

A

Chloroquine

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33
Q

Adverse effect of Chloroquine

A

Pruritus (Common in africans)

34
Q

C/I of Chloroquine

A

Psoriasis and Porphyria

35
Q

Route of administration of Quinine/Quinidine

A

PO, IV, IM

36
Q

Route of administration of Mefloquine

A

PO

37
Q

Route of administration of Chloroquine

A

PO, IV, IM

38
Q

Halofantrine is effective against what species of malaria

A

The four species, especially chloroquine resistant falciparum

39
Q

Absorption of halofantrine is increased with

A

Fatty foods

40
Q

Route of administration of halofantrine

A

PO

41
Q

Lumefantrine and Artemether is used for what malarial species

A

Falciparum

42
Q

Brand name of lumefantrine + artemether

A

Coartem

43
Q

Adverse effect of Halofantrine

A 
GI disturbance (ab pain, diarrhea, vomitting)
Cough
Hypersensitivity (rash, pruritus)
HA
Elevated liver enzymes
QT and PR Prolongation
44
Q

QT and PR prolongation observed in halofantrine at what dose? and is worsened by?

A

Standard doses

Prior mefloquine therapy

45
Q

Coartem exhibits also cardiac toxicity seen in halofantrine (T/F)

A

False

46
Q

C/I Halofantrine

A

Pregnancy (Embryotoxic)
Cardiac conduction defects
Mefloquine

47
Q

Active metabolite of proguanil

A

Cycloguanil

48
Q

Proguanil has some activity against hepatic form (T/F)

A

True

49
Q

MOA of pyrimethamine and proguanil

A

Inhibit folate utilization by inhibiting dihydrofolate reductase

50
Q

Drug combination which is an alternative to mefloquine

A

Proguanil and Chloroquine

51
Q

Presumptive treatment of falciparum malaria

A

Fansidar

52
Q

Adjuct to quinine therapy to shorten the course of quinine and limit toxicity

A

Fansidar

53
Q

Treatment of multi drug resistant falciparum in africa

A

Chlorproguanil + Dapsone

54
Q

First line therapy for treatment of acute toxoplasmosis

A

Sulfadiazine + Pyrimethamine

55
Q

Sulfadiazine can be replaced with what drug as treatment for acute toxoplasmosis

A

Clindamycin

56
Q

First line therapy for pneumocystosis

A

Co-trimoxazole

57
Q

Standard chemoprophylactic drug for the prevention of P. jiroveci infection in immunocompromised individuals

A

Co-trimoxazole

58
Q

A/E of proguanil

A

Mouth ulcers

Alopecia

59
Q

Fansidar A/E

A

Erythema multiform
SJS
Toxic epidermal necrolysis

60
Q

Atovaquone absorption is increased by

A

Fatty foods

61
Q

MOA of atovaquone

A

Mimic ubiquinone thereby inhibiting the parasite’s mitochondrial electron transport chain

62
Q

Treatment of mild to moderate P.jirovecii pneumonia

A

Atovaquone

63
Q

Highly effective for the treatment and chemoprophylaxis of falciparum malaria

A

Atovaquone + Proguanil

64
Q

A/E Atovaquone

A

Fever, Rash
Nausea Vomitting Diarrhea
Headache Insomia

65
Q

Artemisinin and Derivatives are active agains what form of malarial parasite

A

All four

66
Q

Active metabolite of artemisinin

A

Dihydroartemisinin

67
Q

Artemisinin route of administration

A

PO

68
Q

Artesunate ROA

A

PO IV IM rectal

69
Q

Artemether

A

PO IM Rectal

70
Q

`MOA of Artemisinin

A

Production of free radicals that follows the iron-catalyzed cleavage of the artemisinin endoperoxide bridge in the parasite food vacuole

Inhibition of parasite calsium ATPase

71
Q

Only drugs reliably effective against quinine-resistant strains

A

Artemisinin

72
Q

A/E of Artemisinin

A

Nausea Vomiting Diarhea

73
Q

Treatment of highly resistant falciparum malaria in thailand (with mefloquine)

A

Artesunate

74
Q

Primaquine is gametocidal against what malarial species?

A

All four

75
Q

MOA Primaquine

A

Through a quinolone-quinoline metabolite that inhibits coenzme Q mediated respiratory chain of the exoerythrocytic parasite

76
Q

Most effective antimalarial drug for preventing transmission of the disease in all four species of plasmodia

A

Primaquine

77
Q

Only available agent active against the dormant hypnozoite of vivax and ovale

A

Primaquine

78
Q

Hemolysis or methemoglobinemia is an A/E caused by primaquine especially in patients with what condition

A

G6PD-Deficiency

79
Q

Metabolites of primaquine have lesser activity than parent compound (T/F)

A

False. Greater activity

80
Q

Treatment strategies for G6PD-deficient patients with malaria

A
  1. ) Withhold therapy; treat relapse with chloroquine
  2. ) Give standard dose but monitor hematologic status
  3. ) Treat weekly with primaquine (45mg base) for 8 weeks
  4. ) Discontinue if with anemia
81
Q

Malarial drugs used to prevent transmission

A

Primaquine
Pyrimethamine
Proguanil

Module 1 (15 decks)

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