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Pharmacology Test #2 > Other Pathogenic Protozoa > Flashcards

Other Pathogenic Protozoa Flashcards

1
Q

Transmission of Toxoplasma gondii

A

eating raw meat

cat feces

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2
Q

Describe the T. gondii life cycle.

A
  • sexual development only in cat
  • cysts develop in other mammals
  • can get infected from oocysts shed by cats or by eating raw meat containing tissue cysts
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3
Q

Who does severe toxoplasmosis typically happen to?

A

HIV/AIDS patients, organ transplant patients, chemotherapy patients

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4
Q

Congenital toxoplasmosis

A

fetus becomes infected via placenta in women who are infected for the first time

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5
Q

First line therapy for toxoplasma gondii?

A

pyrimethamine + sulfadiazine

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6
Q

Parasitic infections associated with HIV in the US?

A 
Pneumocystis jirovecii (pneumonia)
Toxoplasma gondii (encephalitis)
Cryptosporidium (cryptosporidiosis)
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7
Q

Parasitic infections associated with HIV globally?

A

Malaria
Leishmania
Trypanosoma cruzi (Chagas disease)

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8
Q

First line agent for the treatment of West African trypanosomiasis?

A

Pentamidine

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9
Q

Alternative treatment for visceral leishmania and pneumocystosis?

A

Pentamidine

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10
Q

Describe the toxicity of pentamidine.

A

highly toxic
50% of patients show side effects
can cause hypo or hyperglycemia (rare)

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11
Q

Anaerobic protozoa

A 
Entamoeba histolytica (amebiasis)
Giardia lamblia (giardiasis)
Trichomonas vaginalis
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12
Q

Describe symptoms of an Entamoeba histolytica infection

A

causes diarrhea and ulcers on the lining of the intestine

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13
Q

What promotes the spread of amebiasis?

A

poor sanitation and fecal contamination of food and water

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14
Q

Where does amebiasis initially infect?

A

initially infects the intestine (sometimes reaches other organs such as liver)

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15
Q

Symptoms of amebiasis?

A

diarrhea, increased flatulence, abdominal cramps (some people develop liver abscesses)

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16
Q

Treatment of choice for Giardia lamblia?

A

Metronidazole

Nitazoxanide

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17
Q

Most frequent cause of recreational water-related disease outbreaks?

A

Cryptosporidium

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18
Q

Most common symptoms of Cryptosporidium

A 
Watery diarrhea (most common)
stomach cramps/pain
dehydration
nausea/vomiting
fever
weight loss
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19
Q

Drug of choice for cryptosporidium?

A

Nitazoxanide

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20
Q

Symptoms of Trichomonas in men?

A

frequently asymptomatic

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21
Q

Symptoms of Trichomonas in women?

A

vaginitis with a purulent discharge

vulvar and cervical lesions, abdominal pain, dysuria, and dyspareunia

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22
Q

Drug of choice for extraintestinal Entamoeba histolytica, giardiasis, and trichomoniasis

A

Metronidazole

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23
Q

What does metronidazole kill?

A

kills trophozoites but not cysts

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24
Q

Similar drug to metronidazole with less toxicity

A

Tinidazole

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25
Q

What is metronidazole treatment usually followed by?

A

luminal drug to eliminate asymptomatic infection

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26
Q

What happens with metronidazole and alcohol?

A

Antabuse (disulfrim) effect: nausea, vomiting, and increased heart rate

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27
Q

What does metronidazole inhibit?

A

acetaldehyde dehydrogenase

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28
Q

Drugs for intestinal forms of amebiasis?

A

Paromomycin

Iodoquinol

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29
Q

What is paromomycin also active against?

A

Cryptosporidium

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30
Q

What does Nitazoxanide do?

A

inhibits the growth of sporozoites and oocysts of Cryptosporidium parvum and trophozoites of Giardia lamblia

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31
Q

African trypanosomes

A

Trypanosoma brucei gambiense (West African trypanosomiasis ~95% of cases)
Trypanosoma brucei rhodesiense (East African trypanosomiasis ~5% of cases)

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32
Q

American trypanosome

A

Trypanosoma cruzi

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33
Q

Kinetoplastid parasites

A

Leishmania
African trypanosomes
American trypanosomes

34
Q

Anti-kinetoplastid drugs for Leishmaniasis

A

Sodium stibogluconate or Amphotericin B

Alternatives: pentamidine or Miltefosine

35
Q

Anti-kinetoplastid drugs for African trypanosomiasis

A

Early stage - pentamidine (West) or Suramin (East)

Late stage - Melarsoprol (East and West) or Eflornithine (West)

36
Q

Anti-kinetoplastid drugs for American trypanosomiasis

A

Nifurtimox or Benznidazole

37
Q

What is miltefosine approved for use against?

A

visceral leishmaniasis

38
Q

First oral antileishmanial drug

A

miltefosine

39
Q

When should you avoid using miltefosine?

A

during pregnancy - teratogenic

40
Q

Most commonly used drugs for T. cruzi

A

Nifurtimox and Benznidazole

41
Q

Describe administration of Nifurtimox and Benznidazole

A

Orally available

3-4 month course of treatment

42
Q

Describe toxicity of nifurtimox and benznidazole

A

toxicity common - hypersensitivity, GI complications

leads to premature stoppage of treatment

43
Q

Unique biology of worms

A

multiply outside of their definitive host in contrast to other parasites
evade immune system (infections are chronic and last for the lifetime of the host)

44
Q

Most common helminth infection

A

Ascaris

45
Q

Cestodes (Tapeworms)

A 
Diphyllobothrium latum (Broad fish tapeworm)
Echinococcus granulosus (Dog tapeworm)
Taenia saginata (Beef tapeworm)
Taenia solium (Pork tapeworm)
46
Q

Trematodes (Flukes)

A 
Schistosoma mansoni (Blood fluke)
Schistosoma haematobium (Blood fluke)
Schistosoma japonicum (Blood fluke)
47
Q

Nematodes (Roundworms) - Intestinal infections

A 
Ancylostoma duodenale
Necator americanus
Ascaris lumbricoides (Giant roundworm)
Enterobium vermicularis (Pinworm)
Strongyloides stercoralis (threadworm)
Tricuris trichiura (whipworm)
48
Q

Nematodes (Roundworms) - Tissue infections

A

Toxocara canis (Dog worm)

49
Q

Cysticercosis

A

caused by autoinfection by ingesting eggs produced by T. solium

50
Q

Describe the cysticercosis life cycle.

A

After ingestion, oncospheres hatch in the intestine, invade the intestinal wall, and migrate to striated muscles, develop into cysticerci, can cause serious disease in the brain

51
Q

Cysticercosis infection in the brain

A

neurocysticercosis

52
Q

Enterobiasis

A

pinworm disease

53
Q

Trichuriasis

A

whipworm disease

54
Q

Ascariasis

A

roundworm disease

55
Q

Strongyloidiasis

A

threadworm disease

56
Q

Onchocerciasis

A

river blindness

57
Q

Visceral larva migrans caused by?

A

Toxocara canis

58
Q

Drug therapy for helminths with broad spectrum activity

A

Benzimidazoles

59
Q

Three Benzimidazoles currently on the market

A

Mebendazole
Thiabendazole (limited by toxicity)
Albendazole (useful against GI and tissue)

60
Q

Mechanism of action for Benzimidazoles

A

binds to tubulin

inhibits formation of microtubules (cap ends)

61
Q

What is albendazole a drug of choice for?

A

cysticercosis

62
Q

What is albendazole also used for besides cysticercosis?

A

pinworms, hookworms, ascariasis, trichuriasis, and strongyloidiasis

63
Q

What is mebendazole used for?

A

pinworms, hookworms, ascariasis and trichuriasis

64
Q

What is praziquantel high effective against?

A

cestodes and trematodes

65
Q

Praziquantel’s MOA?

A

at lower concentrations, increased muscular activity (worms detach from blood vessel walls, migrate to liver)
at higher concentrations, tegumental damage and exposes a number of tegumental antigens
may also disrupt calcium homeostasis

66
Q

Therapeutic uses of praziquantel?

A

drug of choice for all forms of schistosomiasis
dramatically reduces egg burden in those not cured in two or three doses
used in mass treatment programs

67
Q

Toxicity of praziquantel?

A

mild and transient adverse effects are common

more severe reaction to dying worms (immune reaction)

68
Q

Ivermectin is a drug for?

A

drug of choice for strongyloidiasis and onchocerciasis

69
Q

Structure of Ivermectin?

A

semisynthetic macrocyclic lactone

70
Q

Ivermectin MOA?

A

paralyzes microfilariae
binds to glutamate-activated CL- channels found in nematode nerve or muscle cells
causes hyperpolarization by increasing intracellular chloride concentration

71
Q

What does Ivermectin not kill?

A

does not kill adult worms

blocks release of progeny

72
Q

Main therapeutic use of Ivermectin?

A

primarily used to treat onchocerciasis (single dose)

73
Q

Other uses of Ivermectin?

A

Ascariasis
Enterobiasis
Strongyloidiasis
Filariasis

74
Q

What is Pyrantel pamoate?

A

broad-spectrum antihelminth

75
Q

What is pyrantel paomoate effective against?

A

High effective for pinworms and ascaris
Moderately effective against hookworms
active against adult and immature worms

76
Q

Pyrantel paomoate MOA

A

depolarizing neuromuscular blocking agent
causes release of acetylcholine and inhibition of cholinesterase
worms are paralyzed and expelled

77
Q

Clinical uses of Pyrantel paomoate

A

Ascariasis - one dose is 85%-100% effective

Pinworms - two doses two weeks apart - 95% cure rate

78
Q

Scabies are caused by?

A

human itch mite, Sarcoptes scabiei

79
Q

Treatment of scabies?

A

Permethrin cream (may need to pretreat with 6% salicyclic acid if crusted scabies)

80
Q

Treatment of head lice?

A

~1% permethrin or pyrethrins

chronic infestations - 0.5% malathion

Pharmacology Test #2 (13 decks)

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