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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
What is metronidazole treatment usually followed by?
luminal drug to eliminate asymptomatic infection
26
What happens with metronidazole and alcohol?
Antabuse (disulfrim) effect: nausea, vomiting, and increased heart rate
27
What does metronidazole inhibit?
acetaldehyde dehydrogenase
28
Drugs for intestinal forms of amebiasis?
Paromomycin | Iodoquinol
29
What is paromomycin also active against?
Cryptosporidium
30
What does Nitazoxanide do?
inhibits the growth of sporozoites and oocysts of Cryptosporidium parvum and trophozoites of Giardia lamblia
31
African trypanosomes
Trypanosoma brucei gambiense (West African trypanosomiasis ~95% of cases) Trypanosoma brucei rhodesiense (East African trypanosomiasis ~5% of cases)
32
American trypanosome
Trypanosoma cruzi
33
Kinetoplastid parasites
Leishmania African trypanosomes American trypanosomes
34
Anti-kinetoplastid drugs for Leishmaniasis
Sodium stibogluconate or Amphotericin B | Alternatives: pentamidine or Miltefosine
35
Anti-kinetoplastid drugs for African trypanosomiasis
Early stage - pentamidine (West) or Suramin (East) | Late stage - Melarsoprol (East and West) or Eflornithine (West)
36
Anti-kinetoplastid drugs for American trypanosomiasis
Nifurtimox or Benznidazole
37
What is miltefosine approved for use against?
visceral leishmaniasis
38
First oral antileishmanial drug
miltefosine
39
When should you avoid using miltefosine?
during pregnancy - teratogenic
40
Most commonly used drugs for T. cruzi
Nifurtimox and Benznidazole
41
Describe administration of Nifurtimox and Benznidazole
Orally available | 3-4 month course of treatment
42
Describe toxicity of nifurtimox and benznidazole
toxicity common - hypersensitivity, GI complications | leads to premature stoppage of treatment
43
Unique biology of worms
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
Most common helminth infection
Ascaris
45
Cestodes (Tapeworms)
``` Diphyllobothrium latum (Broad fish tapeworm) Echinococcus granulosus (Dog tapeworm) Taenia saginata (Beef tapeworm) Taenia solium (Pork tapeworm) ```
46
Trematodes (Flukes)
``` Schistosoma mansoni (Blood fluke) Schistosoma haematobium (Blood fluke) Schistosoma japonicum (Blood fluke) ```
47
Nematodes (Roundworms) - Intestinal infections
``` Ancylostoma duodenale Necator americanus Ascaris lumbricoides (Giant roundworm) Enterobium vermicularis (Pinworm) Strongyloides stercoralis (threadworm) Tricuris trichiura (whipworm) ```
48
Nematodes (Roundworms) - Tissue infections
Toxocara canis (Dog worm)
49
Cysticercosis
caused by autoinfection by ingesting eggs produced by T. solium
50
Describe the cysticercosis life cycle.
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
Cysticercosis infection in the brain
neurocysticercosis
52
Enterobiasis
pinworm disease
53
Trichuriasis
whipworm disease
54
Ascariasis
roundworm disease
55
Strongyloidiasis
threadworm disease
56
Onchocerciasis
river blindness
57
Visceral larva migrans caused by?
Toxocara canis
58
Drug therapy for helminths with broad spectrum activity
Benzimidazoles
59
Three Benzimidazoles currently on the market
Mebendazole Thiabendazole (limited by toxicity) Albendazole (useful against GI and tissue)
60
Mechanism of action for Benzimidazoles
binds to tubulin | inhibits formation of microtubules (cap ends)
61
What is albendazole a drug of choice for?
cysticercosis
62
What is albendazole also used for besides cysticercosis?
pinworms, hookworms, ascariasis, trichuriasis, and strongyloidiasis
63
What is mebendazole used for?
pinworms, hookworms, ascariasis and trichuriasis
64
What is praziquantel high effective against?
cestodes and trematodes
65
Praziquantel's MOA?
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
Therapeutic uses of praziquantel?
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
Toxicity of praziquantel?
mild and transient adverse effects are common | more severe reaction to dying worms (immune reaction)
68
Ivermectin is a drug for?
drug of choice for strongyloidiasis and onchocerciasis
69
Structure of Ivermectin?
semisynthetic macrocyclic lactone
70
Ivermectin MOA?
paralyzes microfilariae binds to glutamate-activated CL- channels found in nematode nerve or muscle cells causes hyperpolarization by increasing intracellular chloride concentration
71
What does Ivermectin not kill?
does not kill adult worms | blocks release of progeny
72
Main therapeutic use of Ivermectin?
primarily used to treat onchocerciasis (single dose)
73
Other uses of Ivermectin?
Ascariasis Enterobiasis Strongyloidiasis Filariasis
74
What is Pyrantel pamoate?
broad-spectrum antihelminth
75
What is pyrantel paomoate effective against?
High effective for pinworms and ascaris Moderately effective against hookworms active against adult and immature worms
76
Pyrantel paomoate MOA
depolarizing neuromuscular blocking agent causes release of acetylcholine and inhibition of cholinesterase worms are paralyzed and expelled
77
Clinical uses of Pyrantel paomoate
Ascariasis - one dose is 85%-100% effective | Pinworms - two doses two weeks apart - 95% cure rate
78
Scabies are caused by?
human itch mite, Sarcoptes scabiei
79
Treatment of scabies?
Permethrin cream (may need to pretreat with 6% salicyclic acid if crusted scabies)
80
Treatment of head lice?
~1% permethrin or pyrethrins | chronic infestations - 0.5% malathion

Pharmacology Test #2 (13 decks)

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