Parasite Drugs Flashcards by J N

chloroquine MOA

erythrocytic stage anti-malarial

inhibits novel heme polymerase enzyme to stop conversion of toxic heme to nontoxic hemozoin

How well did you know this?

Not at all

Perfectly

chloroquine uses and ADR

prophylaxis and acute treatment

ADR: nausea, abd pain, HA, visual disturbances

How well did you know this?

Not at all

Perfectly

quinine sulfate uses

erythrocytic stage anti-malarial from bark of cinchona tree
1st line tx for chloroquine-resistant plasmodium
short T1/2 immediate onset
used with doxy tetra or clinda

How well did you know this?

Not at all

Perfectly

ADR quinine sulfate

n/v/d, cinchonism (tinnitus, vertigo, deafness, HA, dysphoria), hypoglycemia, “Blackwater fever” (? HS rxn -> massive hemolysis, hemoglobinemia, hemoglobinuria)

How well did you know this?

Not at all

Perfectly

quinidine gluconate uses

erythrocytic stage anti-malarial for severe, life-threatening malaria
parenteral until stable enough for oral quinine
given with doxy tetra or clinda

How well did you know this?

Not at all

Perfectly

ADR quinidine gluconate

same as quinine; potent CYP 2D6 inhibitor

*Class 1A antiarrhythmic

How well did you know this?

Not at all

Perfectly

artesunate IV

erythrocytic stage anti-malarial; DOC for parenteral therapy
more effective than quinine and safer than quinidine
ADR: hemolytic anemia

How well did you know this?

Not at all

Perfectly

malarone

erythrocytic stage anti-malarial
atovaquone + proguanil
1st line for chloroquine-res
ADR: n/v, HA, dizziness, weakness, QT prolongation
*avoid CYP 3A4 inhibitors

How well did you know this?

Not at all

Perfectly

doxycycline

erythrocytic stage anti-malarial alternative prophylaxis for chloroquine-res
ADR: in pregnancy and children

How well did you know this?

Not at all

Perfectly

mefloquine

2nd line prophylaxis and tx of chloroquine-res

ADR: “zombie drug” - neuropsych syndrome (depression, psychosis, seizures), use with BB’s = cardiac arrest

How well did you know this?

Not at all

Perfectly

primaquine

only extra-erythrocytic stage anti-malarial for dormant schizonts (ovale, vivax)
use with chloroquine or quinine
ADR: abd cramps, nausea, hemolytic anemia 2/2 G6PD def (screen before use)

How well did you know this?

Not at all

Perfectly

iodoquinol

luminal amebicide

take with meals to limit GI toxicity

How well did you know this?

Not at all

Perfectly

paromycin

luminal amebicide

*aminoglycoside

How well did you know this?

Not at all

Perfectly

metronidazole MOA

tissue amebicide

intracellular conversion to toxic nitro radical by anaerobes and protozoans -> cell death by destruction of DNA

How well did you know this?

Not at all

Perfectly

tinidazole

tissue amebicide with longer T1/2 than metro

How well did you know this?

Not at all

Perfectly

luminal amebicides vs. tissue amebicides

luminal: poorly absorbed, for asymptomatic disease
tissue: DOC for invasive disease

ADR metronidazole

preg cat B (2,3), contraindicated in 1st trimester
nausea, HA, dry mouth, metallic taste (take with food)
increased INR with warfarin
disulfiram reaction with EtOH

ADR tinidazole

same as metro; preg cat C

treatment of giardiasis

metro x7 days or tinidazole single dose

treatment of trichomoniasis

metro or tinidazole (some metro-res strains)

treatment of toxoplasmosis

pyrimethamine + sulfadiazine + daily leucovorin (folinic acid)
ADR: DHF reductase inhibitors may induce folate deficiency and anemia

albendazole

anti-helminth DOC; inhibits MT function, depletes glycogen stores -> worm death
ADR: avoid in 1st trimester of pregnancy

mebendazole

anti-helminth; no longer available d/t low demand

pyrantel pamoate

anti-nematode
depolarizing NMJ blocker -> paralysis of helminth
ADR: GI upset, HA, fever; avoid in pregnancy

praziquantel

for schistosomiasis, flukes tapeworms increases cell membrane permeability and disintegrates parasite ADR: swallow whole tablet and avoid driving for 2 days

ectoparasite drug drawback

pediculocidal but not ovacidal

pyrethrin

ectoparasite drug

permethrin

ectoparasite DOC for lice and scabies, resistance increasing synthetic derivative of pyrethrin that acts on nerve cell membrane to paralyze ectoparasite *safe for kids and pregnancy

spinosad

ectoparasite drug | for head lice in patients over 4 yoa

ivermectin

ectoparasite drug; single-use topical tx for head lice if over 6 months old

lindane

ectoparasite drug absorbed -> neurologic toxicity (tremor, ataxia, insomnia, seizures) - avoid with skin inflammation, young kids, and pregnancy OTC lotion or shampoo

crotamiton

ectoparasite drug cream and lotion for scabies only