Pharm: Antiparasitics Flashcards by Jasper Viloria

During treatment for malaria a patient begins to experience abdominal cramps, headache, vertigo, BOV and tinnitus. What drug was he most probably given?

Quinine

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When quinine cannot be given because of vomiting what stereoisomer can be given IV?

Quinidine

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What enzyme does pyrimethamine and cycoguanil block to stop plasmodium?

Protozoan Dihydrofolate Reductase

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This quinine derivative appears to disrupt the mitochondrial electron transport in Protozoa. It is a component of ___, used in ___.

Atovaquone, a component of malarone (along with proguanil), which is effective for chemoprophylaxis and treatment of falciparum malaria.

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The only anti-malarial drugs reliably effective against quinine-resistant chains

Artemisinins

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Malarone is composed of which two drugs. Fansidar? Coartem?

Malarone is a fixed combination of proguanil with atovaquone.
Fansidar is a fixed combination of pyrimethamine and sulfadoxine.
Coartem is a combination of lumefantrine and artemether

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What are the luminal amebicides?

DIP

Dilozanide furoate
Iodoquinol
Paromomycin

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What is the MOA of emetines?

Tissue amebicides which inhibit protein synthesis by blocking ribosomal movement along mRNA

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What is the mechanism of action of the DOC for Chagas’ disease?

Nifurtimox, inhibits trypanothione reductase

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An aminoglycoside used as a luminal amebicide

Paromomycin

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MOA of pentamidine? Indications?

Unknown but may involve:

Inhibition of glycolysis
Interference with nucleic acid metabolism

Second line drug for toxoplasmosis (1st line is sulfa-pyridoxamine)

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TMP-SMZ prophylaxis in AIDS is started when CD4 count falls below ____. It is prophylactic against:

200 cells/uL
PCP pneumonia
Toxoplasmosis
Isospora belli infection

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What are the mechanism of actions of drugs used for P vivax and P ovals infections?

Chloroquine heme accumulation AND

Primaquine free radical formation

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What is the mechanism of action the drugs used for uncomplicated infections with chloroquine resistant P. falciparum?

Quinine prevents DNA separation AND

Doxycyline binds to 30s ribosome

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What is the mechanism of action of Malarone?

Cygoguanil for dihydrofolate reductase inhibition
AND
Atovaquone disrupts mitochondrial electron transport

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What are the three tissue amoebicides?

Chloroquine, metronidazole/tinidazole, emetine

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Drug of choice for African sleeping sickness? MOA?

Melasoprol

Inhibits enzyme sulfhydryl groups

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What is the drug of choice for toxoplasma infection?

Pyrimethamine plus sulfadiazine with folinic acid if encephalitis long term trreatmet

What is the MOA for the DOC for leishmaniasis?

Sodium stibogluconate, inhibition of glycolysis and nucleic acid metabolism.

Name symptoms of cinchonism, a known adverse effect of quinines.

GI distress
Vertigo
Headache
Blurred vision
Tinnitus

At high doses what are the 2 important AE’s of chloroquine?

Auditory and renal dysfunction

What are the prophylactic regimens in:

Regions without falciparum resistance
Regions with chloroquine-resistant falciparum
Regions with MDR-falciparum

Chloroquine
Mefloquine
Doxycycline / malarone

What is the MOA of the DOC for Ascariasis?

Albendazole or Mebendazole: Inhibition of microtubule formation.

Albendazole is the primary drug for:

Ascariasis
Hookworm
Pinworm
Whipworm

Diethylcarbamazine is the drug of choice in infections caused by:

Wuchereria bancrofti Brugia malayi Loa loa (eye worm disease)

Ivermectin is the drug of choice for:

Strongyloidiasis Cutaneous larva migrans Onchocerciasis

This drug which stimulates nicotinic receptors at the neuromuscular junction is the drug of choice for infections caused by:

Pyrantel pamoate for hookworm and roundworm infections

What is the DOC for all trematodes except Fasciola hepatica? What is it's MOA?

Increase in membrane permeability causing marked contraction then paralysis.

What is the only Cestoda that does not have Praziquantel as DOC?

Echinococcus granulosus uses Albendazole.

What is the MOA of niclosamide?

Uncoupling oxidative phosphorylation and activating ATPases.

Praziquantel is contraindicated in:

Ocular cysticercosis

Organophosphate drug converted by the body to the dichlorvos, which acts on S. haematobium

Metrifonate

This drug is effectively solely in S. mansoni infections causing paralysis of the worms.

Oxamniquine

A patient was treated with DEC after being diagnosed with Brugia malayi. He began to experience rashes, fever, ocular damage, and lymphangitis. Why?

Reactions to proteins of dying filariae

What is the MOA of the SOC for Onchocerca volvulus and Strongyloides stercoralis?

Intensifies GABA transmission in the worms. Resulting in paralysis.

In contrast to the MOA of ivermectin how does Pyrantel pamoate cause paralysis of the worms?

Stimulates nicotinic receptors resulting in depolarization induced paralysis.

What is the treatment for T. brucei that presents with winter bottom sign only and kerandel sign only?

Suramin

What is the toxicity associated with mebendazole at high doses?

Agranulocytopenia and alopecia

What should be avoided when taking niclosamide?

Ethanol for 24 to 48 hours

What is the contraindication to pyrantel pamoate?

Hepatic dysfuncition?

What intensifies GABA in nematodes?

Ivermectin

Fever, dizziness, rashes, pruritus, tachycardia, hypotension, joint pain and muscle pain after DEC treatment?

Mazotti reaction

What accumulates when Chloroquine acts on Plasmodium?

Heme