Regal Malaria IHO Week 3

Question 1

Name the drug with the basis for selectivity is that the RBC concentrates it at least 25x more than unparasitized RBC to accumulate in the acid pH of the food vacuole

Answer 1

Chloroquine

Question 2

MOA is intercalates between base pairs in DNA thus inhibiting nucleic acid synthesis

Answer 2

Chloroquine MOA

Question 3

parasite eats host hgb in the acidic food vaculoe to get lots of ferriprotoporphyrin IX which is toxic to the parasite and so is converted to hemozoin via heme polymerase. How does Chloroquine stop this?

Answer 3

Chloroquine binds to FPIX and prevents its conversion to hemozin and this is toxic to the plasmodium

Question 4

AE of Chloroquine in low doses?

Answer 4

None

Question 5

AE of Chloroquine in acute attack doses

Answer 5

-dizziness, headache, itching, vomiting, skin rashes-difficulty with visual accommodation-large doses for prolonged periods can cause severe eye damage and even blindness

Question 6

Are Qunine and Quinidine more or less toxic than chloroquine

Answer 6

Quinine and Quinidine are more toxic than chloroquine, but less resistance

Question 7

When do you use Quinine and Quinidine

Answer 7

in chloroquine resistant P. falciparum

Question 8

AE of Quinine and Quinidine

Answer 8

cinchonism-tinnitus, blurred vision, nausea, headache, decreased hearing acuity, permanent damage to vision, balance and hearing can result, cardiac problems

Question 9

Uses of Quinidine

Answer 9

-anti-arrhythmic drug that blocks Na and K, IV for severe malaria,

Question 10

When to use Mefloquine

Answer 10

for treatment and prevention of Chloroquine resistant P. falciparum

Question 11

AE of Mefloquine

Answer 11

disorientation, hallucinations, depression, n/v, dizziness, visual or auditory disturbances

Question 12

MOA of Mefloquine

Answer 12

similar to chloroquine

Question 13

MOA of Atovaquone

Answer 13

depolarizes parasitic mitochondria and inhibits their electron transport

Question 14

Proguanil MOA

Answer 14

metabolite inhibits dihydrofolate reductase, selective for the plasmodial enzyme, enhances the mitochondrial toxicity of atovaquone and reduces the frequency of resistance, NOT acitve against hepatic stage of vivax or ovale, concentrated in the erythrocytes

Question 15

What is replacing mefloquine for prophylaxis?

Answer 15

atovaquone-proguanil

Question 16

Which malaria med will cause GI disturbances?

Answer 16

atovaquone-proguanil

Question 17

What are 2 combinations of malaria meds?

Answer 17

artesunate plus mefloquine and artemether plus lumefantrine

Question 18

MOA of Artemisinins

Answer 18

heme iron in the marlarial pigment acts on the drug to produce free radicals that damage parasite proteins; inhibits a calcium ion ATPase in P. falciparum

Question 19

What has RAPID and potent activity against even multi-drug resistant organisms (not hepatic forms)

Answer 19

Artemisinins

Question 20

unkown MOA, effective in erythrocyte stage, rapid initial reduction of parasite biomass afforded by artemether and subsequent clearance of remaining viable parasites by more slowly eliminated what

Answer 20

Lumefantrine

Question 21

Radical Cure to eliminate hepatic forms of P. vivax and P.ovale

Answer 21

Primaquine

Question 22

MOA of Primaquine

Answer 22

unkown, thought to be generation of ROS or by interfering with electron transport in the parasite

Question 23

Ae of Primaquine

Answer 23

occasional GI distress, nausea, headache, pruritis, leukopenia, hemolytic anemia in ppl with G6PDH deficiency