TC5-F--Anti-Malarial Drugs

Question 1

Ivermectin

Answer 1

Increase Cl- channel permeability

Question 2

Chloroquine

Answer 2

Targets blood schizonticides (inhibits heme polymerase)
Tx: drug-sensitive malaria
SE: MI, ototoxicity, retinal toxicity, acute porphyria
– Caution for G6PD deficiency.

Question 3

Quinine

Answer 3

Targets blood schizonticides (inhibits heme polymerase, binds ds DNA)
Tx: pt’s w/ chloroquine-resistant P. falciparum, babesiosis
SE: MI, ototoxicity, retinal toxicity, acute porphyria
– C/I for pregnancy, G6PD deficiency.

Question 4

Mefloquine

Answer 4

Targets blood schizonticides
Tx: 1st line prophylaxis against chloroquine-resistant malaria; 1st line for acute falciparum infection
SE: cardiac conduction defects, headache, seizures

Question 5

Primaquine

Answer 5

Targets tissue schizonticides (binds DNA)
Tx: radical cure for relapsing malaria (acts against late exoerythocytic stage in vivax, ovale strains)
SE: pruritis, GI symptoms, headache (non-spec)
– C/I for pregnancy, G6PD deficiency.

Question 6

Pyrimethamine

Answer 6

Folate synthesis inhibitor (inhibits parasitic DHFR)
Tx: used w/sulfadiazine, leucovorin to treat toxoplasmosis
SE: hypersensitivity, Stevens-Johnson, hemolysis, renal toxicity

Question 7

Sulfonamides

Answer 7

Folate synthesis inhibitor (inhibits parasitic DHPS)
Tx: nocardia, P. jirovecii; prophylaxis for nocardia, P. jirovecii, UTI’s
SE: hypersensitivity, Stevens-Johnson, photosensitivity, nephrotoxicity
– C/I for pregnancy, G6PD deficiency.

Question 8

Doxycycline

Answer 8

Binds 30S ribosomal subunit
Tx: many things– N. gonorrhea (w/ceftriaxone), C. trachomatis, Rickettsia rickettsii, MRSA
SE: hepatotoxicity, photosensitivity, pseudotumor cerebri, vestibular dysfxn
– C/I for pregnancy, children

Question 9

Atovaquone

Answer 9

Targets tissue and blood schizonticides (disrupts pyrimidine, ATP synthesis via ETC disrpution)
Tx: chloroquine-resistant falciparum;
SE: GI symptoms, headache, dizziness (non-spec)