Test-2-Anti-Parasites Flashcards
AMINOQUINOLONES - CHLOROQUINE
INHIBITS DNA SYNTHESIS.
Action:
- TERMINATES ACUTE ATTACK AND CURES NON - RESISTANT FALCIPARUM / MALARIAE (ONLY IN ERYTHROCYTES)
- TERMINATES ACUTE ATTACK – VIVAX / OVALE – NO CURE (IN BOTH ERYTHROCYTES AND LIVER)
TOXICITIES:
- *OCULAR TOXICITY: EXCRETED IN TEARS / ABSORBED IN CORNEA
- **CARDIAC:
HYPOTENSION
- Heme buildup
Contrainidicated:
**RETINAL / VISUAL ABNORMALITIES (TEARS)
**ALCOHOLISM
**NEUROLOGIC DISORDERS (EPILEPSY)
THERAPEUTIC PLACE:
*SUPPRESSIVE PROPHYLACTIC
*NOT EFFECTIVE AGAINST 2ND LIVER STAGES (because it is in the Liver and it can’t be impacted there)
AMINOQUINOLONES - AMODIAQUINE
Same action -> Heme buildup.
Toxicities:
AGRANULOCYTOSIS
APLASTIC ANEMIA
HEPATIC
ARTEMISININ
Herb
*WIDELY USED IN ALL OTHER COUNTRIES
TERATOGEN IN ANIMALS
MOA: HEME IRON DAMAGE / ALKYLATION
USED IN COMBINATION - CONCERN IS DEVELOPMENT OF RESISTANCE
MEFLOQUINE
Uses:
**PROPHYLAXIS + TREATMENT OF CHLOROQUINE - RESISTANT AND MULTIDRUG - RESISTANT FALCIPARUM MALARIA
PROPHYLACTIC AGAINST P. FALCIPARUM AND PROBABLY P. VIVAX, P. OVALE, AND P. MALARIAE
QUININE
ACTION:
*BLOOD SCHIZONTICIDE (ALL 4 MALARIA PARASITES)
KILLS GAMETOCYTES OF VIVAX / OVALE (NOT FALCIPARUM) (KATZUNG DOES NOT MENTION MALARIAE)
NOT EFFECTIVE FOR LIVER STAGES OF VIVAX / OVALE
THERAPEUTIC PLACE:
**SEVERE FALCIPARUM MALARIA
*RESISTANCE – BECOMING PROBLEM
Toxicities:
**CINCHONISM (flush skin, etc):
- OTOTOXIC – TINNITUS, VERTIGO; DEAFNESS
- GI TOXICITY – NAUSEA, VOMITING, DIARRHEA
- VISUAL TOXICITY – RETINAL ISCHEMIA – BLINDNESS
*HYPOGLYCEMIA (DANGEROUS IN PREGNANCY)
**BLACKWATER FEVER (25 - 50% DEATH)
- G6PDH DEFICIENCY
- CURARE (like MG actually) – LIKE ACTION: RESPIRATORY DISTRESS, DYSPHAGIA, IN MYASTHENIA GRAVIS PATIENTS
8–AMINOQUINOLINES: PRIMAQUINE
**EXO – ERYTHROCYTIC, TISSUE SCHIZONTICIDE
Effects both the liver and the erythrocyte
USES:
*PRIMARY EXO-ERYTHROCYTIC FORMS (VIVAX, OVALE)
**(+) CHLOROQUINE (prevents resistance) – RADICAL CURE OF VIVAX / OVALE (RELAPSING)
***TOXICITIES:
HEMOLYTIC ANEMIA (G6PDH)
METHEMOGLOBINEMIA (G6PDH)
Glutathione needs to be available for it to work (G6PDH decreased, makes drug less available).
*RESISTANCE
PYRIMETHAMINE
Anti-folate Malaria drug
SULFONES / SULFONAMIDES
Anti-folate
- INHIBIT COUPLING ENZYME (*DIHYDROPTEROATE SYNTHETASE)
- **SLOW ACTING
PROGUANIL
PROPHYLAXIS / TREATMENT
CHLOROQUINE – RESISTANT P. FALCIPARUM
BABESIA MICROTI
SEVERE, ~FATAL TICK-BORNE DISEASE
TREATMENT: QUININE + CLINDAMYCIN
METRONIDAZOLE
Useful as a AMEBICIDE
PRO – DRUG (NITRO GROUP ACCEPTS ELECTRON TO FORM REACTIVE NITRO RADICAL)
- Indirect action (Tetracyclines, Erythromycins): AFFECT BACTERIAL FLORA THAT SUPPORT AMEBA.
**Useful as a ANTI - PROTOZOAL (_GIARDIASIS, _TRICHOMONIASIS)
EMETINE
Tissue Amebicide
*CARDIAC TOXICITY
PENTAMIDINE
ANTI - PROTOZOAL
PNEUMOCYSTIS JIROVECI (AIDS PATIENT), TRYPANOSOMES (SLEEPING SICKNESS), LEISHMANIASIS (SAND FLIES)
THIABENDAZOLE
ANTI - HELMINTICS (NEMATODES)
Mech of Action: *IMPAIRS GLUCOSE UPTAKE BY NEMATODE
*TRICHINELLA (RAW PORK / MEAT)
*GI PROBLEMS
“Need to associate “bendazoles” with helminths.”
*BROAD – SPECTRUM
Mixed Infections (ASCARIS + HOOKWORMS): _MEBENDAZOLE or ALBENDAZOLE. _
IVERMECTIN
Uses:
STRONGYLOIDIASIS
Causes ****PARALYSIS in organism.
