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VPI Pharmacology and Therapeutics Flashcards

1
Q

What phylum are Ticks, mites, flease and lice…?

A

Phylum Arthropoda

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2
Q

Ticks : Signs

A

Move up Body

Exposed Limbs

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3
Q

Ticks Removal

A

No pharmacological treatment
Done by PHYSICAL removal
(Do not squeeze or crush or leave head behind)

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4
Q

Possible consequences of a tick bite

A
  • Tick-borne Encephalitis

- Lymes disease

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5
Q

Lymes disease Symptoms:

A
  • Bulls eye rash
  • Flue like symptoms
  • Tired and general malaise
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6
Q

Types of Mites

A

Bed mites

Scabies

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7
Q

Life cycle of mites

A

Eggs -> First Nymphal to 5th -> Adult -> eggs

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8
Q

Bed mites: Signs & Symptoms

A

Itchy Bites
Bed bugs

Can survive 6-12 months without feeding

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9
Q

Bed mites prophylaxis

A

How linen wash

Ironing

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10
Q

Bed mites: Treatment

A
  • Empirical treaments for bite reactions
  • Antibiotics
  • Antihistamines
  • Topical and oral corticosteroids
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11
Q

Scabies : Sarcoptes Scabiei

S & S

A
  • Epidermal skin infestation
  • Burrow markings
  • Superficial burrows and pruritus
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12
Q

Life cycle of Scabies

A

Egg
Larva
Nymph
Adult

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13
Q

Scabies spread via…?

A

Scabies spread via;

  • Spread directly (hand-to-hand contact)
  • Spread indirectly by fomites (infested objects)
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14
Q

At risk groups for infections?

A
  • Barracks and dormitories
  • Elderly People (nusring homes)
  • Children (schools)

Young mothers
- Close contact infant

  • Sexually active people
  • STI
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15
Q

Pharmacy and Therapeutics Scabies: 1st and 2nd line + Treatment for PRURITIS

A

1st line : Permethrin
2nd line : Malathian lotion

Pruruitis : sedating antihistamine

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16
Q

Permethrin is a …?

A
  • Synthetic pyrethroid
  • Ion channel agonist
  • Acts on nervous system of animal
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17
Q

Permethrin MOA:

A

Neurlogical toxin

  • Binds to Voltage-gated Na+ channel
  • Prevent Na+ inactivation and deactivation
  • Paralyses animal function leading to death
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18
Q

Paralysing animal function via Na+ deactivation

A

Multiple spikes in Na+ on graph

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19
Q

Mechanism of pyrethroid resistance ( Resistance mutations

A

Specific gene mutations lead to structural alterations arising from these mutations alter interactions pyrethroids with Na Channels

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20
Q

Why are insects more susceptible?

A

Sequence of domain II S4-S5 linker at super-kdr site

Binds to MTI

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21
Q

Malathion is what class of drug,,,?

A

Anticholinesterase

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22
Q

Malathion - Neurological toxin: MOA

A
  • Acts on nervous system
  • Irreversibly binds to and blocks cholinesterase
  • Promotes all cholinergic Neurotransmissions
  • Continous muscle excitation and contraction
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23
Q

Action of Anticholinesterase

A

Stops A + Ch being released in the synaptic space

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24
Q

Malathion overdose & toxicitiy

A

Only with repeated exposure

Ingestion and Metabolism to Malaoxon far more toxic

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25
Anticholinesterase in man
- Parasympathomimetic (promotes muscarininc transmission)
26
Sites of cholinesterase action | 1,2,3
- Ach(nic) -: SkM (somatic efferent system) Sympathetic system -> blood vessels, sweat glands, adrenal medulla Salivary glands (parasympathetic system)
27
Malathion/Malaoxon poisoning; Muscarinic effects: Nicotinic effects: CNS symptoms:
Muscarinic effects; - Miosis - Salivation - Sweating - Bradycardia Nicotinic effects: - Fasciculation CNS S&S: - Anxiety - Restlessness - Dizziness
28
Ivermectin is a ...?
Ivermectin is a Macroyltic lactone (Ion channel agonist & acts on CNS of animal)
29
Ivermectin : Neurological toxin: MOA
- Binds to and activates GluCl | - Causes persitent opening (excitation and contraction)
30
GLuCl is a...?
A glutamate gated Chloride channel | GluCl are inverterbrate specific
31
Contraindications for Ivermectin
Children under 5 Body weight <15kg Breastfeeding Hepatic and renal diseases (reduced functionaility)
32
Complications of scabies & Treatment
- Secondary infection (e. g staphylococcus) - Social stigma - Crusted scabies from immunocomprimised patients T: Ivermectin
33
Life cycle of human fleas
- Eggs - Hatch into Larvae - Larvae form pupae - Adults [D] hatch from pupae -> go onto infect [I]
34
Fleas: S & S
Bites group in clusters
35
Fleas: Treaments
Antihistamines | Reduces swelling and pruritis
36
Fleas : Vectors of disease
Plague | Murine Typhus
37
Lice (NITS) : Pediculus humanus
Cling to hair shafts Can travel quickly up to 25cm/min Highly contagious
38
Three types of lice:
Head lice Body lice Pubic lice (crabs)
39
Life cycle of lice + [I] & [D]
Eggs[D] Nymph stages 1-3 Adult [I]
40
Head lice: S & S
- Prurtis | - Insomnia
41
Head lice diagnosis
Visual inspection (wet comb test)
42
Pharmaceutical T: Head lice
Do not kill live eggs - Dimeticone lotion - Benzyle alcohol Kills live lice -Malathion lotion
43
How do; Dimeticone and | Malathion work
Dimeticone - Silicone based, forms h20 impervous coat on lice suffocating them Malathion - Anticholinesterese - Neurotoix insecticide - Promotes cholinergic neruotransmission
44
Pubic Lice : S & S
Pruritis Black powder in underwear Blue - coloured spots on skin
45
Pubic lice (crabs) treatment
Permetherin Malathion Repeatead after 7 days to kill newly hatched lice
46
Body lice : S & S
Pruritis Skin discoloration Red rash
47
Body lice: Treatment
Laundering (prevent reinfestation) - Permethrin - Malathion
48
Body lice transmited diseases?
Trench Warfare Louse-Borne relapsing fever Epidemic Typhus
49
Which class of drug affects the Hepatic stages of Plasmodium falc infection? + Example
``` Folate inhibitors (Anti-mitochondrials) E.g. Atovaquone ```
50
``` Which class of drug affects the Blood stages of plasmodium falc. infection? + example ```
Quinolines Quinine (e.g Mefloquine - Larium)
51
Malarone is .... + ... drugs together??
Atovaquone + Proguanil hydrochloride
52
How does atavaquone work (MOA)
- Analogue of Ubiquinone - As in the mitochondrial ETC - Blocks ATP synthesis and Mitchondrial function
53
Low mammalian Toxicity
Interacts with cytochrome bc1 complex (Complex III) of ETC 1000x more potent at malarial than mamallian Complex III
54
How does proguanil work? | Where is it effective against in plasmodium?
Chlorguanide (Pro-drug) DHFR inhibitor Effective against sporozites
55
Malarone-contraindications ?
N&V&D Women breast feeding Use of machinery (drowzy) Many drug-drug interactions (e.g. warfarin)
56
How do quinoline containing compounds work?
Weak bases accumulate in acidic digestive (food) vacuole of partisite Base trapping occurs Interacts with haem preventing hamozoin formation -TOXIC to parasite
57
Quinoline resistance
Resitance done by multiple genes Decreased drug accmulation in acidic food vacuole (INCREASED drug efflux) Expression of ATP-dependent P-glycoprotein in FVM
58
Use of Mefloquine (larium)
Rarely used as P.falc. resistance Assosciated with Neuropsychiatric reactions (insomia, depression)
59
Use of Chloroquine: | Adv & Disadv
Non P.falciparum (has resistance) 3 day dose Disadvantages - Retinal toxicity
60
Doxycycline is a .... drug ? | And works on what stages of Malaria?
Tetracycline antibiotic Works on RBC stages
61
How does doxycylcine work?
Imapir progeny of the apicoplast genes | Found in malaria parasites, vital to parasite survival

VPI (7 decks)

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