Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
41 Cards in this Set
- Front
- Back
|
Metronidazole (Flagyl)*
|
Invasive E. Histolytica
Giardia lamblia Trichomonas vaginalis MOA: Free radical damage to DNA PO, IV, Hepatic, CYP450 Interactions ADE: Anorexia, NVD, ab cramping, metallic taste, dizziness, vertigo, headache, paresthesia, disulfram rxn |
|
|
Tinidazole (Tindamax)*
|
Invasive E. histolytica
G. lamblia T. vaginalis (metronidazole resistant) same MOA as metronidazole PO, renal, long t1/2 (shorter regimen) ADE: anorexia, NVD |
|
|
Paromomycin (Humatin)
|
Intestinal E. Histolytica
Dientamoeba fragilis Cryptosporidium parvum MOA: interrupting protein synth (binds 30s subunit) PO, poorly absorbed, works only in lumen ADE: cramping, ab pain, epigastic pain, NVD, statorrhea, diarrhea |
|
|
Iodoquinol (Yodoxin)
|
Intestinal E. Histolytica (use after systemic agent)
MOA: kills trophozoite and cystic forms of E. histo in gut. PO (poorly absorbed), avoid long term use ADE: rash, diarrhea, peripheral neuropathy, discolored hair/nails (iodine), puritis, optic neuritis, blindness BAD DRUG! |
|
|
Dihydroemetine (Dametine)
|
emesis = vomiting
Acute intestinal invasive E. histolytica Extra-intestinal amebiasis MOA: tissue active amoebicide prepared from ipecac, inhibits protozoal protein synthesis IV ONLY, hepatic, 5 day t1/2 ADE: precipitate heart failure, prolong ECG segments, hypotension, DN, injection site rxns, paralysis and polyneuritis BAD DRUG! |
|
|
Nitazoxanide (Alina)
|
(for kids!)
C. parvum G. lamblia MOA: interfere with parasitic PFOR PO and suspension (good for kids), hepatic ADE: mild and transient, ab pain, DNV, headache, dizziness |
|
|
Sodium Stibugluconate (Pentostam)*
|
Leishmania brasiliensis (mucocutaneous)
L. donovani (Kala-azar = visceral) L. tropica (cutaneous) MOA: pentavalent antimony prodrug, interferes with glycolysis and FAO in protozoa IM or IV, hepatic ADE: myalgias/arthralgias, NVD, ab pain, HA, ECG changes, hepatotoxicity -- requires a lot of monitoring |
|
|
Pentamidine (Pentam)*
|
Leishmania spp.
Trypanosoma spp. Pneumocystis jiroveci (prophylaxis & treatment MOA: interferes with nucleic acid synthesis IM, IV, aerosol, hepatic, poor CNS penetration ADE: reversible nephrotox, hypotension, tachycardia, hypoglycemia, electrolyte imbalance, rash, dizziness -- lots of side effects bc of nucleic acid mechanism bad for trypanosomes bc of poor cns penetration |
|
|
Miltefosine (Impavido)*
|
Visceral cutaneous forms of Leishmania spp.
MOA: disrupts lipid remodeling and transduction PO ADE: short lived, NV, wonder drug for Leishmanias |
|
|
Eflornithine (Ornidyl)*
|
Neurologic stage of T. bruzei gambiense (sleeping sickness)
MOA: irreversible suicide inhibition of orinthine decarboxylase enzyme IV, topical (hair remover), renal ADE: anemia, leukopenia, thrombocytopenia, eosinophilia, seizures (CNS penetration), NVD, hearing loss- reversible. "resurrection drug" |
|
|
Melarsoprol (Mel B)*
|
T. bruzei rhodesiense
T. bruzei gambiense Neurological forms MOA: derived from trivalent arsenical agent, inactives sulfhydryl groups to become trypanasomicide Slow IV injection, short t1/2, CNS penetration ADE: encephalopathy (25% of patients), hypersensitivity rxns, NV, ab pain, contraindicated in flu infection, G6PD def caution- fava beans That's a lot of side effects... |
|
|
Suramin*
|
T. bruzei rhodesiense (african)
MOA: decreased ATP synthesis IV, Hepatic, lacks CNS penetration ADE: fatal hypersensitivity, NV, LoC, B.M. suppression, peripheral neuropathy, nephrotox, adrenal insufficiency |
|
|
Nifurtimox (Lampit)*
|
Trypanosoma cruzi (american)
MOA: suppressive, not curative, inhibits DNA biosysthesis PO ADE: Dizzines, NV, rash |
|
|
Pyrimethamine (Daraprim)*
|
Toxoplasma gondii- ONLY combined with sulfadiazine
Chloroquine-resistant Plasmodia spp. -ONLY combined with sulfadoxine MOA: inhibits parasitic dihydrofolate reductase, 10x potency than trimethoprim PO, long t1/2 ADE: B.M. suppression, use folinic acid to prevent, G6PD deficiency |
|
|
Sulfadiazine/Sulfadoxine*
|
Toxoplasma gondii combination treatment
Chloroquine-resistant Plasmodia spp. combination treatment MOA: competitive inhibition of para-aminobenzoic acid, interferes with folic acid synthesis |
|
|
Atovaquone + Proguanil (Malarone)*
|
Prophylaxis and treatment of malaria species
MOA: Atovaquone- selective interferes with parasite mitochondrial electron transport Proguanil - inhibits DNA synthesis, depletes folate cofactors Doesn't affect extra-erythrocytic forms PO qd, absorption increases with milky drink ADE: ab pain, NVD, HA, anorexia, dizziness |
|
|
Artesunate + Lumefantrine (Coartam)
|
Treatment of Plasmodia spp.
MOA: Artesunate- interact with heme metabolism, free radical damage to parasite memebranes- derived from artemesia annua shrub (used for millennia to treat fever) Lumafantrine- interferes with heme metabolism and parasite nucleic acid synth IV, Rectal, PO, rapid acting, short t1/2 ADE: remarkably safe, NVD, LFT increases |
|
|
Quinine + Quinidine (Qualaquin)*
|
Chloroquine-resistant malaria treatment combined with doxycycline or clindamycin
MOA: interferes with heme polymerization, kills intra-erythrocytic form of the parasite PO (quinine), IV (quinidine) ADE: HA (G6PD), arrhythmias, ECG deltas, Cinchonism (quinine toxicity) vomiting, tinnitus, vertigo, deafness, shock (rare), rashes, lupus like syndrome, OD- dizziness, hypotensions, resp arrest |
|
|
Cholorquine (Aralen)*
|
Susceptible Plasmodia spp
SAFE in Pregnancy MOA: affects erythrocytic form, interferes with hemoglobin degradation by raising intravesicular pH, prevents parasitic polymerization of toxic heme compounds PO ADE: ECG deltas, HA, NV, vision blur, rash, pigmentation delta, photosensitivity, BM suppression, reversible hearing loss |
|
|
Amodiaquine*
|
Uncomplicated, susceptible Plasmodia spp treatment in combination with artesunate
Effective against some chloroquine-resistant parasites No longer for prophylaxis MOA: similar to chloroquine PO ADE: NVD, vertigo, lethargy, agranulocytosis, hepatic tox, syncope, spastic, HA, PN, caution in liver disease, G6PD-renal failure |
|
|
Primaquine*
|
pre-erythrocytic and extra-erythrocytic forms of Plasmodia
Tissue shizonticide, gametocide ONLY combined with blood-active drug MOA: interferes with plasmodial DNA and mitochondrial function PO, take with meals ADE: HA-G6PD, methemoglobinemia, NVD, ab cramp |
|
|
Mefloquine (Lariam)*
|
Chloroquine-resistant malaria prophylaxis/treatment- some mefloquine resistance
MOA: inhibits replication of asexual erythrocytic parasites. No effect on gametocytes or tissue stages of vivax and ovale PO ADE: suicidal ideation, forgetfulness, NV, dizziness, hallucinations, depression , ecg changes Adherence problems |
|
|
Review:
Amebiasis, giardiasis, trichomoniasis |
Metronidazole, tinidazole
|
|
|
Malarial exoerythrocytic schizogony and tissue stage vivax and ovale are only blocked by?
|
Primaquine
|
|
|
Toxoplasmosis
|
Pyrimethamine + sulfadiazine
|
|
|
African T. brucei
|
Pentamidine or suramin
(+ melarsoprol or eflornithine for late CNS disease) |
|
|
American trypaanosomiasis (Chagas disease T. cruzi)
|
Nifurtimox
|
|
|
Leishmaniasis (kala-azar)
|
sodium stibogluconate or miltefosine
|
|
|
Albendazole (Albenza)*
|
Ascaris lumbricoides Roundworm, Enterobius vermicularis Pinworm, Ancyclostoma duodenale Hookworm, Larval Migrans (cutaneous and visceral- toxocara spp)
Alternative: strongyloides stercoralis threadworm, trichinella spiralis trichinosis, taenium solium, taenium saginata trematode tapeworms, echinococcus granulosus (hydatid disease) multilocularis- alveolar hydatid disease Second-Line indications: T. saginata and solium- neurocystercosis- treat with Dexamethasone for edema in brain MOA: cytoplasmic microtubule degeneration, inhibits fumarate reductase PO, fatty meals increase bioavail 5x, elevated serum [] with cortocosteroids ADE: drowsiness, dizziness, headache |
|
|
Mebendazole (Vermox)*
|
typically luminal
A. lumbricoides, T. Trichuria (whipworm), E. vermicularis, N. americanus, A. duodenale, Cutaneous larval migrans (alternate), T. spiralis (primary) MOA: inhibits protein function through selective B-tubulin binding, inhibit polymerization Broad spectrum anti-helminthic (not for hydatid disease), PO, poorly absorbed. ADE: diarrhea, abdominal discomfort |
|
|
Pyrantel Pamoate (Pin-x)*
|
Enterobious vermicularis (pinworm)
Drug of Choice MOA: depolarizes parasite-specific nicotinic acetlycholine receptors- spastic paralysis PO- poorly absorbed (luminal) ADE: Headache, dizziness, drowsiness |
|
|
Diethylcarbazine citrate (DEC)*
|
Wucheria bancrofti, brugia malayi, onchocerca volvulus (river blindness, lymphatic filariasis
MOA: enhances microfilaria killings through reticuloendothelial system trapping and phagocytosis, interferes with arachadonic acid metabolism - capillary vasoconstriction impairs passage Specific treatment for filariasis ADE: rapid killing of organisms- fever, swelling, leukocytosis, edema, rashes, eosinophilia, headache, tachycardia |
|
|
Ivermectin (Stromectol)*
|
Filarial river blindness Onchocerca volvulus, Stronglyoidiasis
More effective for W. bancrofti than DEC Annual treatment for river blindness MOA: Paralyzes helminth muscle by blocking transmission of nerve signals through interactions with parasite-specific glutamate-gated channels ADE: fever, lymphadeonpathy, pruritis |
|
|
Praziquantel (Biltricide)*
|
Schistos, flukes, tapeworms
MOA: paralyzes helminth muscle by increasing parasite specific ion membrane calcium permeability PO, renal, p450 NV, abdominal discomfort from dead worms |
|
|
Triclabendazole
|
Liver fluke- Fasciola hepatica
Drug of Choice MOA: inhibits protein function through selective beta-tubulin binding and polymerization inhibition PO |
|
|
Niclosamide
|
Second line cestocide
T. saginata, T. solium, D. latum, H. nana MOA: uncouples anaerobic phosphorylation of adenosine diphosphate ADP in parasitic mito kills cestode segments and scolex Purge gut with magnesium sulfate prior to and after (except saginata) PO - not absorbed |
|
|
Review:
Cutaneous larval migrans, strongyloidiases |
Ivermectin
|
|
|
River blindness, lymphatic filariasis
|
Ivermectin
|
|
|
Tapeworm cestode infections
|
Praziquantel is the drug of choice for most
|
|
|
Hydatid diseases, symptomatic neurocysticercosis
|
albendazole
|
|
|
Schistosomiasis
|
Praziquantel is drug of choice for now
|
