Antiparasitic Drugs

Front 1

1. What is the first principle of selectivity for antiparasitic drugs? What is an example of a drug that uses this principle?

Back 1

a. Drugs are not absorbed by host
b. Parasite is exposed to high concentration of drug
c. Mebadazole

Front 2

2. What is the second principle of selectivity for antiparasitic drugs? What is an example drug?

Back 2

a. The drug acts selectively on the parasite but not the host
b. Based on differences between biochemistry
c. Ivermectin

Front 3

a. What is the MOA of mebadnazole?

Back 3

i. Inhibits beta-tubulin polymerization→ microtubule formation
ii. Inhibits glucose uptake→ no ATP
iii. Worms die in 3 days

Front 4

b. What are the adverse effects of mebadnazole?

Back 4

i. Diarrhea
ii. Abdominal pain

Front 5

c. What are the contraindications for mebadnazole?

Back 5

Pregnant women, has been proven teratogenic in rats

Front 6

d. What is the dosing for mebandazole for round worms??

Back 6

i. 500 mg once or 100 mg x 3d

Front 7

e. What is the dosing of mebadazole for pinworms?

Back 7

i. 100 mg once
ii. Repeat in 2 weeks

Front 8

a. How is ivermectin absorbed po? How is it eliminated?

Back 8

i. Rapidly
ii. Metabolized and excreted in feces

Front 9

b. What is the MOA of ivermectin?

Back 9

i. Causes paralysis of the pharyngeal muscles of worm
ii. Activates gluatamate-gated chloride channels
iii. No toxicity in humans

Front 10

c. What are the adverse effects of ivermectin?

Back 10

i. Usually well tolerated
ii. GI upset, dizziness, vertigo

Front 11

d. What drug would you use to treat onchoceriasis?

Back 11

i. Ivermectin

Front 12

a. What is the MOA of pyrantel?

Back 12

Neuromuscular paralysis of worm through persistent depolarization

Front 13

b. How well is pyrantel absorbed po?

Back 13

i. Poorly absorbed orally

Front 14

c. What are the adverse effects of pyrantel?

Back 14

i. Occassional GI disturbances
ii. Headache
iii. Dizziness
iv. Rash
v. Fever

Front 15

a. What is the MOA of praziquantel?

Back 15

i. Increases the Ca permeability of schistosome integument and causes depolarization

Front 16

b. How well is praziquantel absorbed po? How is it metabolized?

Back 16

i. Rapidly absorbed po
ii. Rabidly metabolized

Front 17

c. What are the adverse effects of praziquantel?

Back 17

i. Occasional sedation
ii. Abdominal discomfort
iii. Fever
iv. Sweating
v. Nausea
vi. Headache
vii. Dizziness

Front 18

c. What is the MOA for treatment of acute attack of plasmodium?

Back 18

Chloroquine (active against erythrocytic form of parasites)

Front 19

d. What is the radical cure treatment for plasmodium? What drugs are used?

Back 19

i. Kill dormant form in liver
ii. Chloroquine and primaquine

Front 20

e. What is prophylactic therapy for plasmodium?

Back 20

avoid mosquitos
Inhibits the erythrocytic stage of parasite development
Suppressive therapy

Front 21

f. What are the two forms of malaria (based on antiparasitic drug)?

Back 21

i. Chloroquine resistant
ii. Chloroquine sensitive

Front 22

a. What is the clinical indication for chloroquine?

Back 22

i. Active against erythrocytic form
ii. Used to treat inflammatory disease for its anti-inflammatory properties

Front 23

b. What is the MOA of chloroquine?

Back 23

i. Not established

Front 24

c. How well is chloroquine absorbed po?

Back 24

i. Rapid and complete absorption po
ii. Can be injected IM for severe infection

Front 25

d. What are the adverse effects of chloroquine?

Back 25

i. Visual distrubances
ii. GI effects
iii. CAREFUL WITH PATIENTS THAT HAVE HEPATIC DISEASE

Front 26

e. What are the contraindications for chloroquine?

Back 26

i. Patients with psoriasis or porphyria
ii. Pregnancy

Front 27

a. What is the clinical use for primaquine?

Back 27

i. Used against hepatic forms of P. vivax
ii. Also for chloroquine sensitive and resistant P. vivax

Front 28

b. What is the MOA of primaquine?

Back 28

i. Not well established

Front 29

c. What are the adverse effects of primaquine?

Back 29

i. Rare CNS symptoms
ii. Hypertension
iii. Dysrhythmias

Front 30

d. What are the contraindications of primaquine?

Back 30

i. G6PDH deficient patients get hemolytic anemia

Front 31

a. What is the clinical use of quinine?

Back 31

i. Used to treat chloroquine-resistant strains of both P. vivax and P. falciparum
ii. Active against erythrocytic forms but not hepatic forms
iii. Must be used in combo with other drugs

Front 32

b. What is the MOA of quinine?

Back 32

Not well established

Front 33

c. What are the adverse effects of quinine?

Back 33

i. Tinnitus, high-tone deafness
ii. Visual disturbances
iii. Headache
iv. Hypoglycemia
v. Hypotension

Front 34

d. What is blackwater fever? What are its symptoms?

Back 34

i. Hypersensitivity reaction with:
ii. Massive hemolysis
iii. Hemoglobinemia
iv. Hemoglobinuria

Front 35

e. What will quinine cause in patients with a G6PD deficiency?

Back 35

i. Milder hemolysis

Front 36

f. What are the contraindications of quinine?

Back 36

i. Pregnancy category X

Front 37

a. What is the MOA for Atovaquone/Proguanil (Malarone)?

Back 37

i. Inhibits parasitic ETC

Front 38

b. Proguanil is synergistic with what drug? What do they do?

Back 38

i. Acts synergistically with atovaquone
ii. Inhibits mitochondrial function

Front 39

c. What is the metabolite of proguanil? What does the metabolite do?

Back 39

i. Cycloguanil
ii. Inhibits parasitic dihydrofolate reductase

Front 40

a. What are Artemether and Artensunate used for?

Back 40

i. Chloroquine-resistant P. falciparum malaria
ii. Not to be used alone

Front 41

a. What drugs can be used for amebiasis?

Back 41

i. Iodoquinol
ii. Paromomycin
iii. Metronidazole
iv. Tinadazole

Front 42

b. What drugs can be used for trichomoniasis?

Back 42

i. Metronidazole or tinadazole

Front 43

c. What drugs are used for giardiasis?

Back 43

i. Metronidazole
ii. Tinadazole
iii. Nitazoxanide

Front 44

d. What do you use to treat cryptosporidiosis?

Back 44

i. Nitozoxanide

Front 45

e. What do you use to treat pneumocystis jirovecii?

Back 45

i. Trimethoprim plus sulfamethoxazole

Front 46

a. What is the clinical use for metronidazole?

Back 46

i. Active against a wide variety of anaerobic protozoal parasites and obligate anaerobic bacteria

Front 47

b. What form of fungi is resistant to metronidazole?

Back 47

i. Cysts

Front 48

c. What is the MOA of metronidazole?

Back 48

i. Prodrug
ii. Reduced by ferredoxin in sensitive protozoal cells

Front 49

d. What type of cell is affected by metronidazole?

Back 49

i. Aerobic mammalian cells

Front 50

f. What are the adverse effects of metronidazole?

Back 50

i. Nausea
ii. Headache
iii. Dry mouth
iv. Metallic taste
v. DON’T TAKE WITH ALCOHOL

Front 51

g. What type of drugs will reduce metronidazole action?

Back 51

i. Drugs that induce CYP3A4

Front 52

a. What is the clinical use of iodoquinol?

Back 52

i. Used to treat asymptomatic intestinal amebiasis

Front 53

b. Against what fungal forms is iodoquinol active?

Back 53

i. Cyst and trophozoite form

Front 54

a. What is the clinical use of nitazoxanide?

Back 54

i. Giardiasis
ii. Amebiasis
iii. Trichomoniasis
Cryptosporidium parvum and giardia duodenalis in children

Front 55

b. What drug is used for diarrhea in children caused by cryptosporidium parvum and giardia duodenalis?

Back 55

i. Nitazoxanide

Front 56

a. What is permethrin used for?

Back 56

i. Lice

Front 57

b. What is the MOA of permethrin?

Back 57

i. Disrupts nerve signaling

Front 58

c. What are the adverse effects of permethrin?

Back 58

none Well tolerated topical medication

Front 59

a. What is malathion used for?

Back 59

i. Lice

Front 60

b. What is the MOA of malathion?

Back 60

i. Inhibits insect cholinesterases

Front 61

c. What are the adverse effects of malathion?

Back 61

None, it its a Well tolerated topical medication