David's Antiparasitic

Front 1

How does metronidazole work against Trichomonas vaginalis and Giardia lamblia?

Back 1

Drug reduced by ferrodoxin

Front 2

Malaria is from what? Describe the life cycle.

Back 2

Female anopheles. Infection occurs first in the liver (schizont!). Ovale and vivax have hypnozoites. The schizonts destroy liver cells, have merozoite offspring which infect RBCs. Reproduction in RBCs causes the classic malaria Sx (fever, HA, muscle ache, anemia). Some merozoites reproduce in RBCs as gametocytes which are ingested by mosquitoes.

Front 3

Why is the geographical area important for malaria Tx?

Back 3

likelihood of drug resistance

Front 4

How does chemoprophylaxis for malaria work? Name 3 regiments.

Back 4

Interferes with eythrocytic stage of infection. 1) Chloroquine (non-resistant falciparum). 2) Atovaquone + Proguanil (all areas). 3) Doxycycline (all areas)

Front 5

Tx for non-resistant falciparum and other infections? MOA? Toxicity? Limitation? Workaround?

Back 5

Chloroquine. Interferes with heme detoxification. More after parenteral than oral admin. Doesn't work against hypnozoites. Primaquine.

Front 6

Hypnozoite Tx? Concern?

Back 6

Primaquine. Need to be careful of patients with glucose-6-phosphate dehydrogenase deficiency

Front 7

Name 4 ways to Tx resistant falciparum (and vivax)

Back 7

1) Quinine + tetracycline/doxycycline/clindamycin. 2) Atovaquone + proguanil. 3) Artemisinin +/- lumefantrine. 4) Pyrimethamine (+sulfonamide)

Front 8

Quinine + tetracycline/doxycycline/clindamycin use? Choice for children? Adverse reactions?

Back 8

resistant falciparum or vivax. 2) Clindamycin. 3) Low dose: cinchonism (tinnitus, HA, nausea, visual/hearing disturbances). High dose: GI, CV, dermal

Front 9

Atovaquone + proguanil MOA? Interesting side effect listed?

Back 9

Atovaquone inhibits Plasmodium mitochondrial function. Proguanil inhibits Plasmodium dihydrofolate reductase. Anorexia

Front 10

Pyrimethamine use? MOA? Occasional side effect? Rare?

Back 10

All 4 Plasmodium species. Inhibits dihydrofolate reductase. 3) rashes and hematopoeisis depression. 4) anemia from inhibited folate acid production

Front 11

Artemisinin +/- lumefantrine use?

Back 11

resistant falciparum

Front 12

Sulfonamide MOA? Adverse reactions?

Back 12

analog of PABA -> prevents dihydrofolic acid synthesis. Agranulocytosis, aplastic anemia, hypersensitivity reactions, anorexia, hemolytic anemia

Front 13

Entameoba histolytica Tx? Life cycle?

Back 13

Iodoquinol +/- Metronidazole. Ingestion of cysts via food/water. Change into trophozoites and inhabit GI tract

Front 14

Iodoquinol +/- metronidazole use? Metronidazole MOA? 1 interesting side effect for each.

Back 14

Iodoquinol for luminal trophozoites. Mucosal and extra-intestinal require Metronidazole. After metabolized it fragments DNA. Iodoquinol: anal pruritus. Metronidazole: metallic taste

Front 15

Cryptosporidium enteritis infection? Tx (3)?

Back 15

Food or water (chlorine resistant!). Nitazoxanide is first choice. Then Paromomycin and azithromycin.

Front 16

Dientamoeba fragilis Tx?

Back 16

DOC is iodoquinol. Tetracycline or paromomycin (only effective against luminal and contraindicated with renal insufficiency) also.

Front 17

Toxoplasma gondii ingestion form? 2) tissue form? 3) Tx?

Back 17

oocysts. 2) tachyzoite. 3) TMP + SMX

Front 18

Giardia lamblia life cycle? Tx of G. lamblia and T. vaginalis?

Back 18

ingested cysts, transform in to trophozoites and populate lumen of GI tract. Metronidazole.

Front 19

1) Roundworm. 2) Tapeworm. 3) Fluke.

Back 19

1) nematode. 2) cestode. 3) trematode.

Front 20

Two routes of transmission for helminthics.

Back 20

1) Ingest eggs or larvae. 2) larvae penetrate skin -> lungs -> swallow to intestines (larva migrans, strongyloides)

Front 21

Albendazole DOC for? Also effective against? MOA?

Back 21

LARVAL tapeworm infections, expecially cysticercosis and hydatid. 2) larva migrans. 3) Inhibits tubulin polymerization by binding to free beta-tubulin and inhibits glucose uptake by tapeworm larvae

Front 22

Mebendazole broad spectrum for? DOC for? Effective against? MOA?

Back 22

1) anti-nematode. 2) DOC for Ascaris, hookworm, pinworms, whipworms. 3) Larval and Adult stages. 4) Binds beta-tubulin and inhibits glucose uptake

Front 23

Ivermectin DOC for? MOA? Adverse reactions?

Back 23

1) Strongyloides stercoralis. 2) stimulates inappropriate release of GABA. 3) tender lymph nodes, dizziness, postural hypotension

Front 24

Praziquantel DOC for? MOA?

Back 24

schistosomiasis (blood fluke infection). Increases cell membrane permeability to Ca

Front 25

Adjunct therapy for anti-protozoics/anti-helminthics (3)

Back 25

1) salicylates. 2) nutritional supplements. 3) maintain hydration

Front 26

Scabies is from? Transmitted? Appearance?

Back 26

Sarcoptes scabiei. 2) by physical contact. 3) small, pimple-like with possible hair loss

Front 27

Scabies Tx? MOA?

Back 27

Permethrin. Inhibits insect neuronal activity

Front 28

Tx for lice? Note about Tx?

Back 28

Body lice doesn't require. Head and pubic use pyrethrin + piperonyl butoxide or permethrin. 2) Does not affect eggs -> multiple Tx. 3) Pyrethrin similar to DDT and inhibits insect neuronal activity to cause paralysis. Piperonyl butoxide is a P450 inhibitor that prevents detoxification of pyrethrin.