Gi: 18. Maloney : Antiparasitics

Front 1

Metronidazole is what kind of drug?

Back 1

anti-parasitic (anaerobics)

Front 2

Tinidazole is what kind of drug?

Back 2

anti-parasitic (anaerobics)

Front 3

Which enzyme does anaerobic organisms use to metabolize pyruvate?

A. Pyruvate dehdrogenase (PDH)
B. Pyruvate: ferredoxin oxidoreductase (PFOR)

Back 3

Pyruvate: ferredoxin oxidoreductase (PFOR)

Front 4

Metronidazole/Tinidazole MOA?

Back 4

The inactive form (prodrug) is taken up by anaerobic organisms
Reduced ferredoxin (generated from the decarboxylation of pyruvate by pyruvate-ferredoxin oxidoreductase) can transfer its electrons to metronidazole
Anaerobic organisms also express nitroreductase that selectively reduces metronidazole and in the process oxidizes NADPH to NADP
The active form disrupts DNA's helical structure and inhibits nucleic acid synthesis causing cell or organism death
It is equally effective against dividing and non dividing cells

Front 5

Metronidazole is selectively toxic toward what type of pathogens

Back 5

anaerobic and microaerophilic pathogens

Front 6

Which of the following are classified as anaerobic or amitochondriate parasites? (select all that apply)

Ascaris lumbricoides
Cryptosporidium
Entamoeba histolytica
Giardia
Schistosomes
Strongyloides
Trichomonas vaginalis

Back 6

Entamoeba histolytica
Giardia
Trichomonas vaginalis

Front 7

what bugs can Metronidazole treat?

Back 7

Entamoeba histolytica
Giardia
Trichomonas vaginalis

"GET MET"

Front 8

A person ingests a mature Entamoeba histolytica cyst in fecally contaminated food. What happens to it?

Back 8

excystation occurs in the small intestine and trophozoites are released, which migrate to the large intestine

Front 9

What are the different type of infections or diseases caused by Entamoeba histolytica?

A. non-invasive infection (asymptomatic)
B. Intestinal disease
C. extra-intestinal

Back 9

A. non-invasive infection (asymptomatic)
B. Intestinal disease
C. extra-intestinal

Front 10

3 things entamoeba histolytica can do

Back 10

1. be asymptomatic (cyst passer)

2. intestinal ulcer

3. liver abscess

Front 11

Treatment of amebiasis has 2 approaches in general, what are they

Back 11

Treat organisms in the lumen of the GI tract
LUMINICIDAL agents

Treat the organisms in the tissues (e.g. invaded the intestinal wall or liver)
TISSUECIDAL agents

Front 12

Metronidazole would be effective in killing Entamoeba histolytica that are located where? 2

Back 12

Intestinal ulcer (small intestine)

Liver Abscess

it is very well absorbed, so it won't really hit the large intestine (it gets taken up at the small intestine)

Front 13

clinical use for Metronidazole/Tinidazole

Back 13

Symptomatic intestinal amebiasis or with extraintestinal infections (DOC)

Mostly tissuecidal
Luminicidal effects are not reliable (aka THE BUG WILL STILL BE THERE)
Used in combination with a luminicidal agent

Front 14

Why do you not use metronidazole for asymptomatic Amebiasis?

Back 14

amebaes are only in the lumen of the colon, met is well absorbed from gut
low concentration of the drug in the colon

Front 15

A person ingests a Giardia cyst in fecally contaminated water. What happens to it?

Back 15

excystation occurs in the small intestine and trophozoites are released and REMAIN in the lumen of the proximal small intestine

aka it just chills in the small intestine

Front 16

Will metronidazole be effective against Giardia?

Back 16

Fuck yea!

giardia sits in the small intestine, and Met gets absorbed here

Front 17

Where does Trichomonas vaginalis reside?

A)lumen of large intestine
B)lumen of the small intestine
C)female lower genital tract and male urethra and prostate

Back 17

C) female lower genital tract and male urethra and prostate

Front 18

Will metronidazole be effective against Trichomonas vaginalis ?

Back 18

hell yes

GET MET!

Front 19

Nausea, metallic taste, headache, and neuropathy can be side effects of what anti-parasitic drug?

Back 19

Metronidazole

Front 20

Which of the following would be BEST to do when network file sharing is needed?
(Select TWO).

Back 20

1.Set a disk quota.
2.Place the share on a different volume than the operating system.

Front 21

Red-brown urine side effect of what?

Back 21

Metronidazole

Front 22

dude is on an anti-parasitic and drinks a beer. gets super fucking sick. what was he on?

Back 22

Metronidazole

Disulfiram-like effects

Front 23

What do you notice about the chemical structure of iodoquinol?

Back 23

iodine containing

Front 24

use for Iodoquinol

Back 24

Luminal amebocide ONLY
Kills trophozoites and cysts in gut

can kill your amoeba friends

Front 25

pt was recently infected with an amoeba parasite, and is now taking a drug to get rid of it. They start itching like mad, including in their bung hole. What drug are they on?

Back 25

Iodoquinol

Luminal amebocide ONLY
Kills trophozoites and cysts in gut

Front 26

Thyroid enlargement and altered thyroid function tests is a side effect of what drug

Back 26

Iodoquinol

Luminal amebocide ONLY
Kills trophozoites and cysts in gut

Front 27

Subacute myelo-optic neuropathy (SMON) is a rare side effect of what anti-parasitic drug

Back 27

Iodoquinol

Luminal amebocide ONLY
Kills trophozoites and cysts in gut

Front 28

MOA for Paromomycin

Back 28

An aminoglycoside!
Not sure how it works as antiparasite
Maybe it kills off gut bacteria, which is food for Entamoeba

Luminal amebocide ONLY

Front 29

When might you use iodoquinol and/or paromomycin (administered orally)?

A) to kill entamoeba histolytica in a liver abscess
B) to kill entamoeba histolytica in the lumen of the large intestine
C) to kill trichomonas vaginalis
D) to kill giardia in the lumen of the small intestine

Back 29

B) to kill entamoeba histolytica in the lumen of the large intestine

D) to kill giardia in the lumen of the small intestine

Front 30

clinical use for Iodoquinol and Paromomycin

Back 30

Asymptomatic amebiasis
Symptomatic intestinal amebiasis or with extraintestinal infections

note: paromomycin is used for giardia, Iodoquinol isn't

Front 31

MOA of Nitazoxanide

Back 31

Exact MOA unclear!
Appears to interfere with pyruvate-ferredoxin oxidoreductase (PFOR) dependent electron transfer reactions
But does not appear to produce DNA mutations

Front 32

Is pyruvate-ferredoxin oxidoreductase (PFOR) involved with aerobic or anaerobic metabolism?

Back 32

anaerobic

Front 33

clinical use (DOC) of Nitazoxanide (one is unique thus far)

Back 33

DOC Giardia

DOC Cryptosporidium (in non-HIV infected patients)

Front 34

what kind of drug are Benzimidazoles


basic moa?

Back 34

- inhibit metabolism

Immobilize worm

Worm Dies/Expelled

Front 35

what kind of drug is Pyrantel pamoate


basic moa?

Back 35

Cause paralysis

Immobilize worm

Worm Dies/Expelled

Front 36

what kind of drug is Ivermectin


basic moa?

Back 36

Cause paralysis

Immobilize worm

Worm Dies/Expelled

Front 37

what kind of drug is Prazaquantal


basic moa?

Back 37

Cause paralysis

Immobilize worm

Worm Dies/Expelled

Front 38

Would mebendazole be effective for killing Ascaris lumbricoides or Schistosoma?

Ascaris-->in intestine

Schistosma->peripheral veins

Back 38

Ascaris

Mebendazole isn't well absorbed orally, so it can't hit the peripheral veins

Front 39

DOC for intestinal roundworm (hook,pin, whipworm) (2)

Back 39

Mebendazole and Albendazole

Front 40

dude has squiggly wavy redness under the skin. It was likely gotten from a dog or cat. What drug would you sue?

Back 40

Albendazole

note: you cannot use Mebendazole because it wont get to the skin

note this is: cutaneous lava migrans

Front 41

DOC for cutaneous lava migrans

Back 41

Albendazole

Front 42

treatment for threadworm?

Back 42

Albendazole

Front 43

Mebendazole and Albendazole major adverse affect?

Back 43

TERATOGENIC

Front 44

Thiabendazole is used for what? how is it taken?

Back 44

Fairly broad spectrum, but toxicity limits its use to:
Strongyloides (threadworm)
Cutaneous larva migrans (topically)

Front 45

Dizziness, disturbed color vision
Hallucinations
Seizures
Stevens-Johnson syndrome are side-effects of what?

Back 45

Thiabendazole

Front 46

Pyrantel pamoate can be used to treat

Back 46

roundworms (intestinal, not well absorbed)

Front 47

pt is pregnant and gets infected with a GI ringworm. What drug should you use?

Back 47

Pyrantel pamoate

PPP (Pyrantel pamoate-->Pregnancy)

Front 48

Would pyrantel pamoate be useful for treating cutaneous larval migrans?

Back 48

NO

it is used for GI roundworms in preggo ladies

Front 49

this drug can be used to treat roundworms, for thread, and cutaneous larva migrans, because it is well absorbed

Back 49

Ivermectin

Front 50

Mazzotti-like reaction
Inflammatory or allergic response to dying microfilariae
Intense itching, enlargement and tenderness of lymph nodes, rash, fever, tachycardia, arthralgias and headache

this is a side effect of what anti-parasitic drug

Back 50

Ivermectin

(broad spectrum, cutaneous and GI anti-worm)

Front 51

what does Praziquantel treat?

Back 51

Tape worm and Blood fluke (schistosoma)

Front 52

if you see a tape worm or a blood fluke what do you treat it with?

Back 52

Praziquantel

Front 53

this anti-parasitic drug increases the rate of abortion

Back 53

Praziquantel

Front 54

What can you use to treat Roundworms (giant, hookworm, whipworm, pinworm)

*****

Back 54

Mebendazole

Albendazole

Pyrantel Pamoate

Front 55

What can you use to treat cutaneous larva migrans?

******

Back 55

Ivermectin

Albendazole

Thiabendazole

Front 56

What can you use to treat threadworm?

******

Back 56

Ivermectin

Albendazole

Thiabendazole

Front 57

What can you use to treat tapeworms?

******

Back 57

Prazaquantel

Front 58

What can you use to treat flukes?

*****

Back 58

Prazaquantel

Front 59

If you have a patient with roundworms who is pregnant, what must you use

****

Back 59

Pyrantel Pamoate

Front 60

What do you use for symptomatic amebiasis?

****

Back 60

Metronidazole

Front 61

What can Metronidazole treat

****

Back 61

Symptomatic amebiasis

Giardia

Trichomonas

Front 62

What can be used to treat amebas in the colon?

****

Back 62

Paromomycin

Idoquinol

Front 63

What is the DOC for Giardia

****

Back 63

Paromomycin

Front 64

DOC for cryptosporidium?

****

Back 64

Nitazoxanide