Gi: Antiparasites

Front 1

Name 5 drugs used to treat intestinal protozoa

Back 1

Iodoquinol, Paromycin, Metronidazole & Tinidazole and Nitrazoxanide

Front 2

Mech of Iodoquinol?

Back 2

Unknown

Front 3

Mech of Paromomycin?

Back 3

Aminoglycoside: 30S unit

Front 4

Mech of Metronidazole and Tinidazole?

Back 4

Reduction of drug liberates toxic intermediates which damage DNA

Front 5

Mech of Nitazoxanide?

Back 5

Interferes with pyruvate::ferredozin oxidoreductase enzyme dependent e transfer (essential to anerobic energy metabolism)

Front 6

Tox can be loss of visual acuity and use caution in pts with thyroid disease

Back 6

Iodoquinol

Front 7

Spectrum of Iodoquinol?

Back 7

Entamoeba

Front 8

Distribution of Iodoquinol?

Back 8

Luminal (only 10% is absorbed)

Front 9

Diarrhea, oto/nephro toxic, IBD possible

Back 9

Paromomycin

Front 10

Distribution of Paromomycin

Back 10

Luminal after oral administration

Front 11

Spectrum of Paromomycin

Back 11

Intestinal protozoa

Front 12

Toxicity of Metronidazole & Tinidazole?

Back 12

Disulfiram rxn (blocks ACDehydrogenase to increase acetaldehyde); metallic taste, headache

Front 13

Distribution of Metronidazole and Tinidazole?

Back 13

Tissue (low concentration in intestine)

Front 14

Sepctrum of Metronidazole and Tinidazole?

Back 14

Gut anaerobes (Entamoeba and Giardia)

Front 15

Only effective Rx against Crytosporidium in the immunocompetent?

Back 15

Nitazoxanide (NO effective tx in the IC)

Front 16

Spectrum of Nitazoxanide?

Back 16

Giardia and Cryptosporidium in the immunocompetent

Front 17

Asymptomatic Cyst in 90% of cases; dysentery, fever or hepatic abcess in other 10%

Back 17

Entamoeba Histolytica

Front 18

Tx for Entamoeba Histolytica (Asymptomatic cyst)

Back 18

Iodoquinol or Paromomycin

Front 19

Tx for Entamoeba Histolytica (dysentery, fever, hepatic abscess: systemic sx)

Back 19

Luminal: Iodoquinol or Paromomycin
+
Tissue: Metronidazole or Tinidazole

Front 20

Acute, secretory, foul-smelling diarhhea; weight loss

Back 20

Giardia Lamblia

Front 21

How do you dx Giardia Lamblia ?

Back 21

stool antigen detection tests (Daycares are problems!)

Front 22

Tx for Giardia Lamblia ?

Back 22

Tinidazole or Nitazoxanide

Front 23

Why don't you tx asymptomatic Giardia Lamblia infections in developing countries?

Back 23

High rates of reinfection

Front 24

What drug is effective in tx Giardia Lamblia, but is avoided due to its high rates of GI SE?

Back 24

Metronidazole

Front 25

Watery diarrhea, trachea and pulmonary sx

Back 25

Cryptosporidium parvum

Front 26

How do you dx Cryptosporidium parvum?

Back 26

Acid fast stain and/or fluorescent antibody to detect oocytes/cysts in stool

Front 27

Tx for Immunocompetent Cryptosporidium parvum?

Back 27

Nitazoxanide (NO effective tx for the IC)

Front 28

Name the Ingested, Intestinal Nematodes (roundworms)

Back 28

Enterobius (pinworm), Ascaris (roundworm), Trichuris spp (whipworm)

Front 29

Name the cutaneous, intestinal Nematodes (roundworms)

Back 29

Ancylostoma duodenale (hookworm), Necator americanus (hookworm) and Strongyloides stercoralis

Front 30

Mech of Albendazole/Mebendazole?

Back 30

Binds to Beta-tubulin and inhibits tubulin polymerization and microtubule formation

Front 31

Mech of Ivermectin?

Back 31

Paralysis by potentiating GABA-mediated signal transmission or by activating glutamate-gated chloride channels

Front 32

Mech of Pyrantel Pamoate?

Back 32

Binds to the nicotinic receptor and causes spastic paralysis of the worm

Front 33

Which anti-helminthic Rx is CONTRA in pregnancy?

Back 33

Mebendazole

Front 34

Tox of leukopenia, alopecia

Back 34

Mebendazole/Albendazole

Front 35

Transient side effects include itching, swollen lymph glands and rarely dizziness

Back 35

Ivermectin

Front 36

Distribution of Ivermectin?

Back 36

Does NOT cross the BBB

Front 37

Spectrum of Albendazole and Mebendazole

Back 37

Nematodes and Cestodes

Front 38

Spectrum of Ivermectin

Back 38

Nematodes (Ascaris, Strongyloides and Onchocera)

Front 39

Spectrum of Pyrantel Parmoate

Back 39

Nematodes (Ancylostoma and Enterobius)

Front 40

Tx for Trematodes (Flukes)

Back 40

Praziquantal

Front 41

Mech of Praziquantal

Back 41

> Ca permeability thus contracts and dislocates worm; tegumental damage

Front 42

Spectrum of Praziquantal

Back 42

Cestodes and Trematodes (Schistosoma

Front 43

Intense anal itching, nocturnal resltessness

Back 43

Enterobius (pinworm)

Front 44

How do you Dx Ascaris lumbricoides/Trichuris trichuria?

Back 44

Identify eggs in stool

Front 45

Pneumonitis followed by ab pain; blood eosinophilia

Back 45

Strongyloides (Nematode) may be life threatening in the IC

Front 46

Primary Tx for Enterobius (pinworm/Nematode)
Secondary Tx?

Back 46

Primary: Mebendazole
Secondary: Pyrantel pamoate, Albendazole

Front 47

Primary and Secondary Tx for Ascaris lumbricoides/Trichuris trichuria?

Back 47

Primary: Albendazole/Mebendazole
Secondary: Ivermectin

Front 48

Tx for Ancylostoma and Necator

Back 48

Albendazole (multiple doses)
Pyrantel pamoate

Front 49

Primary and Secondary tx of Strongyloides

Back 49

Primary: Ivermectin
Secondary: Albendazole not as effective

Front 50

Dx to confirm Echinococcus Cyst

Back 50

Confirm with ELISH

Front 51

Tx for Taenia solium (pork), Taenia saginata (beef), Cysticerocosis

All Cestodes (Tapeworms)

Back 51

Praziquantal

Front 52

Tx for Diphyllobothrium (fish)

Cestode/Tapeworm

Back 52

Albendazole or Praziquantal

Front 53

Tx for Echinoccus Cyst

Back 53

Surgery
Albendazole/Mebendazole

Front 54

Tx for Clonorchis (Oriental Liver Fluke)

Back 54

Praziquantal

Front 55

Tx for Schistosoma (Fluke)

Back 55

Praziquantal