Iid - Block 3 Drugs

Front 1

DOC for Cryptosporidium

Back 1

Non-HIV infected patients - Nitazoxanide

HIV infected patients - no DOC

Front 2

DOC for Giardia

Back 2

Metronidazole or Tinidazole or Nitazoxanide

Front 3

DOC for Pneumocystis

Back 3

Trimethoprim-Suflamethoxazole

Front 4

DOC for Trichomonas

Back 4

Metronidazole or Tinidazole

Front 5

What is the only oral drug available to treat leishmania infection?

Back 5

Miltefosine

Front 6

What is the MOA for Metronidazole?

Back 6

The nitro group serves as an electron acceptor. The reduced cytotoxic compounds bind to proteins and DNA and result in cell death. Inhibits DNA replication.

Front 7

What is the MOA for Tinidazole?

Back 7

Same MOA as Metronidazole.

The nitro group serves as an electron acceptor. The reduced cytotoxic compounds bind to proteins and DNA and result in cell death. Inhibits DNA replication.

Front 8

What is the MOA for Miltefosine?

Back 8

Affects cell-signaling pathways and membrane synthesis.

Front 9

What is the MOA for Nifurtimox?

Back 9

Inhibition of trypanothione reductase. This enzyme is specific to parasite. Generates toxic oxygen radicals.

Front 10

What is the MOA for Paromomycin?

Back 10

Inhibitor of prokaryote protein synthesis (interferes with initiation complex and causes misreading of mRNA).

Front 11

What is the MOA for Pentamidine?

Back 11

Interacts with nucleotides, interferes with uptake and function of polyamines. May inhibit dihyrdofolate reductase.

Front 12

What is the MOA for Suramin?

Back 12

Unknown. Inhibits many parasite specific enzymes, including glycerol phosphate dehydrogenase.

Front 13

What is the MOA for Trimethoprim-Sulfomethoxazole?

Back 13

Inhibition of two sequential steps in folic acid synthesis.

Front 14

What is the DOC for most trematodes?

Back 14

Albendazole

Front 15

What is the DOC for most cestodes?

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Praziquantel; (A) Niclosamide

Front 16

What is the DOC for river blindness?

Back 16

Ivermectin

Front 17

What is the DOC for lymphatic filariasis?

Back 17

Diethylcarbamazine

Front 18

What is the DOC for pinworm?

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Mebendazole or Pyrantel pamoate or Albendazole

Front 19

What is the MOA and significant toxicities for albendazole?

Back 19

MOA - Inhibits microtubule synthesis in nematodes, thus impairing glucose transport. Parasites are immobilized and die (but not immediately). Larvicidal in hydatid diseases, cysticercosis, ascaris and hookworm infection; ovicidal in ascaris, ancylostomiasis, and trichuriasis.

Toxicities - No known pharmacologic effects in humans. Teratogenic and embryotoxic in some species; avoid during pregnancy, especially the first trimester. Avoid in children. With 3 months of treatment, some hepatic changes, GI symptoms, rash, and leukopenia reported. With long term use may see liver function abnormalities and bone marrow depression. Use may be contraindicated with cirrhosis. Rare fatalities from agranulocytosis and pancytopenia. Monitor blood counts every 2 weeks for long-term therapy.

Front 20

What is the MOA and significant toxicities for diethylcarbamazine?

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MOA - Alters microfilarial surface membrane (immobilizes, dislocates). How this occurs is not well understood.

Toxicity - At typical doses, toxic reactions are mild - anorexia, nausea, headache, and vomiting. Use with caution in patients with hypertension or renal disease. For pregnancy, delay treatment until after delivery, but has not been shown to cause birth defects in humans. Adverse effects are often linked to reactions to the dying worms (eosinophilia; reversible proteinuria, nodular swelling). May pretreat with antihistamines or corticosteroids to minimize these indirect reactions.

Front 21

What is the MOA and significant toxicities for ivermectin?

Back 21

MOA - Immobilizes by tonic paralysis of the peripheral musculature and potentiation of the release and binding of GABA at synapses. Acts on host immune system and alters reproductive system of adult female Onchocerca volvulus by reducing microfilariae production. It has no lethal effect on the adult worm.

Toxicities - CNS - lethary, mydriasis, ataxia, postural hypotension, mild Mazzotti reaction. Contraindicated with impaired BBB as seen with African Trypanosomiasis and meningitis. Not cacinogenic or teratogenic. Do not give during first trimester. Crosses into breast milk, so do not breast feed for 1 week after last dose. Avoid using with other drugs that enhance GABA activity to avoid increased sedation.

Front 22

What is the MOA and significant toxicities for mebendazole?

Back 22

MOA - Inhibits microtubule synthesis in nematodes, thus impairing glucose transport. Embryotoxic to larval nematode development in utero. Other effects are to inhibit mitochondrial fumarate reductase, glucose transport and uncouple oxidative phosphorylation.

Toxicity - No systemic toxicity in routine use. With high doses, allergic reaction and allopecia. Contraindicated in the first trimester of pregnancy and in children. Teratogenic in rats.

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What is the MOA and significant toxicities for praziquantel?

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MOA - Inceases membrane permeability to cations particularly Ca++. At low concentrations, increases muscular activity, followed by contractions and spastic paralysis - worms detach. At increased concentrations, vacuolization and vesiculation of the tegument of the schistosomes occurs.

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What is the MOA and significant toxicities for pyrantel pamoate?

Back 24

MOA - Depolarizing neuromuscular blocking agent, resulting in release of ACh and inhibition of cholinesterase. Worms are paralyzed, then expelled.

Toxicity - With large doses may see mild GI symptoms. Not recommended in pregnancy or in children under the age of 2.