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29 Cards in this Set
- Front
- Back
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DOC for Asymptomatic cyst passer amebic infection
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Paromomycin
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DOC for active disease from amebic infection
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Metronidazole + luminal amebicide
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Metronidazole
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Accepts electrons from electron transport proteins, which damages DNA through reactive species
G(iardia)E(ntamoeba)T(richomonas) = GET out of the way of the METRO Use for Amebiasis, Trichomonas vaginal infections, and Giardia Oral w/ good distribution, including into the CNS Cleared by hepatic metabolism so alter in hepatic impaired Changes color of urine Headaches, metallic taste, antabuse RXN w/ alcohol Don't drive the METRO when you drink Godzilla has Metallic taste in his mouth from eating the METRO Take w/ food Teratogen Increases anticoagulant effect of anticoagulants |
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Tinidazole
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Similar to metranidazole, but better tolerated and longer 1/2 life so shorter treatment
Used for trichomonas, giardia, and intestinal / hepatic amebiasis |
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Paromomycin
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Aminoglycoside antibiotic used to treat intestinal amebiasis
DOC for Asymptomatic cyst passer MUST take w/ meals for absorbption |
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Iodoquinol
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Used against trophozoite and cyst forms and intestinal amebiasis
amebicide Enlarges thyroid (sounds like "iodine") |
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DOC for Giardia
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Metronidazole
Tinidazole is alternate (shorter treatment) Consider treating even if asymptomatic if there is a risk of spread |
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Cryptosporidium DOC
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Nitazoxanide (VERY protein bound = Drug interactions)
Treat young and immunocompromised Self-limiting otherwise |
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Trichomonas DOC
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Metronidazole
Tinidazole is alternate Be sure to treat partner too to prevent reinfection |
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Toxoplasmosis DOC
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Pyrimethamine - inhibits Dihydrofolate reductase in protozoa
Synergistic w/ sulfonamide Usually only treat very young, immunocompromised, and pregnant |
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Leishmaniasis DOC
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Antimony-containing compunds (stibogluconate)
If resistant to antimony drugs, use Amphotericin B |
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Treatment Considerations for Malaria
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1.) Species of infecting parasite
2.) Where infection was acquired and drug resistance 3.) Clinical status of patient 4.) Accompanying illness Prevention is targeted at ERYTHROCYTE stage |
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Chloroquine
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Primary drug for treating Malaria
Accumulates in parasitized RBCs. Malaria must process Heme to detoxify it. Chrloroquine blocks this. Binds Heme and disrupts membrane function Used against Schizonticide (doesn't work against liver form) Pruritis in Africans (can be very intense), GI disturbances, Corneal deposits (reversible), Retinopathy (irreversible vision loss) |
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Mefloquine
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Schizonticide drug for malaria (works on blood form)
Very long half life Used for chloroquine-resistant treatment and prophylaxis High incidence of CNS toxicity (not at prophylactic dose) - Dizziness, visual disturbances, depression, psychiatric disorders |
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Atovaquone
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Malaria drug that MUST combine w/ proguanil
Blocks mitochondrial electron transfer Active on RBC and tissue schizonts Highly protein bound so has many drug interactions, such as coumadin Don't use in pregnant women or patients w/ renal impairment |
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Artemisinins
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Derived from sweet wormwood plant
Inhibits nucleic acid and protein synthesis IV Used for severe resistant disease Oral form Artemether-Lumefantrine for uncomplicated Plasmodium falciparum malaria May cause prolonged QT inerval |
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Primaquine
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Active against ALL stages of Malaria, including the liver
Can produce cure for Vivax Used w/ recurring malaria Hemolytic anemia in persons w/ G-6-PD deficiency |
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Quinine
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Natural product used for treatment only (NOT PROPHYLAXIS)
Used to be considered obsolete, but now used against resistant strains of malaria Highly protein bound so many drug interactions |
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Quinidine
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Isomer of quinine
Already used for cardiac dysrhythmias Can be used for severe malaria |
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Pyrimethamine
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Inhibits enzymes of folate metabolism by inhibiting dihydrofolate reductase
Blood schizonticide Useful against chloroquine resistant malarai (falciparum strains) Also used to treat Toxoplasmosis |
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Drugs used for Malaria Prophylaxis
Drugs used to prevent malaria relapse |
Chloroquine
Mefloquine Doxycycline Atovaquone Primaquine Primaquine used to prevent relapse |
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DOC for P. falciparum malaria
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Chloroquine
Chloroquine resistant - Atovaquone, Artemether |
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DOC for P. vivax malaria
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Chloroquine
Chloroquine resistant - Mefloquine, atovaquone, quinine + doxycycline |
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DOC for severe malaria
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Quinidine + doxycycline
Artesunate also works |
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Mebendazole
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Antihelmintic drug
Inhibits microtubles in nematodes Preferentially binds to parasite tubulin, not host tubulin Poorly absorbed (makes it safer) Teratogen Can flair up Irritable bowel disease Cytochrome p450 metabolized so drug interactions |
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Albendazole
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Broad spectrum anthelmintic w/ almost no significant adverse effects
Inhibits microtubules Oral administration and then rapidly undergoes first-pass metabolism in liver (diff. from Mebandazole) to activate albendazole sulfoxide Distributes well, including the CSF and hydatid cysts Coadministration w/ dexamethasone or praziquantel increases toxicity Cytochrome p450 metabolized so potential interactions Have to increase dose when used to treat hydatid disease so more side-effects |
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Pyrantel pamoate
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Antihelminth that inhbitis cholinesterase and release of ACh, which paralyzes the worms so they can't attach to the wall or take in food
Your parent's won't let you out of the house. Pyrantel won't let ACh out of the house Poorly absorbed by host (selectivity) Abdominal pain associated w/ dying off of organisms Used against roundworm, hookworm, pinworm |
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Praziquantel
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Alters cell membrane permeability - massive Calcium influx, massive contractions and paralysis
"Praise the Quantum pysicists" Used against tapeworms, Trematodes (flukes), and schistosomiasis (type of fluke) After oral administration humans inactivate it quickly, but worms can't so they are effected NOt recommended in ocular cysticercosis b/c of inflammation left after organism dies Teratogen Cytochrome p450 metabolism so drug interactions |
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Ivermectin
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Enhances chloride ion channels activity leading to paralysis of parasite
Used against mites, lice, and roundworms Used for strongyloides & onchocerciasis (river blindness) Widely distributed, but NONE to CNS Mazotti reaction in treating onchocerciasis AKA River blidness, which is caused by Onchocerca volvulus (a nematode) (leading cause of blindness world wide) Teratogen Enhances effects of GABAergic compunds Cytochrome p450 metabolized so drug interactions |
