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58 Cards in this Set
- Front
- Back
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tissue schizonticides? |
primaquine
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blood schizonticides?
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chloroquine, quinine
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which organisms is primaquine used against?
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P. vivax, P. ovale
(intrahepatic hypnozoites) |
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Sporonticides?
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proguanil, pyrimethamine
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what should you not give with chloroquine and why?
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antacids, reduces oral absorption
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MOA of chloroquine
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accumulates in organism's food vacuole and prevents conversion of heme to hemozoin; heme accumulation is toxic to parasite
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main resistance mechanism to antimalarials?
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dec intracellular accumulation via membrane pumps
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toxicity of chloroquine?
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GI, rash, HA; hearing and retinal dysfxn at high dose
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MOA of quinine?
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complexes with dsDNA to prevent strand separation, preventing replication and txn
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DOC for chloroquine resistant malaria?
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Quinine + doxycycline or clindamycin
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drug related to quinine used in IV tx of severe falciparum malaria?
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quinidine
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toxicity of quinine?
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cinchonism (GI, HA, vertigo, blurred vision, tinnitus)
cardiac conduction defects at high dose hematotoxic in G6PD def |
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DOC for malaria prophylaxis in areas w/ chloroquine resistance?
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Mefloquine
Malarone (proguanil+atovaquone) |
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toxicity of mefloquine?
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GI, HA, rash, dizziness;
card conduction defects, psych disorders, neuro sxs, seizures (high dose) |
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MOA of primaquine?
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forms redox compounds that act as cellular oxidants. Tissue schizonticide and gametocide.
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Tx for P. vivax/ovale?
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chloroquine followed by 14-day primaquine
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Antifolate antiprotozoal drugs?
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pyrimethamine, proguanil, sulfadoxine, dapsone
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MOA of antifolate antiprotozoals?
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block FA synthesis in some protozoa by inhibiting dihydropteroate synthase
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Selective inhibitors of protozoan dihydrofolate reductases?
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Pyrimethamine, cycloguanil
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which drugs work synergistically to produce sequential blockade of protozoal folic acid synthesis?
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pyrimethamine + sulfadoxine
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Combination drug used for chloroquine-resistant falciparum with slow onset of activity?
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Fansidar
(pyrimethamine + sulfadoxine) |
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toxicity of sulfonamides?
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rash, GI, hemolysis, kidney damage, drug interaction (competition for plasma protein binding sites)
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DOC for prophylaxis for travelers going to areas with chloroquine/mefloquine-resistant P. falciparum?
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Doxycycline
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antimalarial used widely d/t its low cost and effectiveness against resistant strains?
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Amodiaquine
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Component of Malarone that disrupts mitochondrial E- transport that is also used as alternative tx for P. jiroveci infxn?
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Atovaquone
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antimalarial that is active against RBC stages of all 4 species of plasmodium, but may cause wide QT?
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Halofantrine
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MOA of artesunate and artemether?
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metabolized into toxic free radicals in parasite food vacuole
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DOC for quinine-resistant plasmodium?
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Artemesinins
(artesunate, artemether) |
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DOC for travelers prophylaxis to areas w/o resistant P. falciparum?
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Chloroquine weekly
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Drugs that act on amoebas in bowel wall and liver?
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chloroquine, emetines, metronidazole
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drugs that act on amoebas in lumen of the bowel?
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diloxanide furoate, iodoquinol, paromomycin
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DOC for mild to severe intestinal amebiasis?
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metronidazole w/ luminal agent (diloxanide furoate)
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DOC for asymptomatic amebiasis?
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diloxanide furoate
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MOA of emetines?
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inhibit protein synthesis by blocking ribosomal mvmt on mRNA
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toxicity of emetines?
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GI, muscle weakness, CV dysfxn (arrhythmias, CHF)
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uses of Iodoquinol?
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alt in asx intestinal infection or as luminal agent in combo regimen for mild-severe intestinal infections
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DOC in severe intestinal wall amebiasis, hepatic abscess and other extraintestinal amebic dz?
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Metronidazole + luminal agent
OR tinidazole + luminal agent |
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DOC for trichomoniasis?
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metronidazole
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DOC for giardiasis?
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metronidazole
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DOC for Gardnerella and anaerobic bacteria (B fragilis, C diff)?
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metronidazole
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Toxicity of Metronidazole?
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GI, HA, dark urine, leukopenia, dizziness, ataxia, disulfiram-like rxn with eOH
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DOC for metronidazole-resistant protozoa?
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Nitazoxanide
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indications for use of pentamidine?
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trypansomiasis (hemolymphatic stage); P. jiroveci infxn
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tx of active pneumocystosis in HIV pt?
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IV pentamidine for 21 days
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toxicity of pentamidine?
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resp stim followed by depression, hypotension d/t vasodilation, hypoglycemia, anemia, neutropenia, hepatitis, pancreatitis (parenteral use)
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DOC for tx/px of pneumocystis pneumonia?
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TMP-SMX
(px: oral, 3x/wk; active infxn: daily oral or IV) |
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toxicity of TMP-SMX?
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GI, rash, fever, bone marrow suppression (neutropenia, thrombocytopenia)
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DOC for toxo?
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pyrimethamine + sulfadiazine (or clindamycin) + folinic acid supp
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toxicity of pyrimethamine + sulfadiazine?
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GI, glossitis, neuro sxs, hematotoxicity (megaloblastic anemia, thrombocytopenia)
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alternative tx for pneumocystis pneumonia that is less effective than TMP-SMX or pentamidine but is better tolerated?
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Atovaquone
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DOC for African Sleeping Sickness?
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Melarsoprol (enters CNS)
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toxicity of Melarsoprol?
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reactive encephalopathy (can be fatal)
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DOC for American trypaosomiasis?
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Nifurtimox
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MOA of nifurtimox?
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inhibits parasitic trypanothione reductase
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DOC for early hemolymphatic stages of African trypanosomiasis (pre-CNS)?
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Suramin
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drug effective against some forms of African trypanosomiasis that is suicide substrate of ornithine decarboxylase?
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Eflornithine
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DOC for Leishmaniasis?
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Sodium stibogluconate
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Toxicity of stibogluconate?
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QTc prolongation
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