Week 3: Antimalarial drugs

Question 1

What are the three main species of Malaria?

Answer 1

Plasmodium flaciparum, P. vivax, P. ovale

Question 2

What are the most persistent hepatic forms of malaria?

Answer 2

P. vivax and P. ovale

Question 3

What is the most extreme form of malaria?

Answer 3

P. falciparum

Question 4

What drug targets and kills the hepatic form?

Answer 4

primaquine

Question 5

What forms readily become resistant to malaria?

Answer 5

P. vivax and P. falciparum

Question 6

When do most deaths occur from malaria?

Answer 6

within the first 24-48 hours of infection

Question 7

What drug is used for suppressive prophylaxis?

Answer 7

chloroquine, low dose

Question 8

What is the first line treatment for acute attack?

Answer 8

chloriquine

Question 9

What is the treatment for chloroquine-resistant P. falciparum and P. vivax?

Answer 9

Quinine sulfate + doxycycline

Question 10

What is the treatment of parenteral treatment for severe diseases?

Answer 10

Qunidine + doxycyline

Question 11

What are the alternative treatments for prevention of malaria?

Answer 11

atovaquone/proguanil

Question 12

What is the alternative treatment for prevention of chloroquine resistant malaria?

Answer 12

Doxycyline or mefloquine

Question 13

What is the radical cure of prevention of relapse drug?

Answer 13

primaquine

Question 14

T/F: there are no drugs that target the sporozoite form of malaria?

Answer 14

True

Question 15

What form of malaria do all malarial drugs target besides primaquine?

Answer 15

Red blood cell stage

Question 16

How does chloroquine become more selective?

Answer 16

concentrates in parasitized 25 fold more

Question 17

What is the MOA of chloroquine?

Answer 17

binds to FPIX and doesn’t allow the parasite to turn it into hemozoin from its parasite heme polymerase

Question 18

What are the adverse effects of chloroquine?

Answer 18

severe eye damage and blindness

Question 19

T/F: quinine and quinidine are more toxic than chloroquine?

Answer 19

True

Question 20

What is quinine and quinidine used for?

Answer 20

chloroquine resistant P. falciparum

Question 21

What are adverse effects of quinine/quinidine?

Answer 21

Cinchonism; permanent damage to vision, balance and hearing

Question 22

What other thing is quinidine used to treat?

Answer 22

anti-arrhymic, blocks Na and K channels

Question 23

What are adverse effects of quinidine?

Answer 23

cardiac issues

Question 24

What are side effects of mefloquine?

Answer 24

neuropsychiatric reactions

Question 25

What is indicated for the prevention of chloroquine resistant P. falciparum?

Answer 25

mefloquine

Question 26

What is the MOA of atovaquone?

Answer 26

depolarizes parasitic mitochondria and inhibits electron transport

Question 27

What is MOA of proguanil?

Answer 27

inhibits malarial dihydrofolate reductase

Question 28

Is atovaquone/proguanil quick or slow onset?

Answer 28

Slow

Question 29

What is MOA of artemisinins (2 MOAs)?

Answer 29

Heme iron in malarial pigment acts on drug to produce free radicals, inhibitions calcium ion ATPases of P. falciparum

Question 30

Are artemisinins fast or slow?

Answer 30

Very rapid

Question 31

Do you use artemisinins alone?

Answer 31

no, to avoid selection of resistant organisms

Question 32

What stage of malaria is lumefantrine effective against?

Answer 32

erythrocytic state

Question 33

Why do you treat with lumefantrine?

Answer 33

Helps clear remaining viable parasites

Question 34

What pt population can primaquine cause hemolytic anemia?

Answer 34

G6PD deficiency