Anti-Malarial Drugs

Question 1

Plasmodium species cause what?

Answer 1

Malaria

Question 2

Plasmodium species infecting humans.

Answer 2

Plasmodium faciparum
P. vivax
P. ovale
P. malariae
P. knowlesi

Question 3

What component of malaria is distinctive in a blood smear?

Answer 3

Gametocytes

Question 4

Seeing these in the blood stream of malaria patients allows you to make a definitive diagnosis.

Answer 4

Gametocytes

Question 5

How is Malaria diagnosed?

Answer 5

Malaria Rapid Antigen Test

Question 6

Clinical features of Malaria.

Answer 6

Fever that waxes and wanes.

Question 7

This stage of Malaria infection is completely asymptomatic.

Answer 7

Liver stage

Question 8

Taking these drugs prevent the blood stages of malaria, but not the liver stages from infection with P. vivax or P. ovale.

So relapses can occur once you finish the prophylaxis.

Answer 8

Chloroquine and Mefloquine.

Question 9

The oldest and safest synthetic anti-malarial drug.

Answer 9

Chloroquine

Question 10

What do the structures of all quine drugs have in common?

Answer 10

Protonatable Nitrogen

Question 11

How does the protonatable Nitrogen in quine drug, us relate to their mechanism of action?

Answer 11

In neutral pH, the drug is uncharged, so it can enter our cells.

In acidic environments like the lysosome or food vacuole, it gets protonated.

Question 12

What’s so special about a protonated quine drug?

Answer 12

It gets trapped in the area it’s in, like the food vacuole or lysosome, and this is where it does its job.

Question 13

These drugs are used to treat Malaria.

Answer 13

Quine drugs

Question 14

Chloroquine resistance is mostly associated with this parasite.

Answer 14

P. falciparum

Question 15

The main food of malaria parasites.

Answer 15

Globin that’s found on Hb in RBC’s.

Question 16

How do malaria parasites prevent Heme toxicity?

Answer 16

Use heme polymerase to convert Heme to a pigment called Hemozoin, which is not toxic.

Question 17

How does Chloroquine work?

Answer 17

It inhibits Heme Polymerase, so toxic heme accumulates in the food vacuole and kills the cell.

Question 18

What causes Chloroquine resistance?

Answer 18

Mutated pfcrt

Question 19

What does pfcrt stand for?

Answer 19

P. falciparum Chloroquine resistance transporter.

Question 20

How does the mutated pfcrt work?

Answer 20

It increases the export of Chloroquine from the RBC’s food vacuole.

Question 21

Can a pregnant woman take Chloroquinone?

Answer 21

Yes

Question 22

Side effect of Chloroquinone

Answer 22

Retinopathy.

Skin itchiness in Western Africans.

Question 23

How does the retinal degeneration caused by Chloroquinone look?

Answer 23

Bull’s eye maculopathy.

Question 24

This anti-malarial drug is used in areas where there’s Chloroquine resistance.

Answer 24

Mefloquine

Question 25

Side effect of Mefloquine.

Answer 25

Causes tremors and vivid dreams. Exacerbated seizures Fine tremor Worsening of psychiatric disorders

Question 26

Pregnancy category of mefloquine

Answer 26

B

Question 27

Anti-malarial that's from the Cinchona tree.

Answer 27

Quinine.

Question 28

This anti-malarial drug has muscle relaxant side effects.

Answer 28

Quinine

Question 29

Antimalarial that can be given through IV

Answer 29

Quinidine

Question 30

Only anti-malarial that can treat the liver stages of P. ovale and P. vivax.

Answer 30

Primaquine

Question 31

Anti-malarial that has activity against both the liver and blood stages.

Answer 31

Primaquine

Question 32

Considered the 2nd choice treatment for Pneumocystis carinii (P. jiroveci) pneumonia in AIDS patients.

Answer 32

Primaquine + Clindamycin

Question 33

Combination anti-malarial drug that contains Atovaquone and Proguanil.

Answer 33

Malarone

Question 34

This component of Malarone is an electron transport inhibitor.

Answer 34

Atovaquone

Question 35

This component of Malarone is a Dihydrofolate Reductase Inhibitor.

Answer 35

Proguanil

Question 36

Third choice treatment for Malaria

Answer 36

Pyrimethamine and Sulfadoxine. Too many side effects and long half-lives.

Question 37

Can be used for all strains of Malaria, including Chloroquine-resistant P. falciparum.

Answer 37

Tetracyclines, especially Doxycycline.

Question 38

Rapidly malariocidal that kills Plasmodium parasites more rapidly than any other anti-malarial medication.

Answer 38

Artemisinins.

Question 39

Rapidly malariocidal that kills Plasmodium parasites more rapidly than any other anti-malarial medication. NOT used for prophylaxis bc it has to be given 3 times a day.

Answer 39

Artemisinins.