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PHARM 2 > anti-parasitics > Flashcards

anti-parasitics Flashcards

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1
Q

DOC for invasive amebiasis

A

metronidazole

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2
Q

Metronidazole use

A 
giardia
trichomonas
anaerobic cocci
anaerobic gram - bacili
h. pylori in combo tx
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3
Q

metronidazole MOA

A

reduced by reacting with reduced ferredoxin = produces cytotoxic compounds

these bind proteins and DNA = unstable molecules - cell death

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4
Q

metronidazole PK

A

hepatic oxidation
glucuoronidation
CYP P450s

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5
Q

metronidazole AE

A

GI distress
**disulfiram with alcohol
leukopenia
unpleasant metallic taste

safety in pregnancy not established

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6
Q

Tinidazole

A

2nd generation nitroimidazole

better tolerated and shorter duration that metronidazole

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7
Q

Tinidazole AE

A

same as metronidazole

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8
Q

diloxanide furoate

A

luminal antiamebics

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9
Q

iodoquinol

A

luminal antiamebics

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10
Q

paraymomycin

A

luminal antiamebics

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11
Q

What can be used by itself to tx asymptomatic ameobiasis

A

diloxanide furoate

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12
Q

Iodoquinol use

A

orally against luminal trophozoite and cyst forms of entamobea

alternative to diloxanide furoate for mild-severe infections

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13
Q

Iodoquinol AE

A

Adverse: with long term use - risk of optic neuritis

rash, diarrhea, dose related peripheral neuropathy

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14
Q

Paramomycin

A

aminoglycside antibiotic

only effected against luminal forms of E. histolytica and tapeworm

alternative agent for cryptosporidiosis in AIDS pt

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15
Q

paromycin MOA

A

amebicidal = cell membranes become leaky

interferes with bacterial protein synthesis - binds to 30s ribosomal subunits

reduces intestinal flora population

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16
Q

chloroquine use

A

combo: metroniazole, diloxanite furoate

eliminates trophozites in liver abscesses

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17
Q

emetine/dihydroemetine

A

back up drugs for tx of severe intestinal or hepatic amebiasis

MOA: inhibit protein synthesis by bloking ribosomal movement along mRNA

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18
Q

albendazole MOA

A

tx of cestodal infections (t. solium, e. granulosis)

inhibits microtubule synthesis and glucose uptake

ATP production is decreased = worm immobilization and death

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19
Q

albendazole AE

A

1-3 days of tx: HA, nausea

3 months/hydatid tx: hepatotoxicity, agranulocytosis/pancytopenia

CONTRAINDICATED in pregnancy/children

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20
Q

DOC for trichuris trichuria

A

mebendazole (or albendazole)

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21
Q

DOC for enterobius vermicularis

A

mebendazole (or pyrantel pamoate)

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22
Q

DOC for hookworms/n. americanus and a. duodenale:

A

mebendazole (pyrantel pamoate or albendazole)

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23
Q

roundworm/ascariasis lumbricoides DOC:

A

mebendazole (albendazole, pyrantel pamoate)

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24
Q

mebendazole MOA

A

inhibts formation of helminth microtubules

blocks glucose tuptake

affects parasitse that are expelled with feces

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25
mebendazole AE
contraindic in preg caution in children <2 or with cirrhosis
26
Thiabendazole
tx: strongyloidiasis, cutaneous larva migrans, early stage of trichinosis MOA: affects microtubular aggregation
27
thiabendazole AE
more toxic than other benzimidazoles CNS disturbance contraindic in pregnacy erythema multiforme - stevens johnson not used in presence of liver or kidney disease
28
doc for onchoceriasis
ivermectin
29
doc for CLM
ivermectin
30
doc for strongyloides
ivermectin
31
ivermectin MOA
GABA agonist Cl- influx = inc hyperpolarization - death occurs later does not cross BBB
32
Ivermectin AE
mazotti reactions with onchoceriasis: fever, dizzy, somnolence, hypotension contraindic in pregnacy and meningitis DONT give with drugs that enhance GABA: barbiturates and benzos
33
piperazine
alt drug for tx of pinworm and roundworm
34
piperaize MOA
GABA agonist - explusion of worm by peristalsis contraindicated in seizure pt's
35
pyrantel pamoate
tx roundworms, pinworms, hookworms
36
pyrantel pamoate MOA
depolarizing , NM blocker = persistent activation of parasite nicotinic-r = release of Ach and inhibition of cholinesterase
37
diethylcarbamazine
immobilizes microfilarier - makes suscpetible t ohost defense
38
DOC lymphatic filarisis
diethycarbamazine
39
diethylcarbamazine MOA
immobilizes microfilariae - susceptible to host defense
40
Doxycycline MOA
macrofilaricidal against wuchereria bancrofti active against onchoceriasis MOA - indirectly kills wolbachia - intracellular bacterial symbiont of parasite
41
Praziquantel
shisto, trematode, cestode, cysticerosis
42
DOC for schistomasiasis
Praziquantel
43
Praziquantel MOA
inc perm of cell membrane to calcium causing contracture and paralysis of worm = detachment of suckers from BV walls
44
DOC for cysticerosis
albendazole (praziquantel has similar efficacy)
45
praziquantel PK
extensive 1st pass metabolism
46
praziquantel AE
contraindicated in pregnancy, nursing mothers, and OCULAR CYSTICERCOSIS - destroying organism may damage eye drug interactions (CYP P450)
47
bithionol
fasciolosis | alternative tx for pulmonary paragonimiasis
48
bithionol MOA
inhibition of helminth electron transport chain
49
DOC fasciolosis
bithionol
50
niclosamide
2nd line drug for most cestodes uncommon b/c of effectiveness of praziquantel
51
niclosamide MOA
inhibition of parasite's mitochondrial phosphorylation of ADP Lethal for cestode's scolex and segments - BUT not for ova
52
Niclosamide PK
laxative given prior to niclosamide to purge bowel of dead segments - in order to preclude digestion and liberation of ova alcohol should NOT be given within 1 day of dose
53
tinidazole use
amebiasis amebic liver abscess giardiasis trichomoniasis
54
diloxanide furoate MOA
converted in gut to diloxanide freebase active form
55
DOC for luminal amebicide
diloxanide furoate - not available in US
56
paromycin AE
GI distress - diarrhea HA, dizzy, rash, arthralgia
57
systemic antiamebics
chloroquine emetine dehydroemetine tx liver abscesses or intestinal wall infections
58
emetine/dihydroemetine AE
**pain at site of infection cardiotoxicity NM weakness nausea
59
DOC asymptomatic intestinal infection
diloxanide furoate alternative: iodoquinol, paromycin
60
DOC mild to mod intestinal infection
metronidazole + diloxanide furoate alternatives: tinidazole or tetracycline or erythromycin + diloxanide furorate
61
DOC severe intestinal infection
metronidazole/tinidazole + diloxanide furoate alternatives: tetracycline/emetine/dihydroemetine + diloxanide furoate
62
DOC hepatic abscesses and other extraintestinal disease
metronidazole/tinidazole + diloxanide furoate alternatives: emetine/dihydroemetine + chloroquine + diloxanide furoate
63
DOC loiasis
diethylcarbamazine
64
DOC tropical eosinophilia
diethylcarbamazine
65
diethylcarbamazine AE
d/t host response following parasite death: - fever, malaise, myalgias - leukocytosis can use anti-histamines/steroids to resolve AE
66
DOC visceral larva migrans (toxocariasis)
albendazole
67
DOC trichinosis (trichinella spiralis)
albendazole or mebendazole
68
DOC clonorchis sinesis
praziquantel
69
DOC paragonimus westermani
praziquantel
70
DOC echinococcosis
albendazole
71
DOC taeniasis solium/saginata
praziquantel or niclosamide
72
cysticercosis DOC
albendazole or praziquantel
73
diphyllobothriasis DOC
praziquantel or niclosamide
74
DOC giardia
metronidazole
75
DOC trichomonas vaginalis
metronidazole
76
DOC trypanosomiasis
melarsoprol or suramin
77
DOC hemolymphatic stage of trypanosomiasis and PCP infection
pentamidine
78
toxoplasmosis encephalitis DOC
pyrimethamine + clindamycin or sulfadiazine or folinic acid
79
DOC leishmaniasis (all stages)
sodium stibogluconate/amphoteracin B
80
DOC cystercosis with taenia solium larva
albendazole or praziquantel

PHARM 2 (18 decks)

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