Flashcards in Anti-parasitics Deck (91)
The treatment goal for protozoa is ___________, while the treatment goal for helminths is ___________.
- Eradication or reduction
Protozoa: complete replication w/in definitive host; illness results from single exposure.
Helminths: life-cycle involves more than definitive host; repeated exposures necessary for disease.
What's the difference b/w definitive host, intermediate host, and incidental host?
- Definitive: harbors sexual parasitic stage
- Intermediate: harbors larval or asexual stage
- Incidental host: not necessary for parasitic infection
What's the difference b/w gametogony and schizogeny?
- Gametogony: sexual development
- Schizogeny: asexual development
Where would you use chloroquine, and for what reason?
Only in areas w/o resistant Plasmodium falciparum (for prevention).
*Name the 2 best treatments for malarial prevention.
- Atovaquine + proguanil
In areas of high multi-drug resistance, what drug would you give to prevent malaria?
For terminal prophylaxis vs. Plasmodium vivax and ovale, what drug would you use?
In what pt population would you avoid using this?
Avoid in G6PD deficiency pts, pregnancy, and granulocytopenics (children 'okay')
Assuming no resistance, what's the preferred drug to treat P. falciparum malaria?
What drug combo would you use to treat P. vivax and ovale infections?
What defines a "complicated" malarial infection? (not sure if it will be tested)
*Complicated or severe malaria is defined as coma or severely AMS, hypoglycemia, renal failure, parasitemia > 5%, seizures other than 1 short febrile seizure, respiratory distress, shock, etc.
Name the LUMINAL agents used in the treatment of amoebiasis.
What should you add if there is colitis or liver abscess?
- Diloxanide furoate
What substance does an amoebic liver abscess resemble?
What are the 2 primary tx agents for giardiasis?
What are 2 alternates?
Primary: metronidazole, nitazoxanide
Alternate: furazolidone, albendazole
What's an important management principle in treating cryptosporidiosis w/HIV?
What's the DOC?
What are some other agents?
Restoration of immune response
DOC: Nitazoxanide (even in moderately immunosuppressed)
Others: Paromomycin, (azithromycin, clarithromycin)
What's the DOC combo for toxoplasmosis?
Pyramethamine + sulfadiazine/clindamycin
What are the 2 broad categories of leishmaniasis?
Visceral and cutaneous
What's the mainstay for tx of Leishmaniasis?
What else can be used?
- Amphotericin B, liposomal amphotericin B, miltefosine
What's the DOC for AFRICAN trypanosomiasis?
What are some other options?
*Suramin (crosses BBB)
- Alt's: Pentamidine, melarsoprol, eflonithine
What's the DOC for AMERICAN trypanosomiasis?
What's another option?
- Alt: benznidazole
What bug causes Chagas dz?
T. cruzi (American trypanosomiasis)
What diseases have parasites w/ kinetoplasts?
Chagas disease, leishmaniasis, and sleeping sickness
(there is a new drug that targets these. prob not on test)
What is the DOC for neurocystocercosis?
What's the DOC for filariasis?
What the DOC for onchocerciasis?
What the DOC for strongyloidiasis?
What is the major side effect of sodium phosphate?
Acute phosphate nephropathy
Risk factors for nephropathy: old age, renal insufficiency, V depletion, meds (ACEIs/ARBs)
Contraindications for Mg citrate and Mg OH?
Bowel obstruction, renal failure
Which osmotic laxative is used for surgery prep?
What agent should you prescribe to PREVENT the formation of hard stool?
Glycerin suppositories/enemas would also work, but she calls it a lubricant