Antimalarial Drugs

Question 1

Prevents polymerization of heme into hemozoin

BLOOD Schizonticide

Answer 1

CHLOROQUINE

for erythrocytic malaria

Question 2

Side effects of Chloroquine

Answer 2

QT prolongation

Question 3

Complexes w/ DNA to prevent strand separation

Blocks DNA replication and transcription

BLOOD Schizonticide

Answer 3

QUININE

malaria (chloroquine resistant)
severe falciparum malaria
DOC - pregnant patients

Question 4

Effective SINGLE AGENT for suppressing and curing MDR forms of Plasmodium falciparum

BLOOD Schizonticide

Answer 4

MEFLOQUINE

Question 5

Forms electron transferring redox compounds that acts as cellular oxidate

TISSUE Schizonticide
Gametocide

Answer 5

PRIMAQUINE

radical cure for P. vivax, P. ovale

eradicates hypnozoites in the liver – prevents relapse

Question 6

The only drug effective against exoerythrocytic stages of malaria

Answer 6

PRIMAQUINE

Question 7

Side effects of Quinine

Answer 7

Cinchonism - hearing loss, tinnitus, dizziness, flushing, and blurry vision

Question 8

MOA of Atovaquone-Proguanil

Answer 8

Atovaquone - disrupts mitochondrial electron transport
Proguanil - (-) folate synthesis

for treatment and prophylaxis (chloroquine resistant P. falciparum)

Question 9

Sequential blockade of folic acid synthesis

BLOOD Schizonticide
SPORONTICIDE

Answer 9

Sulfadoxime-Pyrimethamine

malaria (chloroquine resistant P. falciparum)

Question 10

Impairs progeny of malarial APICOPLAST genes

BLOOD Schizonticide

Answer 10

DOXYCYLINE

chemoprophylaxis (MDR)

Question 11

Used in combination w/ Artemether

BLOOD Schizonticide

Answer 11

LUMEFANTRINE

Question 12

Forms toxic free radical in malarial food vacuole

BLOOD Schizonticide

Answer 12

ARTEMETHER

Artemisinin

Question 13

DOC for uncomplicated falciparum malaria in Philippines

Answer 13

Artemether-Lumefantrine or
Malarone or
Mefloquine or
Quinine or
Sulfate + Clindamycin

Question 14

For chloroquine sensitive falciparum

Answer 14

Chloroquine

Question 15

For P. vivax and P. ovale

Answer 15

Chloroquine THEN

Primaquine

Question 16

For severe or complicated P. falciparum

Answer 16

Artesunate then Doxycycline OR
Clindamycin OR
CoArtem
Quinidine Gluconate/ Artemether or Quinine dihydrochloride

Question 17

GAMETOCIDAL against Vivax, Ovale, Malaria

Answer 17

QC

Quinine
Chloroquine

Question 18

GAMETOCIDAL against ALL

Answer 18

PrimArt

Primaquine
Artemisinin

Question 19

Only drug that is TISSUE Schizonticide

Answer 19

Primaquine

Question 20

Only drug that can give RADICAL CURE

Answer 20

Primaquine

Question 21

Only drug that can be used for PREVENTION of RELAPSE

Answer 21

Primaquine

Question 22

Malaria chemoprophylaxis for chloroquine sensitive individuals

Answer 22

Chloroquine 500 mg tab q tab weekly

Question 23

Malaria chemoprophylaxis for chloroquine resistant individuals

Answer 23

Mefloquine

Malarone

Question 24

Malaria chemoprophylaxis for MDR

Answer 24

Doxycycline 100 mg/tab

Question 25

Malaria chemoprophylaxis for P. vivax and P. ovale

Answer 25

Primaquine 30 mg daily for 2 weeks

Question 26

Plasmodial resistance to chloroquine is due to

(A) Change in receptor structure
(B) Decreased accumulation of the drug in the food vacuole
(C) Increased activity of DNA repair mechanisms
(D) Increased synthesis of dihydrofolate reductase
(E) Induction of drug-inactivating enzymes

Answer 26

(B) Decreased accumulation of the drug in the food vacuole

Resistance to chloroquine in P falciparum can result from decreased accumulation of the drug in the food vacuole caused by the activity of a transporter system encoded by the pfcrt gene

Question 27

A 10-year-old American girl presented to the
emergency department with fever, chills, lethargy, and splenomegaly. She had recently returned from Nigeria, where she had spent 3 weeks with her grandparents. She had previously received all standard childhood immunizations but no prophylactic travel medications because her parents had returned to Nigeria several times previously without any medical problems. Laboratory examination reveals low hematocrit and
platelet count and elevated creatinine. Blood smear reveals parasites in the erythrocytes and a diagnosis of falciparum malaria is made.

The patient should have received prophylaxis for the prevention of malaria; what prophylactic regimen would have been most appropriate?

(A) Artesunate
(B) Chloroquine
(C) Mefloquine
(D) Quinidine
(E) Tetracycline

Answer 27

(C) Mefloquine

Question 28

A 10-year-old American girl presented to the
emergency department with fever, chills, lethargy, and splenomegaly. She had recently returned from Nigeria, where she had spent 3 weeks with her grandparents. She had previously received all standard childhood immunizations but no prophylactic travel medications because her parents had returned to Nigeria several times previously without any medical problems. Laboratory examination reveals low hematocrit and
platelet count and elevated creatinine. Blood smear reveals parasites in the erythrocytes and a diagnosis of falciparum malaria is made.

This patient should immediately receive

(A) Artemether plus lumefantrine (Coartem)
(B) Artesunate
(C) Pentamidine
(D) Primaquine
(E) Stibogluconate

Answer 28

(B) Artesunate

Question 29

A 10-year-old American girl presented to the
emergency department with fever, chills, lethargy, and splenomegaly. She had recently returned from Nigeria, where she had spent 3 weeks with her grandparents. She had previously received all standard childhood immunizations but no prophylactic travel medications because her parents had returned to Nigeria several times previously without any medical problems. Laboratory examination reveals low hematocrit and
platelet count and elevated creatinine. Blood smear reveals parasites in the erythrocytes and a diagnosis of falciparum malaria is made.

If the girl recovers from the acute falciparum attack but a month later develops P vivax malaria, what drug or drugs should be given to eradicate schizonts and latent hypnozoites in the liver?

(A) Artesunate
(B) Dapsone
(C) Halofantrine
(D) Primaquine
(E) Quinine

Answer 29

(D) Primaquine