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Flashcards in Antimalarial Drugs Deck (18):
1

Plasmodium Vivax

Low parasite burden, easier to take care of, mild anemia, can go into latent form for years, need radical tx. Most common outside Africa. Schuffner's dots 48 hour recurring fever

2

Plasmodium Ovale

Low parasite burden, easier to take care of, mild anemia, can go into latent form for years need radicle tx. Schuffner's dots, 48 hour recurring fever

3

Plasmodium Malariae

Low parasite burden, easier to take care of, mild anemia 72 hour recurring fever

4

Plasmodium falciparum

Most deadly, most common in africa, high parasite burden, severe anemia, cerebral and multi-organ symptoms. gametes look like a sickle or curved banana shape. Forms a rosette and causes small vessels to clog off due and ischemia. Produces cytokine response, and can infect RBCs of any age. 24 hour recurring fever

5

Order of infection

Sporozites from mosquito injected into body, migrate to liver. Enters hepatocytes and become schizonts, multiply and lyse the hepatocyte as merozoites and infect RBCs. They then enter the ring form, become trophozites, then Schizont, and lyse the RBC as Merozoites which can mature and produce gametes, or can reinfect another RBC. The Gametes reproduce in the mosquito.

6

Schuffner's dots

Dots seen in the cytoplasm of cells infected by P. ovale or P vivax

7

Binding site for the merozoite to enter the RBC.

Glycophorin Receptor

8

Fever waxing and waining

Is due to merozoite release from the RBCs.

9

Chloroquine

Prophylaxis agent or tx. inhibits heme polymerase preventing the conversion of ferriptotoporphyrin to hemozolin causing toxic buildup in the cell. Can have dizzyness, headache, skin rashes, can cause serious eye dameage in extended large doses.

10

Quinine

More toxic than chloroquine, but no resistance developed, used for resistant P. falciparum. Inhibits heme polymerase. AE: tinnitus, blurred vision, nausea, headache, decreased hearing aacuity, damage to vision balance and hearing.

11

Quinidine

Often combined with Quinine. Antiarrhythmic drug which blocks Na and K currents. IV for severe malaria, AE: Cardiac problems

12

Mefoquine

Inhibits heme polymerase. AE: neuropsychiatric reactions (disorientation, hallucinations, depression). Used only for chloroquine resistant P. falciparum.

13

Atovaquone

MOA: depolarizes parasitic mitochondria and inhibits electron transport. Usually given with proguanil. Has drug interactions.

14

Proguanil

Metabolite inhibits the plasmodial Dihydrofolate reductase. Enhances mitochondrial toxicity of atovaquone. Becomes concentrated in erythrocytes.

15

Atovaquone-proguanil

Combination acts to depolarize parasitic mitochondrial ETC and DHFR. Has slow onset, expensive, GI disturbances. Replacing mefoquine for prophylaxis.

16

Artemisinins

Heme iron in the malarial pigment acts on the drug to produce free radicals that damage parasite proteins. Inhibits calcium ion ATPase in P. falciparum, rapid and potent effect against all. Do not use alone to prevent resistance.
Often combined with lumefantrine

17

Primiquine

"radicle Care" used to treat hepatic forms of P. vivax and P. Ovale. Unknown MOA. SEE HEMOLYTIC ANEMIA IN PTs With G6P deficiency.

18

Doxycycline

Used for chloroquine resistant P. Vivax in combination with Quinine. binds 16S subunit of the ribosome to prevent translation.