Antimalarials

Question 1

Quinoline derivatives?

Answer 1

Quinine, Chloroquine, Hydroxychloroquine, Mefloquine, Primaquine

Question 2

Quinine is also called?

Answer 2

Quinidine (used in anti-arrhythmias)

Question 3

Quinoline derivative mxn?

Answer 3

Accumulate in parasite’s food vacuole, disrupt heme polymerization to hemozoin, yeilding oxidative damage to membranes and digestive proteases. Primaquine is unique in that it inhibits exoerythrocytic schyzogony by forming quinoline-quinone intermediats that oxidize schizont membranes

Question 4

Quinoline derivatives for?

Answer 4

Prophylaxiws, treatment of acute malarial attacks

Question 5

Quinine side effects?

Answer 5

Cinchonism, hypotension, hypoglycemia, abortion, arrythmias

Question 6

Chloroquine side effects?

Answer 6

Itching (Africans), retinitis (rare)

Question 7

Primaquine side effects?

Answer 7

Hemolysis (G6PD), methemoglobinemia, fever, N/V

Question 8

Hydroxychloroquine is?

Answer 8

Quinoline derivative

Question 9

Mefloquine is?

Answer 9

Quinoline derivative

Question 10

Chloroguanide class and mxn?

Answer 10

Antifolate, Dihydrofolate reductase inhibitor

Question 11

AKA Proguanil?

Answer 11

Chloroguanide

Question 12

Chloroguanide used exclusively with?

Answer 12

As combination therapy: Chloroguanide (Proguanil with Atovaquone)

Question 13

Atovaquone class and mxn?

Answer 13

Napthalene, Depolarizes parasitic mitochondria and inhibits their electron transport

Question 14

Atovaquone + Chloroguanide (Proguanil) used for?

Answer 14

Prophylaxis and treatment of malaria due to P. falciparum, including chloroquine-resistant strains

Question 15

Major resistance amongst P. falciparum to this quinoline derivative?

Answer 15

Chloroquine

Question 16

Artesunate class and mxn?

Answer 16

Artemisinin compound, specifically and selectively inhibits SERCA of P. falciparum

Question 17

Artesunate side effects?

Answer 17

Neurotoxicity, QT prolongation

Question 18

Artemether class and mxn?

Answer 18

Artemisinin compound, specifically and selectively inhibits SERCA of P. falciparum

Question 19

Artemisinin compounds?

Answer 19

Artesunate, Artemether

Question 20

AKA benflumetol?

Answer 20

Lumefantrine

Question 21

AKA Lumefantrine?

Answer 21

Benflumetol

Question 22

Lumefantrine class?

Answer 22

Aminoalcohol

Question 23

Lumefantrine used in combo with?

Answer 23

Artemether (“coartemether”)

Question 24

Prophylaxis in chloroquine-sensitive zone?

Answer 24

Chloroquine

Question 25

Prophylaxis in chloroquine-resistant zone?

Answer 25

Mefloquine, Doxycycline, Atovaquone/Proguanil

Question 26

Mefloquine-resistant zone?

Answer 26

Doxycycline, Atovaquone/Proguanil

Question 27

Terminal prophylaxis?

Answer 27

Primaquine

Question 28

Antibiotics used to treat malaria?

Answer 28

Tetracycline, Clindamycin, Doxycycline

Question 29

Antibiotics treat what?

Answer 29

Severe malaria and chloroquine-resistant uncomplicated malaria

Question 30

Doxycycline side effect?

Answer 30

Photosensitivity

Question 31

Amantadine mxn?

Answer 31

Positive charge helps chloroquine overcome chloroquine-resistant malaria vacuoles; pt mutations against amantadine return bacteria to chloroquine-sensitivity

Question 32

Tx of severe malaria?

Answer 32

IV quinidien gluconate + antibiotic; IV artesunate followed by atovaquone-proguanil, doxycycline (clindamycin in pregnant woman), or mefloquine; blood transfusion

Question 33

Use for "radical cure" of acute attack of P. vivax or P. ovale?

Answer 33

Primaquine phosphate

Question 34

Has P. malaria developed resistance to chloroquine?

Answer 34

No

Question 35

Has P knowlesi developed resistance to chloroquine?

Answer 35

No

Question 36

Tx of uncomplicated malaria in P. falciparum, P. malariae, or P. knowlesi?

Answer 36

Chloroquine phosphate (or hydroxychloroquine)

Question 37

Tx of uncomplicated malaria in chloroquine-sensitive P. vivax or P. ovale?

Answer 37

Chloroquine phosphate + Primaquine phosphate (or Hydroxychloroquine + Primaquine phosphate)

Question 38

Tx of uncomplicated malaria in P. falciparum?

Answer 38

Atovaquone-Proguanil (or Artemether-Lumefantrine, Quinine sulfate + Antibiotic, Mefloquine)

Question 39

Has P. falciparum developed resistance to chloroquine?

Answer 39

Yes

Question 40

Has P. vivax developed resistance to chloroquine?

Answer 40

Some strains have

Question 41

Tx of uncomplicated malaria in chloroquine-resistane P. vivax?

Answer 41

Quinine sulfate + Doxycycline or Tetracycline + Primaquine phosphate (or Atovaquone-proguanil + Primaquine phosphate, Mefloquine + Primaquine phosphate)