Antiparasitics

Question 1

Common protozoal infections in US

Answer 1

Trichomoniasis
Giardiasis
Amebiasis

Question 2

How are antiprotozoal agents classified?

Answer 2

Systemic

Luminal (not absorbed)

Question 3

Systemic antiprotozoal agent

Answer 3

Metronidazole

Question 4

MOA metronidazole

Answer 4

Prodrug that is converted to DNA damaging metabolite by anaerobic organisms

Question 5

Metronidazole uses

Answer 5

Amebiasis
Giardiasis
Trchiomoniasis

Question 6

Metronidazole and amebiasis

Answer 6

Given in combo with luminal amebicide to eradicate luminal survivors

Question 7

Luminal antiprotozoal agent

Answer 7

paromomycin

Question 8

Paromomycin MOA

Answer 8

Aminoglycoside
Binds to 30s of E. Histolytica to inhibit protein synthesis
Not absorbed from GI tract (not good for systemic infections)

Question 9

Paromomycin uses

Answer 9

• alone for asymptomatic amebiasis

- combo with metro for amebic colitis/dysentery

Question 10

What is an alternative to metronidazole during the 1st trimester for giardiasis?

Answer 10

Paromomycin

Question 11

Adverse reactions for paromomycin

Answer 11

GI distress

Question 12

Drugs for prophylaxis

Answer 12

Chloroquine

Primaquine

Question 13

Drugs for treatment

Answer 13

Artemether/lumefantrine
Chloroquine
Primaquine

Question 14

Blood stage drugs

Answer 14

Chloroquine
Artemisinin

Clinical cure

Question 15

Liver stage drugs

Answer 15

Primaquine

Radical Cure

Question 16

Drugs with gametocidal activity

Answer 16

Artemether

Primaquine

Question 17

Properties of prophylactic drugs

Answer 17

• orally effective
• long half life
• low toxicity

Question 18

Chloroquine MOA

Answer 18

• trapped in acidic parasite food vacuoles
• inhibits biocrystallization
• hematin accumulates (toxic to parasite)

Question 19

Chloroquine resistance

Answer 19

mutated vacuolar efflux transporter (PfCRT)

Question 20

Chloroquine use

Answer 20

• cure and prophylaxis sensitive strains

Question 21

Chloroquine in pregnancy?

Answer 21

yes

Question 22

Chloroquine adverse reactions

Answer 22

• well tolerated in prophylaxis

- High doses: pruritis, HA, GI, CV toxicity

Question 23

Drug from qinghao

Answer 23

Artemether

Question 24

Artemether MOA

Answer 24

unclear

Question 25

Drug with short half life and not useful for chemoprophylaxis

Answer 25

Artemether

Question 26

Lumefantrine

Answer 26

long acting drug sustains antimalarial activity

Question 27

Artemether/lumefantrine use

Answer 27

MDR falciparum malaria

Question 28

Artemether/lumefantrine adverse reactions

Answer 28

- safe reputation - neurotoxicity - embryotoxicity

Question 29

MOA primaquine

Answer 29

unknown

Question 30

Primaquine use

Answer 30

- with chloroquine for vivax/ovale malaria | - terminal prophylaxis

Question 31

Drug for terminal prophylaxis

Answer 31

primaquine

Question 32

Primaquine MOA

Answer 32

- drug induced hemolytic anemia in G6PD

Question 33

CI primaquine

Answer 33

G6PD deficient patients

Question 34

Primaquine pregnancy?

Answer 34

No!

Question 35

Metronidazole adverse reactions

Answer 35

- HA, GI, metallic taste | - neuropathy

Question 36

BBW metronidazole

Answer 36

carcinogenic in animals

Question 37

DDI metronidazole

Answer 37

ethanol: disulfiram like reaction

Question 38

Paromycin pregnancy?

Answer 38

Yes