Antiparistics

Question 1

Antimalarials

Answer 1

Chloroquine, primaquine, artemether

Question 2

Prophylactic antimalarials

Answer 2

Chloroquine and primaquine

Question 3

Treatment antimalarials

Answer 3

Artemether/lumefantrine
Chloroquine
Primaquine

Question 4

Blood stage antimalarials

Answer 4

Chloroquine

Artemether

Question 5

Liver stage antimalarials

Answer 5

Primaquine

Question 6

3 characteristics of prophylactic agents

Answer 6

Low toxicity
Orally effective
Long half-life

Question 7

Prophylaxis prevents what stage of malaria?

Answer 7

Blood stage

Question 8

Chloroquine MOA

Answer 8

Weak base trapped in acidic parasite
Inhibits biocrystallization to increase heme concentration in food vacuole

Heme toxic to parasite

Question 9

Chloroquine uses

Answer 9

Clinical cure & Prophylaxis against sensitive strains

Question 10

Is chloroquine safe for pregnancy?

Answer 10

Yes

Question 11

Chloroquine side effects

Answer 11

CV toxicity

Question 12

Chloroquine resistance due to…

Answer 12

Mutated vacuole efflux transporter (PfRCT)

Question 13

Chloroquine does not work for…

Answer 13

P. Falciparum in Asia, Africa, S. America

Question 14

Artemether MOA

Answer 14

Maybe converted to toxic free radicals by heme

Question 15

Artemether Uses

Answer 15

Fixed dose w/ lumefantrine
Oral drug for MDR falciparum

Artesunate (IV)

Question 16

Artemether side effects

Answer 16

Neurotoxicity & embryotoxicity

Question 17

Artemether PK (when not w/ lumefantrine)

Answer 17

Absorbed from GI tract —> short half-life

Does NOT work as prophylactic

Question 18

Artemether Fun Fact

Answer 18

Inactive counterfeit to mimic drug

Question 19

Liver Antimalarial

Answer 19

Primaquine

Question 20

Primaquine MOA

Answer 20

Unknown

Question 21

Primaquine Uses

Answer 21

Clinical & radical cure of vivax/ovale (take w/ chloroquine)

Terminal prophylaxis for vivax/ovale regions

Primary prophylaxis if other drugs inappropriate

Question 22

Primaquine side effects

Answer 22

Mild cyanosis in normal G6PD

Hemolytic anemia in G6PD deficiency

Question 23

Primaquine contraindications

Answer 23

G6PD deficiency

Pregnancy

Question 24

Antiprotozoal Drugs

Answer 24

Metronidazole

Paromomycin

Question 25

Common protozoans in USA

Answer 25

Trichomoniasis Giardiasis Amebiasis Cryptosporidiosis

Question 26

Classifications of antiprotozoal agents

Answer 26

Systemic | Luminal - agents not absorbed

Question 27

Metronidazole classification

Answer 27

Systemic

Question 28

Metronidazole MOA

Answer 28

Prodrug DNA damaging metabolite by anaerobic organism

Question 29

Metronidazole Uses

Answer 29

Amebiasis, giardiasis, trichomoniasis, anaerobic bacteria For amebiasis, add luminal amebicide to eradicate luminal “survivors”

Question 30

Metronidazole side effects

Answer 30

Metallic taste Red/brown urine Carcinogenic

Question 31

Nitazoxanide uses

Answer 31

Diarrhea caused by cryptosporidiosis or giardiasis

Question 32

Nitazoxanide MOA

Answer 32

Pyruvate Ferrell in oxidoreductase inhibitor

Question 33

Paromomycin classification

Answer 33

Luminal antiprotozoal

Question 34

Paromomycin MOA

Answer 34

Binds 30s subunit of S hisolytica Inhibits protein synthesis (not absorbed by GI, so can’t treat systemic infections)

Question 35

Paromomycin uses

Answer 35

Asymptomatic amebiasis (solo) Amebic colitis/dysentery (combo w metro) 1st trimester pregnant pts w/ giardiasis

Question 36

Antihelminthics

Answer 36

Albendazole Praziquantel Ivermectin

Question 37

Nematodes

Answer 37

Round worms

Question 38

Cestodes

Answer 38

Tapeworms

Question 39

Trematodes

Answer 39

Flukes

Question 40

How do humans get worms?

Answer 40

Ingestion of eggs/larvae in food or soil to skin Worms lodge in digestive tissue

Question 41

Neurocysticercosis

Answer 41

Ingestion of undercooked pork or feces contaminated w/ Taenia solium tapeworm eggs Cysts in brain cause seizures

Question 42

Most common infection in kids in USA age 5-10 years old

Answer 42

Enterobiasis (pinworm)

Question 43

Single dose antihelminthic

Answer 43

Expels worms from GI tract

Question 44

Extended treatment antihelminthic

Answer 44

Systemically eradicate adults or developmental forms in other tissues

Question 45

Antihelminthic prototype

Answer 45

Albendazole

Question 46

Albendazole MOA

Answer 46

Block polymerization of B-tubulin, disrupts nematode motility and uptake of glucose Cell death in ~3 days

Question 47

Best way to improve albendazole absorption

Answer 47

Take with fatty meal

Question 48

Active form of albendazole

Answer 48

Albendazole sulfoxide

Question 49

Albendazole uses

Answer 49

Cestode infections Roundworm infections Pinworm (400mg dose, two weeks apart)

Question 50

Albendazole side effects

Answer 50

Teratogenic Liver toxicity Bone marrow suppression

Question 51

Albendazole contraindications

Answer 51

Pregnancy

Question 52

Praziquantel MOA

Answer 52

Increases perm of trematode & cestode membrane to Ca, causes paralysis, dislodgement, and worm death

Question 53

Praziquantel use

Answer 53

Schistosomiasis Most trematodes and cestodes Cysticerosis

Question 54

Praziquantel side effects

Answer 54

Fever, rash, itching associated w/ protein release from dying worms

Question 55

Ivermectin MOA

Answer 55

Tonic muscle paralysis, activates glutamate gated Cl channels, hyperpolarization of cell

Question 56

Why does Ivermectin not effect human cells?

Answer 56

Human cells have p-glycoprotein efflux transporters

Question 57

Ivermectin uses

Answer 57

Fleas, ticks, mites Onchocerciasis (river blindness) Strongyloidiasis Scabies, head lice

Question 58

Ivermectin side effects

Answer 58

Mazzotti reaction | Cleft palate

Question 59

Ivermectin contraindications

Answer 59

Pregnancy