Antiprotozoal tx Flashcards
(22 cards)
Albendazole: MOA and adverse rxns
Used for nematodes
MOA: inhibits microtubule synthesis in nematodes, irreversibly impairs glucose uptake –> parasite immobilized or dies slowly; also has larvicidal and ovicidal effects
Adverse rxn: migration of roundworms through mouth and nose, leukopenia, alopecia, increased transaminases
Drug interactions: dexamethasone and praziquantel increase levels
Praziquantel: MOA and adverse rxns
MOA: loss of intracellular calcium results in paralysis and dislodgement of worms
Adverse: fever, sweating, esoinophilia; structurally similar to benzos
Drug interactions: dexamethasone, carbamazepines, phenobarbital, phenytoin all cause decreased drug levels; cimetidine, ketoconazole, erythromycin all increase levels
Pyrantel pamoate: MOA and adverse rxns
used for pinworms and roundworms
MOA: depolarizing neuromuscular blocker, spastic paralysis of parasite, inhibits cholinesterase
Adverse rxn: rash, transient AST elevations
Drug interactions: piperazine -
avoid concomitant use; increases theophylline levels in peds
luminal vs. extraluminal tx
luminal = never absorbed systemically extraluminal = absorbed systemically
Drugs used for amebiasis
Luminal: Iodoquinol, Paromomycin
Extraluminal: Metronidazole, Pentamidine
Metronidazole: Used for, adverse rxn, drug/food interactions
Used for: tx of amebiasis (extraluminal)
Adverse rxn: xerostomia, METALLIC TASTE, furry tongue, change in taste sensation, DARK URINE, SEIZURES, NEUROPATHY, pancreatitis, DISULFIRAM TYPE REACTION WITH ALCOHOL (flushing, HA, N/V, sweating, tachycardia)
Drug interactions: phenytoin and phenobarbital decrease levels, alcohol or disulfiram contraindicated, increases warfarin effects, increases lithium levels, cimetidine increases levels
Food interaction: antibiotics impaired
Malaria cause and sxs
Plasmodium!
Initial sxs: chills, fever, HA, malaise, fatigue, nausea, muscle pains, and mild diarrhea
Severe sxs: delirium, impaired consciousness, generalized convulsions, followed by coma and death
Most deadly cause of malaria
P. falciparum
malaria tx: DOC (all plasmodium except chloriquine resistant P. falciparum and P. vivax)
chloroquine phosphate
Malaria tx: DOC ALL PLASMODIUM
quinidine gluconate or quinine dihydrochloride
Malaria tx: prevention of relapses for P. vivax and P. ovale
primaquine phosphate
Malaria tx: DOC chloroquine resistant P. falciparum
Quinine sulfate + doxycycline, tetracycline, pyrimethamin-sulfadoxine, or clindamycin
atovaquone/proguanil (malarone)
Malaria tx: DOC chloroquine resistant P. vivax
quinine sulfate + doxycycline or mefloquine
Prophylaxis of malaria: chloroquine sensitive areas
chloroquine phosphate
prophylaxsis of malaria: chloroquine resistant areas
mefloquine or doxycycline or atovaquone/proguanil (malarone)
Chloroquine contraindications and adverse reactions
Contra: retinal or visual field changes; patients with psoriasis and porphyria
Adverse: GI, fatigue, hypotension, EKG changes, blood dyscrasias, ocular toxicity, blurred vision, skin reactions, peripheral neuropathy, psychosis and seizures
Quinine and quinidine: adverse reactions
Tinnitus, nausea, visual disturbances, headache, dizziness, flushing - cinchonism, Blood dyscrasias, Hepatitis
Cardiovascular toxicity, Severe hypotension with IV administration, Hypoglycemia,
NO GI SXS
Use in pregnancy can cause ototoxicity and deafness in neonates
Mefloquine: contraindications and adverse reactions
Contra: recent h/o depression, generalized anxiety disorder, psychosis, or schizophrenia or other major psychiatric disorders
Adverse: Toxic psychosis
Seizures, Prolonged QT syndrome, Dysrhythmias, GI, Dizziness, Weakness, Nightmares, Dysphoria, Visual disturbances, Disturbed sense of balance, Post-malaria neurologic syndrome
Primaquine: why its unique and adverse rxn
Only available agent active against dormant stages of P. vivax and P. ovale
Adverse: GI, Hemolytic anemia in G-6-PD deficiency, Methemoglobinemia, Arrhythmias, pruritus, leukopenia, agranulocytosis, leukocytosis, interference with visual accommodation
Pyrimethamine: adverse rxn
GI, Megaloblastic anemia, leukopenia, thrombocytopenia, agranulocytosis,
***Stevens-Johnson syndrome
Proguanil: adverse rxn
Aphthous ulcerations, Hair loss, Scaling of palms and soles, Urticaria, Hematuria (with large doses), GI, Thrombocytopenia
Atovaquone: adverse rxn
Rash, Headache, Fever, Insomnia, Asthenia, Pruritus, Anemia (rare), Neutropenia (rare), Hyponatremia, Elevated hepatic enzymes
