Chemotherapy of Malaria and Schistosomiasis

Question 1

Name the organisms of Plasmodium: frequency of febrile paroxysms: Irregular, every 2 days, every 3 days

Answer 1

falciparum, vivax, malariae

Question 2

Quinoline derivatives mechanism

Answer 2

Chloroquine, mefloquine, quinidine, and quinine accumulate in parasite’s food vacuole, disrupt heme polymerization to hemozoin, yielding oxidative damage to membranes and digestive proteases.

Question 3

Quinoline derivatives use

Answer 3

Prophylaxis, treatment of acute malarial attacks

Question 4

Chloroguanide (proguanil): Inhibits what, used with what other drug, and used for what

Answer 4

Inhibitor of folate metabolism (used with Atovaquone). Prophylaxis and tx of falciparum.

Question 5

Atovaquone: Acts on what parasitic organ, used for what

Answer 5

Depolarizes parasitic mitochondria and inhibits their e- transport (used with chloroguanide). For prophylaxis and tx of malaria due to falciparum including chloroquine-resistant strains.

Question 6

Artesunate: Class. Acts on what parasitic organ of what parasite

Answer 6

Artemisinin cpd. Specifically and selectively inhibit the SERCA of P. falciparum.

Question 7

Lumefantrine: Class. Used in combo with what drug

Answer 7

Aminoalcohol class. Used in combo with artemether.

Question 8

Primaquine: Forms what type of intmds that act upon what and how? What is inhibited? Uses?

Answer 8

Forms quinolone-quinone intermediates that oxidize schizont membranes. Inhibits exoerythrocytic schyzogony. For prophy and prevention of relapses.

Question 9

For radical cure of persistent exoerythrocytic parasites after clinical cure of acute attack by P. vivax or P. ovale, what drug is the drug of choice?

Answer 9

Primaquine phosphate

Question 10

Tx of uncomplicated malaria, chloroquine-sensitive strains: (falciparum, malariae, knowlesi) main and alternative

Answer 10

Chloroquine phosphate, hydroxychloroquine

Question 11

Tx of uncomplicated malaria, chloroquine-sensitive strains: (vivax, ovale) main and altn

Answer 11

Chloroquine phosphate + primaquine phosphate, hydroxycholorquine + primaquine phosphate

Question 12

Tx of uncomplicated malaria, chloroquine-resistant strains: (falciparum) main and altn

Answer 12

Atovaquone-proguanil; artemether-lumefantrine, quinine plus doxy, tetracycline or clinda, mefloquine.

Question 13

Tx of uncomplicated malaria, chloroquine-resistant strains: (vivax)

Answer 13

Quinine + either doxy or tetra + primaquine; atovaquone-proguanil + primaquine, mefloquine + primaquine

Question 14

S.E.s:
Chloroquine:
Quinine/Quinidine:
Primaquine:
Doxycycline:
Proguanil:
Artesunate:

Answer 14

Itching, retinitis; cinchonism, hypotension, hypoglycemia, abortion, arrhythmias; hemolysis (in G6PDdef pts), metHbemia, fever, n/v; photosensitivity; S.E.s rare; neurotoxicity, QT prolongation.