Exam 3: Antiprotozoal/Antihelmintic

Question 1

What is the DOC for an invasive amebiasis infection caused by Entamoeba histolytica?

Answer 1

Metronidazole + Luminal amebicide

Question 2

What protozal form is infective and inactive?

Answer 2

Cyst

Question 3

What protozal form is active and can invade tissues?

Answer 3

Trophozoite

Question 4

What causes a patient to have symptoms from an Entamoeba histolytica infection?

Answer 4

If the cyst forms into trophozoites that invade the tissue of the intestinal wall

Question 5

What is the DOC for an asymptomatic amebiasis infection caused by Entamoeba histolytica?

Answer 5

Luminal amebicide (Iodoquinol or Paraomomycin)

Question 6

What is the DOC for a giardiasis infection caused by Giardia lamblia?

Answer 6

Metronidazole

Question 7

What is the most common cause of non-bacterial diarrhea in North America?

Answer 7

Giardia lamblia

Question 8

What is the DOC for a trichomoniasis infection caused by Trichomoniasis vaginalis?

Answer 8

Metronidazole

Question 9

How are amebiasis and giardiasis infections transmitted?

Answer 9

Contact with contaminated feces, food, or water

Question 10

How is a trichomoniasis infection transmitted?

Answer 10

Sexually transmitted

Men often asymptomatic, tx both partners

Question 11

What is the DOC for a toxoplasmosis infection caused by Toxoplasma gondii?

Answer 11

Pyrimethamine + Sulfadiazine + Folinic acid

Question 12

What pathogen is common in cats and can cause serious fetal infection?

Answer 12

Toxoplasma gondii

Question 13

What is the DOC for a pneumocytosis infection caused by Pneumocystis jirovecii?

Answer 13

Trimethoprim + Sulfamethoxazole + Folinic acid

Question 14

Is Pneumocystis jirovecii a protozoa?

Answer 14

No, it is a yeast-like fungus

Question 15

What infection is a major cause of death in AIDs patients?

Answer 15

Pneumocytosis

Question 16

What can be given as a prophylaxis treatment as apart of HIV therapy to prevent pneumocytosis infections?

Answer 16

Trimethoprim + Sulfamethoxazole + Folinic acid

Question 17

What are the tissue amecicide drugs?

Answer 17

Metronidazole
Tinidazole
Emetine and Dehydroemetine

Question 18

What are the luminal amecicide drugs?

Answer 18

Iodoquinol
Paramomycin
Diloxanide furoate
Tetracycline and Erythromycin

Question 19

What is the MOA of metronidazole?

Answer 19

Reacts with ferrodoxin (found only in anaerobes)

Metronidazole metabolites are taken up into DNA and form unstable molecules

Question 20

What is metronidazole DOC for?

Answer 20

Invasive entamoeba histolytica (with a luminal amebocide)
Giardia lamblia
Trichomonas vaginalis

Question 21

What are the toxicities associated with metronidazole?

Answer 21

Dysgeusia (metalic taste)

Disulfiram-like reactiin

Question 22

What can Tinidazole be used to treat?

Answer 22

Alternative to metronidazole for tx of:
Invasive entamoeba histolytica (with a luminal amebocide)
Giardia lamblia
Trichomonas vaginalis

Question 23

What can Emetine and Dehydroemetine be used to treat?

Answer 23

Alternative to metronidazole for tx of severe intestinal or systemic entamoeba histolytica infections

Question 24

What are the toxicities associated with Emetine and Dehydroemetine?

Answer 24

Cardiotoxicity
GI effects
Teratogenic

Question 25

What are contraindication of Emetine and Dehydroemetine?

Answer 25

Cardiac disease Renal disease Pregnancy

Question 26

What is Iodoquinol DOC for?

Answer 26

Asymptomatic entamoeba histolytica | Invasive entamoeba histolytica (with a tissue amebocide)

Question 27

What is Paraomomycin DOC for?

Answer 27

Asymptomatic entamoeba histolytica Invasive entamoeba histolytica (with a tissue amebocide) Can also be used to treat giardia lamblia and trichomonas vaginalis

Question 28

What are the toxicities associated with Iodoquinol?

Answer 28

High iodine content (enlarged thyroid) | Optic neuritis and optic atrophy that can lead to blindness

Question 29

What can Diloxanide furoate be used to treat?

Answer 29

Alternative to Iodoquinol or Paromoycin for treatment of invasive entamoeba histolytica (with a tissue amebocide)

Question 30

What can Tetracycline and Erythromycin be used to treat?

Answer 30

Alternative for treatment of amebiasis and giardiasis

Question 31

What can is an alternative drug an HIV patient can take instead of Trimethoprim + Sulfamethoxazole for treatment of P. pneumonia? Why would you not use this drug as a first choice?

Answer 31

Pentamidine | Not as effective, more expensive, more toxicities

Question 32

What are the DOC for treatment of a roundworm (nematode) infection?

Answer 32

``` Albendazole or mebendazole Pyrantel pamoate (OTC) ```

Question 33

What drug is an alternative for treatment of a roundworm (nematode) infection?

Answer 33

Ivermectin

Question 34

What is the DOC for a fluke (trematode) infection?

Answer 34

Praziquantel

Question 35

What is the DOC for a tapeworm (cestode) infection?

Answer 35

Praziquantel

Question 36

What drug is an alternative for treatment of tapeworm (cestode) infection?

Answer 36

Albendazole

Question 37

What is the MOA of Albendazole or Mebendazole?

Answer 37

Inhibits microtubules polymerization by binding to b-tubulin, preventing glucose uptake

Question 38

What is the MOA of Pyrantel pamoate?

Answer 38

Cholinesterase inhibitor; produces depolarizing neuromuscular bloackade

Question 39

What is the MOA of Ivermectin?

Answer 39

Paralyzes the parasite; intensifies GABA mediated transmission of signals in peripheral nerves