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Spring Pharmacology > Malaria > Flashcards

Malaria Flashcards

1
Q

How is malaria transmitted

A

female anopheles mosquito

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2
Q

What is the infectious agent of malaria

A

plasmodium falciparum

-protozoan parasite

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3
Q

Name 2 4-aminoquinolines

A

chloroquine

amodiaquine

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4
Q

MOA of 4 aminoquinolines

A

inhibit DNA & RNA polymerase
Internal pH changes
Nucleoprotein synthesis interference

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5
Q

When are 4 aminoquinolines utilized?

A

Active malaria, and prophylaxis

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6
Q

ADRs of 4-aminoquinolines

A

HA, dizzy, GI

Pruritus- transient, unresponsive

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7
Q

Drug interactions for 4-aminoquinolines

A

CYP2D6 and CYP3A4
Inducers will decrease blood levels of chloroquine
Inhibitors will increase blood levels of chloroquine

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8
Q

Dose a prophylactic dose for a 4-aminoquinolines

A

Chloroquine 500mg
once a week always on the same day
(want to start 1-2 weeks pre-trip, continue 4 weeks once home)

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9
Q

Name 2 4-methanolquinolines

A 
Quinine Sulfate (not used anymore)
Mefloquine
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10
Q

MOA of 4-methanolquinolines

A

Depress oxygen uptake & carbohydrate metabolism

Disrupt replication & transcription

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11
Q

What are 4-methanolquinolines used for

A

active and prophylaxis

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12
Q

ADRs of 4-methanolquinolines

A

Cardiovascular- qtc prolong, ECG changes
CNS- szs may increase pre-exist condition
Neuropsych warnings
Misc- rash, tinnitus, anorexia

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13
Q

Drug-drug interactions of 4-methanolquinolines

A

CYP3A4 substrate (major)
Inhibits 2D6, 3A4
P-glycoprotein weakly

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14
Q

Dose a 4-methanolquinolines for prophylaxis

A

Mefloquine 250mg

once a week

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15
Q

Name 2 8-aminoquinolines

A

Primaquine
Lumefantrine
Halofantrine

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16
Q

MOA of 8-aminoquinolines

A

Questionable

-disrupts mitochondria and binds to DNA

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17
Q

8-aminoquinolines can be used to tx

A

Active and prophylaxis

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18
Q

What screening should be done before using 8-aminoquinolines

A

Glucose-6-phosphate dehydrogenase (G6PD) deficiency

- watch for sxs hemolytic anemia

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19
Q

ADRs of Glucose-6-phosphate dehydrogenase (G6PD) deficiency

A 
Rare cardiac arrhythmias
Headache
Pruritus
Abdominal cramps, nausea, vomiting
Ocular
   Visual accommodation disturbances
20
Q

Dose a 8-aminoquinolines

A

Primaquiine 30mg

once daily for 14 days

21
Q

Name an anti-folate

A

sulfadoxine/pyrimethamine

atovaquone/proguanil

22
Q

MOA of anti-folates

A

blockade of mitochondrial transport chain

Dihydrofolate reductase inhibition

23
Q

Anti-folates and renal therapy

A

Don’t do prophylactic tx if <30ml/min

can use to treat active but with extreme caution and good benefit to risk ration

24
Q

ADRs of anti-folates

A

Gi- abd pain, n/v
Hepatic- elevated LFTs
CNS- dizzy HA
Neuromuscular- weakness

25
Q

Dose an anti-folate

A

Malarone 250/100

One tablet daily starting 1-2 days before entering malaria-endemic area

26
Q

Name an antimicrobial used to tx Malaria

A

Tetracycline
Doxycycline
Clindamycin

27
Q

Dose an antimicrobial to prevent Malaria

A

Doxycycline 100mg

1 tab daily starting 1-2 days prior to travel to malaria-endemic area

28
Q

Name two artemisinin derivatives

A

Artemether
Arteether
Artesunate

29
Q

MOA of artemisinin derivatives

A

Schizontocides

  • inhibits calcium ATP
  • generates free radicals
30
Q

Artemisinin derivatives can be used for

A

active malaria

31
Q

Couse or therapy for artemisinins is

A

no less than 5-7 days to prevent recurrent parasitemia

32
Q

ADRs or artemisinins include

A

generally mild, low incidence
transient neurological sym
-nystagmus
-balance disruptions

33
Q

Drug interactions of artemisinins

A

CYP3A4 and 2D6
3A4 inducer to reduce effects of other drugs
2D6 inhibitor to increase effects of other drugs

34
Q

Dose an artemisinin

A

Coartem™

Four (4) tablets now and 8 hours later on Day 1, 4 tablets twice a day on Day 2 and Day 3

35
Q

MC intestinal protozoal infection in U.S.

A

Giardiasis

36
Q

How is trichomoniasis transmitted

A

STD

37
Q

Common sources of toxoplasmosis include

A

undercooked meats with tissue cysts
vegetables contaminated w/ soil containing oocytes
cats

38
Q

How is cryptosporidiosis transmitted

A

Infected fecal material via human-to-human contact or through contaminated water

39
Q

“sleeping sickness” is

A

Trypanosomiasis

40
Q

Infectious vector for trypanosomiasis

A

tsetse fly

“assassin/kissing bugs”- Chagas Disease

41
Q

Drug choice for amoeba for mild to severe intestinal, hepatic abscesses, ameboma, and extraintestinal disease

A

Metronidazole (Flagyl)

42
Q

MOA of metronidazole

A

interacts with DNA; loss of helical structure

43
Q

ADRs of metronidazole

A

possible carcinogenesis

alcohol interaction?

44
Q

When would metronidazole need to be dose adjusted?

A

severe liver impairment

45
Q

MOA of paromomycin

A

interferes w/bacterial protein synthesis by binding to 30s ribosomal subunits

46
Q

Drug of choice for E. histolytica

A

Paromomycin

47
Q

ADRs of Iodoquinol

A

Myelo-optic neuropathy
Peripheral neuropathy

Dose dependent

Spring Pharmacology (9 decks)

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