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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
Dose an anti-folate
Malarone 250/100 | One tablet daily starting 1-2 days before entering malaria-endemic area
26
Name an antimicrobial used to tx Malaria
Tetracycline Doxycycline Clindamycin
27
Dose an antimicrobial to prevent Malaria
Doxycycline 100mg | 1 tab daily starting 1-2 days prior to travel to malaria-endemic area
28
Name two artemisinin derivatives
Artemether Arteether Artesunate
29
MOA of artemisinin derivatives
Schizontocides - inhibits calcium ATP - generates free radicals
30
Artemisinin derivatives can be used for
active malaria
31
Couse or therapy for artemisinins is
no less than 5-7 days to prevent recurrent parasitemia
32
ADRs or artemisinins include
generally mild, low incidence transient neurological sym -nystagmus -balance disruptions
33
Drug interactions of artemisinins
CYP3A4 and 2D6 3A4 inducer to reduce effects of other drugs 2D6 inhibitor to increase effects of other drugs
34
Dose an artemisinin
Coartem™ | Four (4) tablets now and 8 hours later on Day 1, 4 tablets twice a day on Day 2 and Day 3
35
MC intestinal protozoal infection in U.S.
Giardiasis
36
How is trichomoniasis transmitted
STD
37
Common sources of toxoplasmosis include
undercooked meats with tissue cysts vegetables contaminated w/ soil containing oocytes cats
38
How is cryptosporidiosis transmitted
Infected fecal material via human-to-human contact or through contaminated water
39
"sleeping sickness" is
Trypanosomiasis
40
Infectious vector for trypanosomiasis
tsetse fly | "assassin/kissing bugs"- Chagas Disease
41
Drug choice for amoeba for mild to severe intestinal, hepatic abscesses, ameboma, and extraintestinal disease
Metronidazole (Flagyl)
42
MOA of metronidazole
interacts with DNA; loss of helical structure
43
ADRs of metronidazole
possible carcinogenesis | alcohol interaction?
44
When would metronidazole need to be dose adjusted?
severe liver impairment
45
MOA of paromomycin
interferes w/bacterial protein synthesis by binding to 30s ribosomal subunits
46
Drug of choice for E. histolytica
Paromomycin
47
ADRs of Iodoquinol
Myelo-optic neuropathy Peripheral neuropathy Dose dependent

Spring Pharmacology (9 decks)

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