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PT3 ID 2 > malaria pharmacology > Flashcards

malaria pharmacology Flashcards

(64 cards)

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1
Q

most common strains of malaria

A

P.falciparum ~75%

P.vivax/ovale

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2
Q

p.falciparum characteristics

A
  • most common cause of mortality

- symptoms appear after 5-15 days after RBC lysis

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3
Q

p.vivax/ovale characteristics

A
  • look very similar

- exoerythrocytic (liver) stage lasts for long

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4
Q

infection sequence of malaria

A
  • female mosquito deposits spores
  • spores collect in liver where they multiply for days to weeks
  • spores enter RBCs, multiply
  • RBCs lyse and spread more spores
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5
Q

symptoms of malaria

A
  • anemia
  • fever
  • chills
  • nausea
  • flu-like symptoms
  • hypoglycemia
  • seizures
  • multiple organ failure
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6
Q

stages of infection

A
  • exoerythrocytic stage (liver)
  • erythrocytic stage (RBC)
  • latent (only P.vivax/ovale)
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7
Q

drug for exoerythrocytic stage

A

palurdrine (proguanil)

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8
Q

drug for latent exoerythrocytic

A

primaquine

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9
Q

rapid acting drugs for erythrocytic stage

A

chloroquine
quinine
mefloquine
artemisinin

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10
Q

slow acting drugs for erythrocytic stage

A

pyrimethamine
tetracyclines
sulfonamides

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11
Q

combo therapy drug

A

atovaquone/proguanil

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12
Q

proguanil MOA

A

inhibit plasmodial dihydrofolate reductase, inhibiting DNA synthesis

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13
Q

proguanil use

A

prophylaxis primarily, sometimes treatment

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14
Q

proguanil adverse effects

A

diarrhea

nausea

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15
Q

primaquine use

A

hepatic and latent p.vivax/ovule

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16
Q

primaquine adverse effects

A

mild GI

methemoglobinemia

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17
Q

primaquine contraindications

A

glucose-6-phosphate deficiency

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18
Q

chloroquine MoA

A

prevents parasite from inactivating heme

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19
Q

why isn’t chloroquine used much

A

resistance in p.falciparum is common enough

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20
Q

chloroquine adverse effects

A
  • GI disturbances
  • blurred vision
  • possibly hypotension and cardiac arrest
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21
Q

chloroquine contraindications

A

psoriasis or porphyria, can cause flares

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22
Q

quinine MoA

A

interference with heme metabolism

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23
Q

quinine use

A
  • treatment of choice for chloroquine resistant strains of p.falciparum
  • NO Prophylaxis
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24
Q

quinine adverse effects

A

GI
vision
hypoglycemia

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25
mefloquine MoA
unknown, maybe similar to chloroquine
26
mefloquine unique ADME
really long half life - 12-33 days
27
mefloquine use
prophylaxis and treatment
28
mefloquine adverse effects
GI | rarely neuropsychiatric effects
29
mefloquine contraindications
epileptic patients psychiatric disorders pregnant women
30
artemisinin MoA
produce reactive oxygen species that damage parasitic macromolecules
31
artemisinin use
initial treatment of p.falciparum
32
artemisinin adverse effects
very few reported | maybe allergic reaction
33
pyrimethamine MoA
inhibits plasmodial dihydrofolate reductase
34
pyrimethamine use
treatment only of chloroquine resistant strains of p.falciparum or in combo with sulfonamide
35
pyrimethamine adverse effects
GI | hypersensitivity reaction
36
pyrimethamine contraindications
megaloblastic anemia
37
tetracyclines use
- prophylaxis and acute treatment of p.falciparum | - often used in combo with quinine
38
most commonly used tetracyclines
tetracylcine | doxycycline
39
tetracyclines adverse effects
photosensitivity | GI
40
sulfonamides use
used in combo with pyrimethamine and quinine for resistant strains of p.falciparum
41
sulfonamides MoA
dihydrofolate reductase inhibitor
42
sulfonamides effectiveness
better at p.falciparum than vivax
43
atovaquone/proguanil MoA
inhibit mitochondrial function AND dihydrofolate reductase
44
atovaquone/proguanil counseling
eat with fatty meal once a day
45
atovaquone/proguanil use
prophylaxis and treatment of p.falciparum and p.vivax
46
atovaquone/proguanil adverse effects
uncommon | GI
47
atovaquone/proguanil contraindications
small children | pregnancy/lactation
48
malaria vaccine
RTS,S
49
how long after infection does malaria become symptomatic
1-3 weeks
50
phases of malaria infection
``` prodrome (HA, fatigue, ~10-21 days after infection) paroxysm (high fever, chills) cold phase hot phase (severe fever) sweating phase ```
51
fever is most common in which malaria strain
p.falciparum
52
important complication of p.falciparum
severe anemia
53
how to ensure positive diagnosis of malaria
thick and thin blood smears ever 12-24 hours for 3 days
54
what does thick smear detect
if parasite is present
55
what does thin smear detect
if plasmodium is present
56
giemsa stain
stain of the blood that makes thick and thin blood smears more reliable
57
treatment for uncomblicated malaraia
chloroquine
58
treatment for p.falciparum and vivax infection or severe illness
- admit to ICU - quinidine for at least 24 hours and until PO can be started - quinine + doxy
59
treatment for chloroquine-R p.falciparum, vivax, and ovale
mefloquine
60
treatment for p.falciparum if hx of seizure, cv issues or psychiatric issues
atovaquone/proguanil 2 BID for 3 days
61
monitoring for quinidine
EKG for long QT | hypoglycemia
62
monitoring for mefloquine
EKG | neurologic effects like hallucinations, psychosis
63
what to do with quinidine if QT interval is >0.6 sec
slow infusion
64
how often to check blood smears for parasitemia
every 12 hours until <1%

PT3 ID 2 (6 decks)

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