Parasitology Pharmacology

Question 1

What two drugs are a part of the Nitroimidazole class?

Answer 1

Metronidazole, tinidazole

Question 2

What can you treat with nitroimidazoles?

Answer 2

Giardia, Entamoeba

Question 3

How do nitroimidazoles work?

Answer 3

Toxic metabolites generate free radicals, inducing DNA damage

Question 4

What is toxicity for nitroimidazoles?

Answer 4

Disulfram (avoid alcohol)
Nausea, diarrhea, metallic taste
Disturb normal GI flora

Question 5

What does Nitazoxanide treat?

Answer 5

Giardia and cryptosporidium

Question 6

Since nitazoxanide is rapidly metabolized, what would you give with it?

Answer 6

Loperamide (anti-peristaltic)

Question 7

What drugs are often given for crypto in someone with immunocompromise?

Answer 7

HAART

Question 8

What is the mechanism of iodoquinol?

Answer 8

Unknown

Question 9

What does iodoquinol used to treat?

Answer 9

Amebic dyssentery

Question 10

What is the toxicity of iodoquinol?

Answer 10

Loss of visual acuity

Use caution with patients with thyroid disease

Question 11

What is the mechanism of action of paromomycin?

Answer 11

Targets 30S ribosomal subunit

Question 12

What is toxicity for paromomycin?

Answer 12

Diarrhea, other GI effects because affects normal flora

Question 13

What is the distribution for paromomycin?

Answer 13

Luminal (minimal absorption)

Question 14

What is paromomycin used for?

Answer 14

Intestinal protozoa, but only partially affective against crypto

Question 15

What are good drugs for luminal amebicide?

Answer 15

Iodoquinol

Paromomycin

Question 16

What are good drugs for tissue amebicide?

Answer 16

metronidazole

Tinidazole

Question 17

What is the spectrum for TMPSMX

Answer 17

Broad spectrum antibiotic
Apicomplexans including Toxoplasma and
Cystoisospora
Cyclospora

Question 18

What two drugs are used to target roundworms and tapeworms?

Answer 18

Albendazole

Mebendazole

Question 19

What is the mechanism of albendazole and mebendazole?

Answer 19

Bind to parasite Beta-tubulin and inhibit microtubule formation

Question 20

Which of the “benzimidazole” drugs is better for targeting tissue-migrating larvae?

Answer 20

Albendazole (better absorbed)

Question 21

What are some toxicities for benzimidazole drugs?

Answer 21

Liver/bone marrow damage
Abd pain, nausea, dizziness, headache
Embryotoxic and teratogenic

Question 22

What is the mechanism of action of levamisole and pyrantel pamoate?

Answer 22

Opens an acetylcholine receptor calcium channel in nematode nerve and muscle

Question 23

What is the mechanism of action of ivermectin?

Answer 23

Binds to glutamate gated chloride channels in invertebrate nerve and muscle cells

Question 24

How is ivermectin toxic to humans?

Answer 24

Itchy, swollen lymph glands

Inflammatory reaction due to adult worm death

Question 25

What is ivermectin specific for?

Answer 25

Nematodes (ascaris, strongyloides, onchocerca)

Question 26

What is the mechanism of action of praziquantel?

Answer 26

Increased permeability to divalent cations, leading to contraction of worm's musculature

Question 27

What is the toxicity for praziquantel?

Answer 27

Well tolerated | Nausea, dizziness

Question 28

What is the spectrum for praziquantel?

Answer 28

Tapeworms | Trematodes (flukes)