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MD3002 > Protozoal and Helminthic infections > Flashcards

Protozoal and Helminthic infections Flashcards

1
Q

How to treat acute amoebiasis

A

Metronidazole

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2
Q

How to treat chronic amoebiasis

A

Diloxanide furoate

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3
Q

How does metronidazole act

A
  • Under anaerobic conditions, it generates toxic radicals that damage bacterial and protozoal DNA
  • Penetrates well into tissue
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4
Q

What is metronidazole active against

A
  • E histolytica

- G lamblia

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5
Q

Side effects of metronidazole

A
  • Metallic taste

- Acute nauseous reaction with alcohol

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6
Q

What is diloxanide furoate

A

Luminal amoebicide

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7
Q

Side effects of diloxanide furoate

A
  • Flatulence
  • Itchiness
  • Hives
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8
Q

Describe paromomycin

A
  • Aminoglycoside
  • Kills amoebic cystic stage
  • Not absorbed from GI tract
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9
Q

Side effects of paromomycin

A
  • Abdo cramps
  • Diarrhoea
  • Heartburn
  • Nausea
  • Vomiting
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10
Q

Give examples of vectors

A
  • Flies= onchocerciasis
  • Crysops= guinea worm
  • Snails= capillaria
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11
Q

Give examples where inflammation is the main pathogenic mechanism

A
  • Filariasis
  • Onchocerciasis
  • Toxocariasis
  • Enterobius
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12
Q

What can acute lymphodaema progress to

A

Elephantiasis

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13
Q

Trichuiris clinical features

A
  • Vague abdo symptoms
  • Trichiuris dysentery syndrome
  • Growth retardation
  • Intellectual compromise (due to micronutrient deficiency and mucosal integrity)
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14
Q

Give example of space occupying lesions

A
  • Cysticercosis causing CSF obstruction

- Ascaris causing intestinal obstruction

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15
Q

Clinical manifestations of S stercoralis

A
  • Erythema migras
  • Dysentery
  • Dehydration
  • Anal pruritis
  • Malabsorption syndrome
  • Associated with appendicitis
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16
Q

How to treat helminths that compete for nutrients

A
  • Reduce worm burden

- Support nutrition

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17
Q

How to treat space occupying lesions

A
  • Surgery

- Decompression

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18
Q

How to treat cestodes

A

Praziquantel

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19
Q

How to treat cysticercosis

A
  • Anti-epileptic drugs
  • Anti-helmithic
  • Steroids
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20
Q

How to treat nematodes

A
  • Albendazole (most effective)

- Levamisole and piperazine

21
Q

Action of praziquantel

A
  • Increases Ca2+ permeability of membranes depolarising them

- May interfere with purine synthesis

22
Q

What is praziquantel used for

A
  • Hydatid disease
  • Cysticercosis
  • Schistosomiasis
  • Clonorchis, Fascioliasis and Paragnomiasis
23
Q

Physiology of praziquantel

A
  • Significant first pass effect
  • Excreted in kidneys
  • Short half life
24
Q

Side effects of praziquantel

A
  • Dizziness, headaches, drowsiness etc
  • Abdo cramps and diarrhoea
  • Urticaria, rash and pruritis
  • Interacts with rifampicin, carbamazine, phenytoin
25
Q

What is Albendazole used to treat

A
  • Nematode infections (trichuiriasis, filariasis)
  • Some protozoa (giardia)
  • Cestode (Hydatid, neurocysticercosis)
26
Q

Mode of action of albendazole

A
  • Binds to colchicine sensitive receptor or tubulin
  • Prevents polymerisation into microtubules
  • Impaired glucose uptake and depleted glycogen stores
  • Degenerative changes appear in worm
27
Q

Side effects of albendazole

A
  • May be teratogenic (concentrated in semen)
  • Persistent sore throat
  • Headaches, dizziness
  • Acute liver failure
  • Aplastic anaemia and marrow suppression
28
Q

Action of piperazine

A

Agonist activity against the gamma butyric acid receptor paralysing muscular activity

29
Q

Physiology of piperazine

A
  • Orally active
  • Metabolism in liver
  • Variable half life
30
Q

What is piperazine used to treat

A
  • Ascariasis

- Enterobius

31
Q

Side effects of piperazine

A
  • GI upset
  • Hypersensitivity
  • Dizziness
32
Q

What is pyrantel used to treat

A
  • Hookworms

- Roundworms

33
Q

Action of pyrantel

A

Causes depolarising muscular blockade

34
Q

Physiology of pyrantel

A
  • Poorly absorbed, providing selective toxicity
  • Excreted unchanged in faeces
  • Antagonistic with piperazine
35
Q

When to avoid pyrantel

A
  • Pregnancy

- Heavy worm load (can cause intestinal obstruction)

36
Q

Action of levamisole

A

Nicotinic ACh receptor antagonist

37
Q

When to use levamisole

A

-Ascariasis
-Mixed ascaris hookworm infection
(-Don’t use in pregnancy)

38
Q

Side effects of levamisole

A
  • Abdo pain
  • Nausea
  • Vomiting
39
Q

Action of diethyl carbamazine

A

Inhibits arachidonic acid, making parasites more susceptible to immune attack

40
Q

When to use diethyl carbamazine

A

Filaria infection

41
Q

What is use of diethyl carbamazine associated with

A
  • Increase in inflammation (Mazzotti reaction)

- Loss of site in onchocerciasis

42
Q

Action of ivermectin

A

Binds glutamate-gated chloride increases in the permeability of membrane to Cl- ions with hyper polarisation of nerve/muscle cell resulting in paralysis and death of parasite (either directly or by causing the worms to starve)

43
Q

What is ivermectin used against

A
  • Fliarial worms
  • Lice
  • Scabies
  • Bed bugs
  • Lymphatic filariasis
  • Onchocerciasis
44
Q

Risks of ivermectin

A
  • Not for use in children <5 or breast feeding mothers
  • Complicated by CNS depression
  • Increased risk of absorption past the BBB of HIV protease inhibitors, CCBs and glucocorticoids
45
Q

Action of niclosamide

A

Inhibits glucose uptake, oxidative phosphorylation and anaerobic mechanisms

46
Q

When is niclosamide used

A

Tape worm infections

47
Q

Side effects of niclosamide

A
  • Dizziness
  • Skin rashes
  • Drowsiness
  • Perianal itching
48
Q

Prevention and control of intestinal helminths

A
  • Vector control for filariasis
  • Meat inspection for cysticercosis
  • Sanitation and hygiene for intestinal nematodes

MD3002 (14 decks)

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