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Antiparasitics (drugs-MOA)
Creighton University School of Medicine
29
Medical
Professional
08/26/2013

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Term
atovaquone/proguanil
Definition
Atovaquone interferes with mitochondrial electron transport and ATP and pyrimidine biosynthesis. Proguanil (prodrug) inhibits dihydrofolate reductase-thymidylate synthetase (folic acid synthesis).
Term
artemether/lumefantrine
Definition
Releases free radicals which attack the cell membrane and inhibits parasite heme detoxification
Term
quinine/tetracycline or doxycycline
Definition
Unknown, may increase vesicle pH and interfere with macromolecular transport. Not effective against exoerythrocytic forms of the parasite
Term
mefloquine
Definition
Unknown
Does not eliminate the exoerythrocytic (intrahepatic) stages.
Term
chloroquine
Definition
May prevent organism from converting heme to nontoxic metabolites where the build up of heme is then toxic. Not effective against exoerythrocytic forms of the parasite (major organism resistance for P. falciparum)
Term
primaquine
Definition
Unknown, may interfere with plasmodium DNA. Only effective against P. vivax liver forms preventing relapse
Term
metronidazole (tinidazole)
Definition
Activated in anaerobic cells causing DNA breakage and loss of structure. Tinidazole has a longer half life with more convenient dosing
Term
diloxanide furoate
Definition
Unknown –may inhibit protein synthesis (luminal only)
Term
paromomycin
Definition
Aminoglycoside inhibiting protein synthesis
Term
iodoquinol
Definition
Unknown mechanism but may involve zinc chelation and metabolism
Term
amphotericin B (liposomal)
Definition
Binds to sterols and disrupts membranes
Term
sodium stibogluconate
Definition
Unknown—Metal ion Sb+5 to Sb+3 in cell and compromises cellular function
Term
miltefosine (not available in US)
Definition
Unknown-- synthetic ether phospholipid analog which may stimulate T-cell activation
Term
nitazoxanide
Definition
interference with anaerobic energy metabolism.
Term
furazolidone (not available in US)
Definition
Inhibits Kreb cycle enzymes
Term
nifurtimox
Definition
Inhibits DNA synthesis
Term
benznidazole (not available in US)
Definition
Unknown, may interfere with the synthesis of macromolecules
Term
pentamidine (early stage T.b.g)
Definition
Interferes with DNA and RNA
Term
suramin (early stage T.b.g & T.b.r*)
Definition
unknown
Term
melarsoprol (late stage T.b.g & T.b.r*)
Definition
Combination drug -- melarsen oxide (arsenic compound) and dimercaprol (reduces toxicity), easily penetrates parasite membranes and inactivates enzymes sulfhydryl groups
Term
eflornithine (late stage T.b.g)
Definition
Inhibits ornithine decarboxylase and cell division
Term
pyrimethamine plus sulfadiazine
Definition
dihydropteroate synthase blocking folic acid synth.
Term
praziquantel
Definition
Readily absorbed by worms and increases permeability of membrane to calcium resulting in paralysis and detachment
Term
niclosamide
(not available in US)
Definition
Kills only adult worms (not eggs) possibly by inhibiting oxidative phosphorylation or stimulation of ATPase activity
Term
mebendazole
(benzimidazole)
Definition
Selectively damages cytoplasmic microtubules preventing glucose uptake and disrupts secretory substances causing cell autolysis (luminal only)
Term
albendazole
(benzimidazole)
Definition
Inhibits polymerization of tubulin and the microtubule-dependent uptake of glucose by binding free β-tubulin by susceptible intestinal worms
Term
pyrantel pamoate
Definition
A depolarizing neuromuscular blocking agent causing paralysis of worms
Term
ivermectin
Definition
Selectively opens glutamate gated chloride channels in parasites and disrupts nerves and muscles resulting in hyperpolarization, paralysis
Term
diethylcarbamazine
Definition
displaces microfilariae from tissues increasing their susceptibility to the host immune system
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