Term
| Which drug accumulates in the food vacuole of plasmodia and prevents polymerization heme into hemozoin, killing the parasite with toxic levels of heme? |
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Definition
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Term
| What is a mechanism of resistance to chloroquine and other anti-malarials? |
|
Definition
| decreased intracel accumulation via increased activity of membrane pumps, decreased intravaculolar concentrations via a transporter encoded by pfcrt gene |
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Term
| What is the DOC for acute attacks of nonfalciparum and sensitive falciparum malaria, and for chemophrophylaxis except in regions where falciparum is resistant? |
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Definition
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Term
| Which drug has these adverse affects: GI distress, rash, HA, auditory dysfunction and retinal dysfunction at high dose |
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Definition
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Term
| Which drug complexes with dsDNA to prevent strand separation, resulting in block of DNA replication and transcription to RNA? |
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Definition
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Term
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Definition
| chloroquine-resistant falciparum, often used with doxycycline or clindamycin to shorten duration of tx, stereoisomer quinidine is used in severe cases |
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Term
| Which drug has these adverse effects: cinchonism, hemolysis in G6PD deficiency, blackwater fever |
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Definition
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Term
| What is mefloquine used for? |
|
Definition
| prophylaxis and treatment for resistant falciparum |
|
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Term
| Which drug has these adverse effects: GI distress, rash, HA, cardiac conduction defects and neuro symptoms |
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Definition
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Term
| Which drug forms quinoline-quinone metabolites, which are electron-transferring redox compounds that act as cellular oxidants, and works as a tissue schizonticide and also limits malaria transmission by working as a gametocide? |
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Definition
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Term
| What is primaquine used for? |
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Definition
| eradication of liver stages of vivax and ovale, should be used in conjunction with a blood schizonticide |
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Term
| Which drug has these adverse effects: GI distress, methemoglobinemia, hemolysis in G6PD deficiency |
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Definition
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Term
| Pyrimethamine, proguanil, sulfadoxine and dapsone are members of which group? |
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Definition
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Term
| Which anti-folate drug has a shorter half-life than the others? |
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Definition
|
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Term
| How do sulfonamides work? |
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Definition
| act as antimetabolites of PABA and block folic acid synthesis by inhibiting dihydropteroate synthase, |
|
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Term
| Proguanil is bioactivated to... |
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Definition
|
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Term
| pyrimethamine and cycloguanil are selective inhibitors of... |
|
Definition
| protozoan dihydrofolate reductase |
|
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Term
| How are anti-folate drugs used for malaria? |
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Definition
| prophylaxis and treatment of multidrug resistant falciparum |
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Term
| Which drug has been used to treat malaria in many countries because of its low cost and effectiveness against chloroquine-resistant falciparum, and has adverse effects including agranulocytosis and aplastic anemia? |
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Definition
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Term
| Which drug disrupts mitochondrial electron transport in protozoa, and is effective for chemoprophylaxis and treatment of falciparum malaria, but can cause abd pain and GI effects at higher dosage. This is also an alternative treatment for P jiroveci. |
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Definition
| atovaquone, a component of Malarone |
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Term
| Which drug is active against erythrocytic stages of all malara species, but is not used for chemoprophylaxis due to potential cardiotoxicity (QT prolongation) and embryotoxicity? |
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Definition
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Term
| Artesunate and artemether - MOA? Usage? Adverse effects? |
|
Definition
| metabolized in food vacuole of parasite, forming toxic free radicals. Active against resistant falciparum, but not used for chemoprophylaxis due to short half-lives. ONLY DRUGS RELIABLY EFFECTIVE AGAINST QUININE-RESISTANT STRAINS. N/V/D. |
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Term
| What to use for malaria chemoprophylaxis? |
|
Definition
| chloroquine, mefloquinefor regions with resistant falciparum, doxycycline or Malarone (atovaquine plus proguanil) in areas with multidrug-resistant falciparum |
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Term
| Chloroquine, emetines and metronidazole act on organisms located where? |
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Definition
|
|
Term
| diloxanide furoate, iodoquinol and paromymycin act on organisms located where? |
|
Definition
| in the lumen of the bowel |
|
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Term
| For asymptomatic amebiasis, use... |
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Definition
|
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Term
| for mild-severe amebiasis, use... |
|
Definition
| metronidazole plus a luminal agent |
|
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Term
| for amebic liver abscess, use... |
|
Definition
| metronidazole plus a luminal agent |
|
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Term
| Diloxanide furoate is converted in the gut to... |
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Definition
|
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Term
| Emetine and dehydroemetine: MOA? |
|
Definition
| inhibit protein synthesis by blocking ribosomal mvmt along messenger RNA |
|
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Term
| What are emetines used for? Toxicity? |
|
Definition
| used parenterally as backup drugs for tx of severe intestinal or hepatic amebiasis together with a luminal agent in hospitalized pts. Severe tox - GI distress, muscle weakness, CV dysfunction |
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Term
| Which drug is a halogenated hydroxyquinolone used orally as a luminal amebicide for mild-severe intestinal infections? HIgh doses and systemic absorption can lead to what effects? |
|
Definition
| iodoquinol, thyroid enlargement and neurotoxic effects - periph neuropathy and visual dysfunction |
|
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Term
| Which drug undergoes a reductive bioactivation of its nitro group by ferredoxin (present in anaerobic parasites) to form reactive cytotoxic products? |
|
Definition
| metronidazole, tinidazole |
|
|
Term
| Metronidazole or tinidazole is DOC for? |
|
Definition
| severe intestinal wall disease and in hepatic abscess and other extra-intestinal amebic disease |
|
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Term
| Which drug has these adverse effects: GI irritation, HA, dark color to urine. More serious - leukopenia, dizziness, ataxia. Can have disulfiram-like rxn with ethanol and potentiation of coumarin effects? |
|
Definition
| metronidazole and tinidazole |
|
|
Term
| What is paromymycin? What is it used for? |
|
Definition
| aminoglycoside antibiotic, used as luminal amebicide, may be superior to diloxanide for asymptomatic infection |
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|
Term
| Paromoycin may have efficacy against ____, in addition to amebiasis |
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Definition
|
|
Term
| Systemic abs of paromomycin can lead to... |
|
Definition
| HA, dizziness, rashes and arthralgia |
|
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Term
| Which drug has activity against various protozoans and helminths, and is currently approved in the US for GI infections caused by giardia and cryptosporidium, and appears to have activity against metronidazole-resistant protozoal strains? |
|
Definition
|
|
Term
| Which drug's MOA is unknown, but may involve inhibition of glycolysis or interference with nucleic acid metabolism of protozoans and fungi, and may be preferentially accumulated by susceptible parasites? |
|
Definition
|
|
Term
| What is pentamidine used for? |
|
Definition
| prophylaxis, daily treatment for active pneumocytosis, trypanosomiasis |
|
|
Term
| Which drug has severe adverse effects with parental (as opposed to aerosol) use, including respiratory stimulation followed by depression, hypotension from periph vasodilation, hypoglycemia, anemia, neutropenia, hepatitis, and pancreatitis? |
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Definition
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|
Term
| Which drug is first choice in prophylaxis and treatment of pneumocystis pneumonia? |
|
Definition
|
|
Term
| Prophylaxis for pneumocytis is recommended when CD4 ct drops below... |
|
Definition
|
|
Term
| In addition to pneumocystic, TMP-SMX is used for... |
|
Definition
| toxoplasmosis and isospora belli |
|
|
Term
| What are the adverse effects of TMP-SMX? |
|
Definition
| GI distress, fever, neutropenia, thrombocytopenia |
|
|
Term
| For pts allergic to sulfonamides, ______ can be used in combo with pyrimethamine for prophylaxis/tx of toxoplasmosis |
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Definition
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|
Term
| HIgh doses of pyrimethamine plus sulfadiazine are assoc with which adverse effects? |
|
Definition
| gastric irritation, glossitis, neurologic symptoms and hematotoxicity, colitis with clindamycin |
|
|
Term
| Which drug is approved for mild-mod PCP, for malaria in combo with proguanil, and works by inhibiting mitrochondrial electron transport and probably folate metabolism? |
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Definition
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|
Term
| Common adverse effects of atovaquone? Should be avoided in who? |
|
Definition
| rash, cough, N/V//D, fever, abd LFTs, avoid in pts with hx of cardiac conduction defects, psychiatric disorders or seizures |
|
|
Term
| Pentamidine, melarsoprol, nifurtimox, suramin and eflornithine are used for... |
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Definition
|
|
Term
| Which drug is used in the hemolymphatic stages of trypanosomiasis, but doesn't cross the BBB? |
|
Definition
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|
Term
| Which drug is an organic arsenical that inhibits enzyme sulfhydryl groups, enters the CNS, and is the DOC for African Sleeping Sickness? |
|
Definition
|
|
Term
| How is melarsoprol given? It can cause what fatal adverse effect? |
|
Definition
| parenterally, reactive encephalopathy |
|
|
Term
| Which drug is a nitrofurazone derivative that inhibits the parasite-unique enzyme trypanothione reductase? |
|
Definition
|
|
Term
| Which drug is the DOC in American trypanosomiasis, and is an alternative agent for African forms? |
|
Definition
|
|
Term
| In addition to trypanosomiasis, which drugs have been used for leishmaniasis? |
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Definition
|
|
Term
| Nifurtimox can cause severe toxicity, including... |
|
Definition
| allergies, GI irritation and CNS effects |
|
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Term
| Which drug is the DOC for early hemolymphatic stages of African trypanosomiasis, is an alternative to ivermectin in onchocerciasis, is used parenterally and causes skin rashes, GI distress and neuro complications? |
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Definition
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|
Term
| Which drug is a suicide substrate of ornithine decarboxylase? |
|
Definition
|
|
Term
| How is eflornithine given? Adverse effects? |
|
Definition
| oral and IV, penetrates CNS - seizures in overdose, GI irritationa and hematotoxicity |
|
|
Term
| What is the primary drug for all forms of leishmaniasis? How does it work? |
|
Definition
| sodium stibogluconate, inhbiits glycolysis or affects nucleic acid metabolism |
|
|
Term
| How is stibogluconate given? Toxicity? Alternative drugs? |
|
Definition
| parenterally, potentially cardiotoxic (QTc prolongation), pentamidine or miltefosine (visceral), fluconazole or metronidazole (cutaneous), and amphotericin B (mucocutaneous) |
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