Anaerobic ETS makes free radicals

Anaerobic Protozoa (giardia, trichomonas, entamoeba) and bacteria (Clostridium, Helicobacter)

*Avoid alcohol (disulfiram effects)

Quinine + Doxycycline?

if pregnant?

Tx for P. falciparum and P. vivax

If pregnant use Quinine + Clindamycin

Parasitized RBC's take up 100x more than uninfected, heme cannot polymerize (parasites die in own waste)

Resistance in vacuole transporter crt

Contra in epilepsy, myasthenia gravis, and *exacerbates psoriasis

Effective against chloroquine resistant erythrocytic forms of Plasmodium

resistance with mdr1

*do not give with tinnitus or optic neuritis

Ato-Selective mitochondrial cyt bc1 inhibitor

Proguanil- enhances collapse of mito membrane potential and inhibits DHFR

Tx: malaria prophylaxis and tx, Toxoplasma, and pneumocystis

Tx for severe malaria

*cardiotoxic, hypoTN, hypoglycemia, prolonged QT interval

Tx for Toxoplasma gondii (apicomplexa protozoa)

-DHPS and DHFR inhibitor

*Sulfa allergies, pyr toxicity (bone marrow suppression)

Also, does not eliminate cyst form

*supplement with leucovorin, lowers toxicity

sub Clindamycin if sulfa allergy

Effective against Leischmaniasis

*may also be able to use Amphotericin B

Anti-trypanosoma

Tx for American Chagas dx and 2nd stage African Sleeping sickness (both trypanosomas)

-causes free radicals

*can cause hypersensitivity, periph neurop

Anti-trypanosoma

Tx for African Sleeping sickness 1st stage (hemolymphatic)

Anti-trypanosoma

Tx for African Sleeping sickness 1st stage (hemolymphatic)

Anti-trypanosoma

"Arsenic in antifreeze"

Chronic stage of Trypanosoma Brucei

*kills 10% of patients

Anti-Helminthic (antiparasite)

Tx: Nematode, Onchoceriasis (river blindness)

-Kills larvae, not effective against adult worms. induces paralysis via glutamate Cl- channels

*contra when host BBB is impaired

One dose a year

Tx: Nematodes/Roundworms

inhibits microtuble polymerization (binds worm tighter)

-absorbed poorly (good for gut)

Tx: Nematodes esp. Ascaris, hookworm, pinworm (alt to MBZ)

-Depolarizing NM blockers in worms (spastic paralysis)

Tx for flatworms and cestodes (schistosomes and tapeworms)

-spastic paralysis and tegument damage (exposes worm to immune system)

*dont use with ocular cysticercosis cuz host response to dead worm will damage eye