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Pharm 36 Parasites

Pharm

QuestionAnswer
Accumulates in parasite food vacuole and binds to ferriprotoporphyrin IX->oxidative membrane damage. Tx and prophylaxis of Malaria. SE: Retinopathy, Prolonged QT, Pruritis. Contra: Visual field changes. Kills only blood stage and many strains resist Chloroquine
Accumulate in food vacuole and bind to ferriprotoporphyrin IX->oxidative memb damage and intercalates into DNA. Tx blood stage Malaria (P. falciparum) only. SE: Cinchonism (tinnitus, deaf, HA, N/V, visual prob), prolong QT, DIC, Rash. Contra: G6PD def, MG Quinine (Quinidine)
Tx and prophylaxis of Chloroquine resistant Malaria. SE: Seizure, Vivid dreams, Insomnia, Depress, Hallucinate. Contra: Psych probs. Mefloquine
First line for un/complicated malaria in combo w 2nd antimalarial agent tx (not prophy). SE: Hemolytic anemia, bradycardia. Artemisinin - Artesunate, Artemether-Lumefantrine
Inhibit plasmodial ETC. Kill both blood and liver stages of P. vivax and ovale. SE: Hemolytic anemia, leukopenia. Contra: G6PD def, Preg, RA, LE, bone marrow suppress. Primaquine
Inhibit plasmodial ETC. Combo w Proguanil or Doxycycline. For P. falciparum, Toxoplasmosis, Babesiosis. SE: GI distress, HA, High Liver enzymes. Atovaquone
Inhibit prot synth by binding to 30S. Combo w Quinine for Tx of Chloroquine-resist P. falciparum. SE: Photosensitivity, Tooth discolor (kids). Contra: Preg, <8 y/o kids Doxycycline, Tetracycline
Inhibit prot synth by binding to 50S. Combo w Quinine when Preg or <8 y/o for Tx of Chloroquine-resist Malaria. SE: C. difficile Pseudomembranous Colitis. Clindamycin
Inhibit plasmodial Dihydropteroate Synthetase and Dihydrofolate Reductase. Kills blood schizont stage (not gametocytes) of P. falciparum. SE: SJ synd, toxic epidermal necrolysis. Contra: Blood dyscrasia, Infants, Preg/breastfeed Sulfadoxine-Pyrimethamine
Inhibits plasmodial Dihydrofolate Reductase. Active against Hepatic (pre-blood) forms of P. falciparum and vivax. Combo w Chloroquine or Atovaquone. SE: Pancytopenia. Contra: Severe Renal impair Proguanil
When activated, forms cytotox cmpds that damage microbial prots, membs, and DNA. Active against Anaerobic bac, E. histolytica Amebiasis in tissues (not intraluminal). SE: Leuko/Thrombpenia, Ototox, Metallic taste. Contra: Disulfram effect w Alcohol, Preg Metronidazole - Tinidazole is better tolerated and requires shorter Tx duration
Inhibit DNA/RNA/Prot/Phosphlipid synth and Dihydrofolate Reductase. For African Trypanosomiasis, P. jiroveci (2nd line). SE: Pancreatitis, Nephrotox, Rash. Pentamidine
Inhibit RNA Polymerase and Glycerol Phosphate Dehydrogenase. For EARLY African Trypanosom. SE: Pruritus, Paresthesias, N/V Suramin
Inhibits Glycolysis and ATP productions. 1st line for LATE African Trypanosom (involves CNS). SE: Reactive Encephalopathy (w corticosteroids to lessen), Death (4-6%), Polyneuropathy (w thiamine to lessen) Melarsoprol
For WEST African Trypanosom (gambiense). SE: Myelosuppress, Seizure, Ototox. Also, for Hair Removal Eflornithine
For Chagas. SE: Pancytopenia, Convulsions, Anorexia. Nifurtimox
For Leishmaniasis. SE: Myelosuppress, Prolong QT, Rash. Sodium stibogluconate Meglumine antimonate
For Visceral Leishmaniasis and Cutaneous Lymphomas and skin metastat. SE: Leuko/Thrombcytosis. Contra: Breastfeed/Preg, Concurrent radiation Miltefosine
Increased GABA->Worm pharyngeal paralysis. For Onchocerciasis, Lymphatic filariasis, Strongyloides, Scabies. SE: Seizure, Mazzotti Rxn. Doesn't kill adult filarial worms-> can't cure Ivermectin
Inhibit tubulin polymerization. For Nematode infx. SE: Agranulocytosis, -penias. Dose reduction for renal insuff Albendazole (oral), Mebendazole
Increase worm membrane permeability to Ca-> contraction paralysis. For Schistosomiasis, Tapeworm, Liverfluke. Praziquantel
Kills adult Filarial worms (curative), excreted by kidneys (dose adjust w kidney probs). SE: Mazzotti Rxn (w heavy worm burden). Diethylcarbamazine
Created by: Jakphooey
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