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antiparasitis
UVa med pharm block 4
| Question | Answer |
|---|---|
| What is the indication for TMP-SMZ in parasitic treatment? | DOC Tx of pneumocystic jirovecii in AIDS patients prophylaxis in children with acute lymphocytic leukemia or predisposing conditions |
| What drug is used to treat Lymphatic Filariasis and Loa Loa? | Diethylcarbamazine |
| What is the mechanism of Metronidazole and Tinidazole in parasite treatment? | 1. They are activated inside the parasite under low redox potential 2. They yield non-specific reactive radicals that damage DNA and proteins |
| What effect does TMP-SMZ have on phenytoin metabolism? | decreased |
| Praziquantel is DOC for all _______, with the exception of ________ | - Flukes except Fasciola hepatica |
| If a child has ALL or predisposing condition to Pneumocystis, what drug do you give as prophylaxis? | TMP-SMX |
| What is Lindane used for? Preparation? | used for treatment of scabies prepared as lotion or creme |
| What type of drug is Paramomycin? What is its mechanism? | Aminoglycoside antibiotic Inhibits protein synthesis (same mechanism as for antibacterial effects) |
| What is special about the administration of pyrimethamine/sulfadiazine? | Pyrimethamine has a long half life and eliminated slowly Sulfadiazine has a short half life and eliminated rapidly THUS --> must be administered as separate entities |
| What are the uses of Paromomycin? | - Luminal infections with E. histolytica - Alternative for Giardiasis |
| What are some untoward effects of Paromomycin? | Abdominal pain, nausea, vomiting, diarrhea Neprotoxic and Ototoxic for patients with renal failure |
| What is the preparation and use of Diethyltoluamide (DEET)? | insect repellent for prevention of malaria and sandfly disease |
| What is the use Diethylcarbamazine? | lymphatic filiriasis (elephantitis) and Loa Loa |
| What drug is used as repellent for malaria mosquitos and sandfly (leishmania)? | Diethyltoluamide (DEET) |
| What antiparasitic can cause Hypotension based on the infusion rate? | Pentamidine |
| What is Parmomycin nephro/ototoxic for patients with renal failure? | It is very poorly absorbed, and can accumulate in the kidney and cochlea of renal patients |
| What malari drugs are co-administered with pyrimethamine for toxo tx? | atovaquone+proguanil |
| What antiparasitic causes Megaloblastic Anemia? | Pyrimethamine |
| TMP- SMZ has increased PT time in whom? | patients taking Warfain |
| What drug only treats Crypto/Giardia in Children? | Nitazoxanide |
| What drug binds to tubulin and decreases glycogen storage in protozoa? | Albendazole |
| What drug is used for Lice/ticks/fleas/mites? | Permethrin |
| What is the mechanism of Pyrantel Pamoate? | Causes NM blockade and spastic paralysis in roundworms |
| What two drugs are used to treat Toxoplasmosis? | Pyrimethamine and sulfadiazine |
| What drugs cause the formation of radicals/DNA adducts in protozoa? | Metronidazole Tinidazole |
| What kind of resistance develops to Metronidazole in parasites? | None that are clinically important |
| What three drugs are used as insectisides? | Permethrin Lindane Diethyltoluamide |
| Ivermectin is the DOC for what? | DOC for: - Strongyloides stercoralis - Cutaneous larva migrans - Onchocerciasis |
| What is the DOC for Cutaneous Larva Migrans? | Ivermectin |
| What is the mechanism and use of Pentamidine Isethionate? | Mechanism: unknown Use: p. jirovecii, and trypanosoma brucei gambiense (west african sleeping sickness) |
| TMP-SMZ has a higher incidence of thrombocytopenia in whom? | elderly taking thiazide diuretics |
| Despite its wide spectrum, what are the only two approved uses for Nitazoxanide? | Approved for pediatric (1-11 y/o) cases of Cryptosporidium and Giradia |
| What are some untoward effects of Metronidazole and Tinidazole? What is a difference in side effects between Metro and Tini? | Metallic tastae Disulfuram-like effect when consumed with ETOH Abdominal pain, nausea diziness, vertigo |
| What drug releases GABA in protozoa, leading to paralysis? | Ivermectin |
| Why are pyrimethamine and sulfadiazine synergistic? | They both act on protozoal dihydrofolate reductase |
| How is Permetrhin prepared? Mechanism? Active against.... | cream, shampoo, or spray Disrupts Na+ channels leading to paralysis active against a broad range of pests: lice, ticks, fleas, mites **can be sprayed on sheets to limit mosquito bites and exposure to malaria |
| In what ratios are TMP and SMZ administered? Why? | Vd of Trimethoprim is five to seven times larger that SMZ thus combination is formulated in a 1:5 ratio |
| What are the indications of Metronidazole and Tinidazole? What is an additional indication for Metronidazole? | Both approved for the treament of Giardiasis, Trichomoniasis, amebiasis Metronidazole is effective against anaerboic bacteria |
| What drugs has Albendazole replaced? | Has replaced mebendazole and other benzimidazoles for most menatode infections |
| What is a disposition difference between Metronidazole and Tinidazole? | Tinidazole has a longer half life and less complicated dosing regimen |
| Which antiparasitic interferes with Anaerobic metabolism of protozoa? | Nitozoxanide |
| What are three potentailly fatal side effects of Pentamidine Isethionate? | Hypotension --> related to rapid infusion rate Hypoglycemia followed insulin-dependent DM due to islet cell destruction Pancreatitis in AIDS patients |
| What is the mechanism of Albendazole? | binds to tubulin and impairs glucose uptake causing glycogen depletion |
| What do almost ALL patients treated with Diethylcarbamazine develop? What are other untoward effects? | leukocytosis which slowly resolves Mazzotti rxn --> pruritus, hypotension, facial edema, eiosinophilia Keratitis, uveitis |
| What two drugs are used for tx of Pneumocystis jirovecii? | Trimethoprim-Sulfamethoxazole Pentamidine Isethionate |
| What kind of drug is Nitozoxanide? What is its mechanism? What is the implication of this mechanism? | Nitrosalicylaminde antibiotic Interferres with pyruvate:ferrodoxin oxidoreducatse, which is necessry for anaerobic energy metabolism Wide range of activity against parasites and bacteria that live anaerobically in intestine |
| What two drugs are used to treat Western African Sleeping sickness? Which one treats only the hemolymphatic stage? | Eflornithine Pentamidine (Hemolymphatic only) |
| What is the mechanism of Trimethoprim-Sulfamethoxazsole (TMP-SMZ)? | Two pronged inhibition of formation of tetrahydrofolate ** Sulfamethoxazole inhibits incorporation of PABA into folic acid ** Trimethoprim inhibits dihydrofolate reductase |
| What drug has a depolarizing muscular blockade in roundworms via nicotinic receptors? | Pyrantel Pamoate |
| Which drug is often associated with the "Mazotti Reaction" (Pruritus, fever, facial edema, eosinophils, hypotension)? What infection is it used to treat when this happens? | Diethylcarbamazine Onchocerciasis |
| What are some untoward effects of Pyrimethamine? | Can cause megaloblastic anemia, rash, or rarely Stevens-Johnson Syndrome |
| How is Albendazole administered? What is the use of Albendazole? | Single dose Tx: - Ascaris lumbricoides - hookworms - Trichuris trichiura - Enterobius vermicularis - Echinoccocal liver cysts - Neurocystercosis - Giardia lamblia |
| What are the four drugs used to treat intestinal protozoal infections? | Metronidazole Tinidazole Paromomycin Nitazoxanide |
Created by:
sam.mrosenfeld
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