click below
click below
Normal Size Small Size show me how
Antiprsitics
Question | Answer |
---|---|
TMP-SMZ (Bactrim) Uses | PCP prophylaxis/treatment in HIV/ALL |
TMP-SMZ Mechanism | inhibits tetrahydrofolate production (Sulfamethoxazole inhibits incorporation of PABA into folic acid; Trimethoprim inhibits dihydrofolate reductase) |
TMP-SMZ SE's | CYP450 inhibitor Rare: agranulocytosis, aplastic anemia, Stevens-Johnson/rash SE's in 65% of AIDS pts |
Pentamidine isethionate Uses | PCP pneumonia Trypanosoma brucei gambiense hemolymphatic stage (IV, IM) PCP prophylaxis (inhaled) |
Pentamidine isethionate Mechanism | interferes with nuclear metabolism: inhibits DNA/RNA/protein synthesis |
Pentamidine isethionate SE's | hypotension, hypoglycemia followed by insulin dependent DM b/c destruction of pancreatic B cells AIDS pts: rare fatal pancreatitis inhaled version is well tolerated |
Albendazole uses | Nematodes and Invasive cestodes DOC for inoperable echinococcal liver cysts; neurocysticercosis |
Albendazole mechanism | binds tubulin > disrupts MT formation impairs glucose uptake in worms Can administer as single dose for worms! |
Albendazole SE's | corticosteroids increase its levels |
Pyrantel pamoate Uses | Nematodes (enterobius, ascaris, hookworm) NOT effective for whipworm (Trichiuris) |
Pyrantel pamoate Mechanism | causes depolarizing NM blockade & spastic paralysis in roundworm. Inhibits cholinesterases |
Pyrantedl pamoate SE's | GI distress |
Ivermectin Uses | DOC: Strongyloides, cutaneous larva migrans, onchocerciasis (w/ limited inflammation) Not effective against cestodes/trematodes b/c they have no GABA control of muscle |
Ivermectin Mechanism | induces GABA release > suppresses neuronal transmission > paralysis + death of parasite |
Ivermectin SE's | well tolerated, no CNS penetration to mess w/ our GABA |
Diethylcarbamazine Uses | filariasis (elephantitis) Loa Loa DO NOT use in onchocerciasis (SE's) |
Diethylcarbamazine Mechanism | immobilizes parasite thru hyperpolarizaiton of muscle |
Diethylcarbamazine SE's | Leukocytosis (resolves) Mazzotti rxn in pts with onchocerciasis (pruritis, fever, hypotension, facial edema, eosinophilia); keratinitis, uveitis, atrophy of retinal epit) Cerebral edema if level of Loa Loa infection too high |
Praziquantel Uses | Trematodes (Flukes) Non-invasive cestodes (Tapeworms) |
Praziquantel Mechanism | Unknown - Ca dependent Cx spastic paralysis in worm and vacuolization of parasite tegument |
Permethrin Uses | Topical - lice, fleas, mites Mosquito, sandfly repellant |
Permethrin Mechanism | Na channel disruption > paralysis |
Permethrin SE's | erythema, numbness, tingling, rash |
Lindane Uses | Scabies (topical) |
Diethyltoluamine (DEET)Uses | insect repellent (malaria, sandfly) |
DEET SE's | Rare toxic encephalopathy with high doses in small children |
Lindane SE's | Rare CNS toxicity (seizure) if applied to cracked skin |