Term
| why do antiprotozoal drugs cause more side effects, where are they usualy at? (4) |
|
Definition
Protozoa are eukaryotes and have metabolic processes closer to humans so drugs have more toxic effects
Increased in cells with high metabolic activity like kidney, neurons, intestinal, and stem cells |
|
|
Term
| what is the most common ameoba pathogen and the disease it causes |
|
Definition
E. histolitica
amebiasis (amebic dysentery) |
|
|
Term
| what are the three categories of amebocides, what distinguishes them |
|
Definition
mixed: effective in lumen and systemic, concentration too low for single drug treatment
luminal: act on parasite in lumen of bowel
systemic: act on parasite in intestine wall and liver |
|
|
Term
| what are the three antiameoba drugs and their category |
|
Definition
mixed: metronidazole
luminal: diloxanide furolate
systemic: chloroquine |
|
|
Term
|
Definition
| female anopheles mosquito |
|
|
Term
| what are the 4 types of malaria, what is the their severity and prevelence |
|
Definition
plasmodium falciparum: severe, common
P. vivax: mild, common
P. malariae: mild very common
P. ovale: mild, rare |
|
|
Term
| what categories of drugs are used to treat malaria (2) |
|
Definition
tissue schizoniticides
blood schizoniticides |
|
|
Term
| what are the tissue schizoniticides |
|
Definition
|
|
Term
| what are the blood schizoniticides (3) |
|
Definition
chloroquine
quinine
mefloquine |
|
|
Term
| what two diseases do trypanosomiasis cause |
|
Definition
african sleeping sickness
american sleeping sickness (Chagas') |
|
|
Term
| what microbes cause african sleeping sickness (2) |
|
Definition
T. bruceo gambiense
T. bruci rhodinese |
|
|
Term
| what microbe causes american sleeping sickness |
|
Definition
|
|
Term
| what is the treatment for trypanosomiasis (3) |
|
Definition
melarsoprol
pentamidine
isethionate
nifurtimox |
|
|
Term
| how is leshmianisis transmitted |
|
Definition
| animal to human by bite of sand flies |
|
|
Term
| what are the three types of leshimaniasis |
|
Definition
cutaneous
mucocutaneous
visceral |
|
|
Term
| what is the treatment for leshimaniasis |
|
Definition
|
|
Term
| what is the cause of toxoplasmosis |
|
Definition
|
|
Term
| what is the transmission of toxoplasmosis gondii (2) |
|
Definition
| raw meat or oocytes shed from cats |
|
|
Term
| what is the treatment of toxoplasmosis gondii |
|
Definition
|
|
Term
| what is the most commonly diagnosed intestinal parasite in the US |
|
Definition
|
|
Term
| how is giardia transmitted |
|
Definition
|
|
Term
|
Definition
|
|
Term
| what are the two forms of E. histolytica, where are they located |
|
Definition
Cysts: survive outside the body
Labile: invasive trophozoites that cannot live outside the body |
|
|
Term
| how is E. histolica transferred, where does it grow, how does it cause infection |
|
Definition
Cysts ingested through feces contamination and pass to intestines
Trophozoites are born and invade and ulcerate the mucosa and feed on intestinal bacteria
As they increase in numbers they are able to invade systemically
As they migrate to the rectum they return to cyst form and are excreted in feces |
|
|
Term
| how is E. histolitca diagnosed |
|
Definition
| E. histolytica in fresh feces |
|
|
Term
| what are the signs of P. falciparum (5) |
|
Definition
persistent high fever
orthostatic hypotension
erythrocytosis (swollen limbs)
capillary obstructiondeath |
|
|
Term
| why is P. falciprum dangerous (3) |
|
Definition
it can infect RBC of any age
increased drug resistance
increased insectacide resistance |
|
|
Term
| what is the main clinical concern for P. vivax |
|
Definition
| may remain in the liver after the blood part of the disease is elminated |
|
|
Term
| what is the main clinical concern for P. ovale |
|
Definition
| may remain in the liver after the blood part of the disease is elminated |
|
|
Term
| how is trypanosomiasis acquired, where does it go in the body, how does it cause pathoology, what are the signs |
|
Definition
Initially live and grow in the blood
Invade CNS and cause inflammation of the brain and spinal cord
Produces lethargy and continuous sleep |
|
|
Term
|
Definition
ferredoxin like, low redox, e- transport chains occur in anaerobic abeobe making ROS.
nitro group of drug accepts e- and forms reduced cytotoxic compounds that bind to proteins and DNA causing cell death |
|
|
Term
|
Definition
|
|
Term
| chloroquine: MOA (4 parts) |
|
Definition
1. decreases DNA synthesis but disrupting tertiary structure of DNA
2. alkalinization of food vacoule: tops Hb digestion of the parasite by going into food vacoule and picking up a protein and making the food basic
3. interferes with heme polymerase: parasites eat Hb to get AA and Fe but this makes soluble Hb which is toxic so it uses heme polymerase and turns the Hb into hemozoin and puts it away in its food vacoule.
4. binds ferriprotoprophyrin iX damaging membrane causing lysis of the parasite and RBC |
|
|
Term
|
Definition
| intermediates act as oxidants which cause hemolysis and methemoglobenmia toxicities |
|
|
Term
|
Definition
inhibit heme polymerase
affect DNA synthesis
damage the membrane |
|
|
Term
|
Definition
|
|
Term
|
Definition
| reacts with sulfhydryl inducing enzymes in organism and host |
|
|
Term
| pentamide isethionate: MOA |
|
Definition
| binds to parasite DnA and stops RNA/DNA/phospholipid/protein synthesis in parasite |
|
|
Term
|
Definition
| undergoes reduction so it has a free e- to attack O2 forming superoxide, hydeoxyl, and H2O2 raicals. Organism dosent have catalase so it kills it |
|
|
Term
| sodium sitbogluconate: MOA |
|
Definition
reduced to trivalent antiomy for activity
inhibits phosphofructokinase stopping glycolysis |
|
|
Term
|
Definition
stops diydrofolate reductase at a low enough concentration to not inhibit it in the host
this deprives it of tetrahydrofolate so it cant make purines and pyrimidines |
|
|
Term
|
Definition
| some P. falciprum has become resistant |
|
|
Term
|
Definition
| some trichomonas have become resistant |
|
|
Term
| metronidazole: side effects (7) |
|
Definition
GI: nausea, vomiting, cramp
metalic taste
oral moniliasis
disulfiram like effect
rare CNS: numbness upon drug discontinuation |
|
|
Term
| diloxanide fulorate: side effects (3) |
|
Definition
mild flatulence
dryness of the mouth
puritus |
|
|
Term
| chloroquine: side effects (3) |
|
Definition
ECG changes - quinidine effect
chronic Tx: discoloration of nail beds, visual disturbances |
|
|
Term
| primaquine: side effects (3) |
|
Definition
GI
drug induced hemolytic anemia in people with low G6PDH
rare blood dyscrasia in patients with lupus |
|
|
Term
| quinine: side effects (7) |
|
Definition
cinchonism: nausea, vomiting, tinnitus, vertigo
discontiune for positive coombs test for hemolytic anemia
potentiation of neuromuscular blocking agents (surgery)
elevation of digoxin levels |
|
|
Term
| mefloquine: side effects (3) |
|
Definition
| dizzy, disorientation, hallucinations (caution to SCUBA divers), neurotic and psychotic stuff |
|
|
Term
| melarsoprol: side effects (1) |
|
Definition
| CNS: encephalopathy may appear soon after therapy. Usually subsides, can be fatal |
|
|
Term
| pentamide isethionate: side effects (3) |
|
Definition
renal dysfunction
hypotension
toxic to B cells of pancreas |
|
|
Term
| nifurtimox: side effects (3) |
|
Definition
anaphylaxis
delayed hypersensitivity
peripherial neuropathy |
|
|
Term
| sodium sitbogluconate: side effects (1) |
|
Definition
|
|
Term
| pyrimethamine: side effects (2) |
|
Definition
megaloblastic anemia: reversable with leuconvorin
hypersensitivity (can be severe) |
|
|
Term
| metronidazole: administration, absorption |
|
Definition
|
|
Term
| diloxanide furolate: administration, absorption (and its significance) |
|
Definition
| 90% absorbed, but the unabsorbed part is the amebocide |
|
|
Term
| chloroquine: administration |
|
Definition
|
|
Term
| primaquine: administration |
|
Definition
|
|
Term
| melarsoprol: administration |
|
Definition
|
|
Term
| pentamide isethionate: administration methods, why not the others |
|
Definition
IM or aerosol
Avoid IV: tachycardia, decrease in BP |
|
|
Term
| sodium sitboqluconate: asministration |
|
Definition
|
|
Term
| metronidazole: how is it metabolized (2), what can enhance this (1), what can increase the half life (1) |
|
Definition
hepatic oxidation of the side chain by oxidase and glucuronidation (accumulates in hepatic disease)
enhanced by phenobarbital
cimetidine increases half life (heart burn) |
|
|
Term
|
Definition
| some metabolic products retain antimalarial activity |
|
|
Term
|
Definition
| rapidly oxidized to many other compounds |
|
|
Term
| primaquine: distribution and its significance |
|
Definition
| can get to the liver to get P. vivax and P. ovale but does not concentrate anywhere in particular |
|
|
Term
|
Definition
|
|
Term
|
Definition
| excretion decreased due to alkalinization of the urine |
|
|
Term
| what antiprotozoa has the longest half life how long is it, who is the runner up |
|
Definition
mefloquine
long half life (17d)
pentamide isethionate |
|
|
Term
| what antiprotozoa enters the CNS |
|
Definition
|
|
Term
|
Definition
| host oxidizes non-toxic pentavalent arsenic compoind |
|
|
Term
| what is pyrmithamine used to |
|
Definition
|
|
Term
| what is sodium sitboglyconate used for |
|
Definition
|
|
Term
| what is nifurtumox used for |
|
Definition
| acute T. cruzi infection, chronic stage treatment results are variable (drug is supressive not curative) |
|
|
Term
| what is pentamide isethionate used for (2) |
|
Definition
T. brucei gambinese in hematological stage
Pneymocystis carinii |
|
|
Term
| what is melarsoprol used for |
|
Definition
| drug of choice: late stages with CNS involvement for gambinense and rhodesiense |
|
|
Term
| what is mefloquine used for (2) |
|
Definition
prophylaxis for chloroquine resistant malaria (also doxycycline)
treatment for chloroquine resistant malaria |
|
|
Term
| what is quinine used for (2) |
|
Definition
reserved for resistant strains
treatment for chloroquine resistant malaria |
|
|
Term
| what is primaquine used for (5) |
|
Definition
kills…
*primary exoerythrocytic P. falciparum and P. vivax
*secondary exoerythrocytic forms of P. vivax and P. ovale (in liver)
*sexual forms of all plasmodia are destoried in blood or prevented from maturing
*little activity on erythrocytic schizonts so often used in combo with blood schizoniticide |
|
|
Term
| what is metronidazole used for (3), how is it used |
|
Definition
E. histolitica
Giardia lamblia
Trichomonas vaginalis
usually combined with a luminal ameboside because it is rapidly absorbed |
|
|
Term
| what is diloxanide furolate used for (2) |
|
Definition
asymptomatic passers of cysts
intestinal amebiasis |
|
|
Term
| what is chloroquine used for (4) |
|
Definition
use with metronidazole and diloaxnide to treat and preent liver abscesses
drug of choice forerythrocytic P. falciparum
prophylaxis for chloroquine sensitive malaria
treatment for chloroquine sensitive acute malaria |
|
|
Term
| what drug has to be gotten from the CDC |
|
Definition
|
|
