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24 Cards in this Set
- Front
- Back
Is Entamoeba Histolytica :
protozoa flatworm roundworm Describe it's life cycle. What takes place in asympt chronic cases? Can this individual spread the infection? Are cysts able to form in those with active diarrhea? |
protozoa
cyst ingestion --> trophozoites form in sm. intes. where they: a)mult in bowel lumen b)encyst and ulcerate in the intes. wall c)portal vein --> liver --> abscesses & hepatitis cysts form in intestine and are passed in the feces - no No, they are not. |
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What is the drug of choice for tx'ing all invasive forms of amebic infection?
- mech? - SE? - contraindications? |
metronidazole
- inhibits anaerobic metabolism of parasite - nausea, HA, drymouth; unpleasant sensations if used w/ alcohol. - pregnancy |
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What type of organisms are giardia and trichomonas? Tx?
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protozoan parasites; one intestinal, the other genital
Metronidazole |
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What is the difference b/t plasmodium vivax and plasmodium falciparum re: # of exoerythrocytic cycles in the liver?
Implications for tx? |
vivax can go thru several cycles
falciparum - only once Tx for vivax must be active in both exoerythrocytic and erythrocytic cycles ...whereas falciparum tx need only be active erythrocytically |
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Chloroquine
- exo or erythrocytically active? - gametocidal against which? - mech? - degraded by which organ? - can it build up over long tx? - short term SE? - long term? |
- erythrocytic only
- vivax, ovale, malariae (not falciparum) - inhibits parasite breakdown of host hemoglobin. - liver - yes - GI upset, HA, blurring of vision - retinal damage, palsies b/c drug b/ to mucles. |
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Primaquine
- exo or erythrocytically actv? - actv against which organisms? - actv against which gametocytes? - cleared quickly or slowly? - SE? - who is sensitive? Why? |
- exoerythrocytic cycle
- exo forms of vivax and ovale. - all 4 parasites - quickly - can cause leukocytosis, ^^doses --> BM suppression **can cause hemolysis in those with Primaquine sensitivity. - esp. AA males; G6PD deficiency |
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Some Chloroquine-resistance is being seen in falciparum. What is the current 1st line in falciparum tx?
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Malarone
or Quinine + doxycycline or Mefloquine |
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What is Malarone?
- mechs? - SEs? - uses? |
Atovaquone + Proquanil
1. interferes w/ mitochondrial e transport i/ parasite 2. DHFR inhibitor - HA, GI upset - tx of chloroquine resistant falciparum |
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Mefloquine
- class? - uses in malarial tx? - SEs? |
- quinolone
- chloroquine resistant falciparum - CNS related: +dizziness +headache +vivid dreams +rare psychotic events |
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T. Brucei can cause complications in which system that especially worrisome?
T. Cruzi? What does chemotx choice depend on in these organisms? |
CNS
Myocardium whether the infection has gotten into the CNS. |
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Which two drugs are used to tx both forms of african sleeping sickness if they haven't reached the CNS?
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Suramin and Pentamidine
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Suramine:
- admin? - mech? - toxicities? - used in? |
- IV
- unclear - CNS, urticaria, pruritis, nepthrotoxicity - African sleeping sickness that hasn't made it to the CNS |
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Pentamidine:
- admin? - mech? - toxicities? - cleared quickly or slowly? - used in? |
- IM
- b/kinetoplast DNA of mitochondria - hypotension, nausea, vomiting, renal & hepatic damage - v. slowly (months) - African sleeping sickness that hasn't made it to the CNS |
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Which drug is used to tx both forms of african sleeping sickness if they get to the CNS?
- admin? - mech? specific or non? - SEs? |
Melarsoprol
- IV in hospital - reacts with sulfhydrl groups + not very - myocardial damage, HTN, peripheral neuropathy |
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What is Elfornithine? Mech? Advantages?
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newer drug that shows some promise in african sleeping sickness tx.
Ornithine decarboxylase inhibitor Somewhat less toxic than the alternatives |
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What drug is used to tx Chagas dz?
- admin? - mech? - SE? - organ of clearance? |
Nifurtimox
- only orally - generates free rads - anorexia, nausea, rashes, HA - kidneys |
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What can be used to treat Leishmania donovani (leshmaniasis?)?
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Stibogluconate
- highly toxic compound |
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What is the most prevalent parasitic infestation of humans? (general category)
Most infections of this sort are tx'ed with what? |
Round worms
Mebendazole |
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Mebendazole
- admin? - area of effects? - contraindications? - SEs? |
- oral
- largely intraluminal - pregnancy - not many, stays luminally |
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The following medications can be used to treat what, even though they aren't usually the 1st choice?
Albendazole Pyrantel pamoate |
Roundworm infestations
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How do you tx Schistosomiasis?
- admin? - SE? - mech? |
praziquantel
- orally - RARE... sedation, ab discomfort, fever, sweating, nausea, HA, eosinophilia - contractionand paralysis of worm's muscle by ^^Ca mem permeability |
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In tx of tapeworms, it is important to determine whether the ___ has been eliminated, since it can regenerate the proglottids.
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scolex
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What is the most common tapeworm? Prevalent population/Geographic area?
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hymenolepis nana (dwarf tapeworm)
SE USA in kids |
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What is the drug of choice for most tapeworms?
What about for T. Solium (exception)? Why? |
niclosamide
praziquantel - niclosamide cannot kill the ova released from the proglottids... which can get into the CNS and cause bad shit. |