Pharmacology Exam I

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Rx2013
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61333
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Pharmacology Exam I
Updated:
2011-01-22 16:55:25
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Anti malarial agents
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Anti-malarial agents
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  1. Anti-malarial agents are important for travelers to
    • South America
    • Africa
    • Asia
  2. Types of Malaria
    • single cell invasion and multiplication
    • dormant hepatic stage
  3. Single liver cell invation and multiplication
    • falciparum
    • malariae
  4. Dormant hepatic stage
    • vivax
    • ovale
  5. goal for treatment of falciparum and malaria
    eradicate erythrocytic stage
  6. goal for treatment of vivax and ovale
    eradicate erythrocytic and hepatic stages
  7. A single sporozoite infecting a liver cell can produce____ merozites within 6 days of infection
    30-40K
  8. agents that target stages of malaria
    • blood schizonticidal agent
    • tissue schizonticidal agent
    • gametocidal agent
  9. Classes of antimalarial agents
    • 4-aminoquinoline
    • quinoline
    • 8-aminoquinoline
    • folate antagonists
    • artemisinins
    • antagonistic combinations
  10. 4-aminoquinolines
    • chloroquine
    • drug of choice
    • schizonticide and gametocide
    • 3-5 day half life
  11. Chloroquine is not effective against
    falciparum
  12. Chloroquine clinical use
    prophylaxis 500mg weekly
  13. must be used to cure dormant liver forms vivax and ovale
    primaquine
  14. chlorpquine mechanism of action
    causes heme toxicity to parasite
  15. Adverse effects with chloroquine
    • pruritus
    • hemolysis with G6PD deficiency
  16. Chloroquine contraindications
    • psoriasis
    • visual field abnormalities
    • caution in liver disorders
    • cations (antidiarrheals) interfere with absorption
  17. safe for use during pregnancy
    chloroquine
  18. Amodiaquine
    • similar to chloroquine but limited use due to toxicity
    • used for falciparam that is resistant to chloroquine
  19. Toxicities with amodiaquine
    • agranulocytosis
    • hepatotoxicity
    • aplastic anemia
  20. Quinoline class
    • quinine
    • quinidine
    • mefloquine
  21. quinine and quinidine used for
    • protection against erythrocitic stage
    • not active against hepatic parasites
    • not gametocidal (falciparum)
  22. Quinine and quinidine are not generally used for prophylaxis due to
    • toxicity
    • cardiac dysrhythmias and hypotension
    • tinnitus
    • chinchonism
  23. Contraindications of quinine and quinidine
    • mefloquine
    • digoxin
    • warfarin
  24. Mefloquine
    • potent blood schizonticide
    • used for chloroquine resistant parasites
  25. prophylactic dose of mefloquine given
    weekly
  26. mefloquine usually recommended for
    travelers
  27. Mefloquine contraindicated with
    • seizures
    • psychosies
    • arrhythmias
    • children under 5kg
  28. 8-aminoquinoline class
    • primaquine
    • atovaquone
  29. only agent effective agiainst hepatic stage of vivax and ovale
    primaquine
  30. Atovaquone
    • recommened for chloroquine resistance
    • disrupts mitochondrial electron transport
  31. Atovaquone active against
    falciparum but not vivax and ovale
  32. Atovaquone bioavailability increased with
    fatty food
  33. Atovaquone + rifampin or tetracycline
    decrease plasma concentrations by 50%
  34. Folate metabolism antagonists
    • Pyrimethamine
    • Proguanil
    • erythrocytic stage
  35. Sulfonamides and sulfones
    • active against erythrocytic stage
    • not used alone
  36. Fansidar
    • sulfadoxine and pyrimethamine
    • for toxoplasmosis
    • no longer for malaria due to resistance
  37. Fansidar is contraindicated in
    • 3rd trimester of pregnancy
    • lactating mothers
  38. Fansidar and sulfonamides act on
    pteridine synthetase
  39. pyrimethamine or proguanil act on
    dihydrofolate reductase
  40. Antibiotics used as co-therapy in malaria
    • doxycycline
    • clindamycin
    • azithromycin
  41. Artemisinin
    • chinese herbal
    • no prophylaxis
    • irreversible neurotoxicity
    • avoid in pregnancy
  42. Artesunate
    • artemisinin derivative
    • available through CDC
    • free radical production
    • active against multi drug resistant malaria
  43. Drugs used for travelers
    • mefloquine
    • doxycycline
    • chloroquine
    • hydroxychloroquine
    • malarone
  44. Prophylaxis dosing
    2 weeks before travel and up to 1 month after return

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