NUR 219: Antmalarials, Anthelmintics, and Peptides

for Exam 2

Malaria

Was eliminated in US in 1950s, 2000-2500 cases since that time; caused by protazoan parasites

Malaria two phases

tissue phase→erythrocytic phases

Tissue phase

Invasion of body tissue; makes clinical symptoms

Erythrocytic phase

Invasion of RBCs causes chills, fever, diaphoresis, incubation period is 10-35 days with flu like symptoms

Malaria prevention

Controlling mosquitos, spraying, bug spray

Malaria drug treatment

Quinine was only available from 1820-1940s; antimalarial drugs have treatment as well as prophylaxis, chlorophine is widely used and resistance is common; can be used w/ or w/o antibiotics

Malaria prophylaxis

Prevention; chloroquine and primaquine

Acute malaria treatment

Chlorophine and mefloquine

Malaria prevention of relapse

Mosquito nets, spraying

Chloroquine pharmacokinetics

Absorbed in GI tract, long half-life, metabolized in liver, excreted mostly in urine (some in stool)

Chloroquine contraindications

Hypersensitivty, ocular disease

Chloroquine pharmacodynamics

Interferes with protein synthesis; onset is rapid, duration is long (days to wks)

Chloroquine side effects and adverse reactions

GI upset, retinal damage, cranial nerve 3 involvement, renal impairment, CV effects

Quinine

Antimalarial drug

Quinindine

Antidysrhythmic drug

Quinine FDA warning

Black-box warning=muscle weakness

Quinine adverse reactions

Anemia, elevated hepatic enzymes

Mefloquine FDA warning

Black-box warning=permanent neuro issues

Mefloquine advserse effects

Anxiety, restlessness, disorientation, hallucinations, paranoia, suicidal ideation

Helminths

Parasitic worms; transmitted d/t poor sanitation and hygiene from soil; feed on host tissue

Helminthiasis

Worm infections; most commonly in intestine, can be in lymphatic system, blood vessels, and liver

Anthelmintic drugs

Ivermectin, praziquantel, pyrantel pomoate, triclabendazole

Ivermectin

Broad-spectrum antiparasitic; treats pediculosis, inflammation lesions of rosacea, river blindess

Praziquantel

Liver flukes

Pyrantel pamoate

Pinworms

Triclabendazole

Fascioliasis

Antihelmintic side effects

GI issues, neuro issues, adverse rxns not common, given for short period (1-3 days)

Antimicrobial peptides

Broad spectrum; kill bacteria, parasites, fungi and virus

Colistimenthate

Polypeptide that targets gram neg bacteria

Colistimenthate adverse reactions

Dyspnea, tingling, slurred speech, dizzyness, paresthesia, pruritis, rash, fever

Polymyxins

Polypeptide antibiotics; not absorbed PO except for colistin

Bacitracin

Polypeptide structure; causes bacterial cell death

Bacitracin skin application

Not absorbed PO

Bacitracin side effects

Skin redness and rash, NV

Bacitracin severe adverse reactions

Renal damage, ototoxicity, allergic reactions