6. ANTIPROTOZOALS & ANTI-HELMINTICS DRUGS (AI)

What enzyme is inhibited by sulfa drugs?

Dihydropteroate synthetase

What enzyme is targeted by metronidazole?

Pyruvate ferredoxin oxidoreductase

What enzyme is inhibited by nifurtimox?

Trypanothione reductase

What enzyme is inhibited by ketoconazole in protozoa?

Lanosterol C14-α demethylase

What enzyme is inhibited by eflornithine?

Ornithine decarboxylase

What is the mechanism of suramin?

Inhibits glycolytic enzymes

What enzymes are targeted by antifolate drugs?

Dihydrofolate reductase and thymidylate synthase

What is the mechanism of atovaquone?

Inhibits mitochondrial electron transport

What is the mechanism of benzimidazoles like albendazole?

Inhibit microtubule polymerization

What is the mechanism of ivermectin?

Affects nervous synaptic transmission via GABA

What is the mechanism of artemisinin?

Generates free radicals and inhibits Ca-ATPase

What type of antimalarial is artemisinin?

Rapid-acting blood schizonticide

What is the first-line therapy for uncomplicated falciparum malaria?

Artemether-lumefantrine (Coartem)

What class does chloroquine belong to?

4-aminoquinoline

What class does quinine belong to?

Quinoline methanol

What class does primaquine belong to?

8-aminoquinoline

What class do sulfadoxine drugs belong to?

Antifolate sulfa

What class does proguanil belong to?

Antifolate quinone

What class does doxycycline belong to in malaria?

Tetracycline

What class does halofantrine belong to?

Phenanthrene methanol

What class does lumefantrine belong to?

Aryl alcohol

What is another name for artemisinin?

Qinghaosu

What infection is caused by Entamoeba histolytica?

Amebiasis

What are possible manifestations of amebiasis?

Asymptomatic infection, colitis, dysentery, liver abscess

What is the DOC for asymptomatic amebiasis?

Diloxanide furoate or paromomycin

What is the DOC for mild to moderate intestinal amebiasis?

Metronidazole

What is the DOC for severe intestinal amebiasis?

Metronidazole

What is the DOC for hepatic amebiasis?

Metronidazole with chloroquine

What drug combination treats babesiosis?

Clindamycin and quinine

What is the DOC for balantidiasis?

Tetracycline

What drug also treats balantidiasis aside from tetracycline?

Metronidazole

What is the DOC for giardiasis?

Metronidazole or tinidazole

What is the DOC for trichomoniasis?

Metronidazole or tinidazole

What is the DOC for leishmaniasis?

Sodium stibogluconate

What alternative drugs are used for leishmaniasis?

Amphotericin B or ketoconazole

What is the DOC for Pneumocystis jiroveci?

Trimethoprim-sulfamethoxazole

What is an alternative regimen for Pneumocystis?

Clindamycin with primaquine

What is the DOC for toxoplasmosis?

Pyrimethamine with sulfadiazine and folinic acid

What is used for toxoplasmosis in pregnancy?

Spiramycin

What drugs are used for trypanosomiasis?

Suramin, benznidazole, nifurtimox, eflornithine

What is the DOC for ascariasis?

Albendazole or mebendazole

What is the DOC for trichuriasis?

Mebendazole or albendazole

What is the DOC for enterobiasis?

Mebendazole or albendazole

What is the DOC for strongyloidiasis?

Ivermectin

What is the DOC for filariasis?

Diethylcarbamazine

What is the DOC for onchocerciasis?

Ivermectin

What is the DOC for schistosomiasis?

Praziquantel

What is the DOC for clonorchiasis?

Praziquantel

What is the DOC for paragonimiasis?

Praziquantel

What is an alternative drug for paragonimiasis?

Bithionol

What is the DOC for fasciolopsiasis?

Praziquantel

What alternative drug is used for fasciolopsiasis?

Niclosamide

What is the DOC for heterophyidiasis?

Praziquantel

What alternative drug is used for heterophyidiasis?

Niclosamide

What is the DOC for fascioliasis?

Bithionol

What is the DOC for taeniasis?

Praziquantel or niclosamide

What is the DOC for diphyllobothriasis?

Praziquantel or niclosamide

What is the DOC for hymenolepiasis?

Praziquantel or niclosamide

What is the DOC for neurocysticercosis?

Albendazole or praziquantel

What is the DOC for echinococcosis?

Albendazole

What is the DOC for capillariasis?

Albendazole or mebendazole

What drug is used for cutaneous larva migrans?

Albendazole or ivermectin

What drug is used for visceral larva migrans?

Albendazole or mebendazole

What is the DOC for trichinosis?

Mebendazole or albendazole

What additional drug may be used in trichinosis?

Steroids

What drug class do albendazole and mebendazole belong to?

Benzimidazoles

What is the mechanism of benzimidazoles?

Inhibit microtubule formation in parasites

What is the primary mechanism of praziquantel?

Increases membrane permeability to calcium causing paralysis

What is the primary mechanism of niclosamide?

Inhibits oxidative phosphorylation in parasites

What is the mechanism of diethylcarbamazine (DEC)?

Alters parasite membrane making them susceptible to immune attack

What is the mechanism of ivermectin?

Enhances GABA-mediated neurotransmission leading to paralysis

What is a key clinical use of ivermectin?

Onchocerciasis

What infection is ivermectin used for aside from helminths?

Scabies and lice

What dermatologic condition can ivermectin treat?

Acne rosacea

What is a major adverse reaction of ivermectin?

Mazzotti reaction

What are symptoms of Mazzotti reaction?

Fever, hypotension, bronchospasm

How is Mazzotti reaction treated?

Prednisone

What respiratory condition is associated with ivermectin toxicity?

Reactive airway dysfunction syndrome

What ocular adverse effect is associated with ivermectin?

Corneal opacities

What drugs should not be combined with ivermectin?

GABA-enhancing drugs (benzodiazepines, barbiturates)

Who should avoid ivermectin?

Pregnant women and children under 5 years

What was ivermectin tested for but found ineffective?

COVID-19

What drug is used for necatoriasis and ankylostomiasis?

Albendazole or mebendazole

What is another name for hookworm infection?

Ankylostomiasis

What drug treats multiple nematode infections broadly?

Albendazole

What drug is commonly used for intestinal worms broadly?

Mebendazole

Which drug is commonly used for both protozoa and anaerobic infections?

Metronidazole

What is the mechanism of metronidazole in protozoa?

Forms free radicals that damage DNA

What drug is similar to metronidazole?

Tinidazole

What class of drug is tetracycline in protozoal infections?

Protein synthesis inhibitor

What is the mechanism of clindamycin in protozoa?

Inhibits protein synthesis

What combination is used for Pneumocystis jiroveci?

Trimethoprim-sulfamethoxazole

What is the mechanism of trimethoprim?

Inhibits dihydrofolate reductase

What is the mechanism of sulfamethoxazole?

Inhibits dihydropteroate synthetase

What is folinic acid used for in toxoplasmosis therapy?

Prevents bone marrow toxicity

What drug is used in combination with clindamycin for toxoplasmosis?

Pyrimethamine

What is the mechanism of pyrimethamine?

Inhibits dihydrofolate reductase

What is the mechanism of lumefantrine?

Interferes with heme detoxification in malaria parasites

Why is lumefantrine always combined with artemisinin?

To enhance efficacy and prevent resistance

What is the primary target of chloroquine?

Heme polymerization in parasite food vacuole