Amebic Infections and Drug Treatments Quiz

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Questions and Answers

What must Histolytica be used with to ensure eradication of the infection?

Chloroquine

Diloxanide furoate

Metronidazole (correct)

Paromomycin

Which of the following is an adverse effect commonly associated with Metronidazole?

Severe CNS toxicity

Pancreatitis

Dry mouth (correct)

Metallic taste (correct)

What condition may occur as a result of using lithium with Metronidazole?

Acute renal failure

Liver damage

Lithium toxicity (correct)

Severe dehydration

Which drug is effective in the treatment of asymptomatic passers of cysts?

Diloxanide furoate Signup and view all the answers

Which of the following is true regarding Paromomycin?

It has direct amebicidal action likely due to membrane leakage. Signup and view all the answers

What is the primary use of Chloroquine in the context of amebic infections?

To prevent liver abscesses Signup and view all the answers

What adverse effect may be observed as rare with Chloroquine?

Hemolysis in G6PD-deficient individuals Signup and view all the answers

Which statement about Iodoquinol is false?

It is effective against trophozoites in the intestinal wall. Signup and view all the answers

Which mechanism of action is associated with Ivermectin?

Intensifying GABA-mediated transmission in peripheral nerves Signup and view all the answers

Which drug is indicated for the treatment of Schistosoma haematobium?

Metrifonate Signup and view all the answers

What is the primary treatment for asymptomatic intestinal infection caused by Entamoeba histolytica?

Luminal amebicide Signup and view all the answers

What is a common adverse effect associated with Mebendazole use?

Mild gastrointestinal symptoms Signup and view all the answers

Which of the following is NOT classified as a systemic amebicide?

Paromomycin Signup and view all the answers

What is the primary action of Praziquantel?

Increasing membrane permeability to calcium Signup and view all the answers

What percentage of patients can expect to have their carriage eradicated after a single course of treatment with standard luminal amebicides?

80-90% Signup and view all the answers

Which drug serves as an alternative treatment for ascariasis by causing paralysis?

Piperazine Signup and view all the answers

Which drug is commonly associated with CNS symptoms as adverse effects?

Oxamniquine Signup and view all the answers

In the treatment of amebic colitis and dysentery, which combination of drugs is considered the treatment of choice?

Metronidazole and a luminal amebicide Signup and view all the answers

Which characteristic makes metronidazole selectively toxic to anaerobic organisms and amebae?

Its ability to form reduced cytotoxic compounds Signup and view all the answers

What is the primary action of Mebendazole?

Inhibition of microtubule synthesis Signup and view all the answers

Which of the following is classified as a mixed amebicide?

Metronidazole Signup and view all the answers

Which drug is indicated for Taeniasis and Neurocysticercosis treatment?

Praziquantel Signup and view all the answers

Among the following infections, which one is NOT caused by Entamoeba histolytica?

Leishmaniasis Signup and view all the answers

What is the primary aim of therapy in the treatment of amebiasis?

To treat the acutely ill and carriers Signup and view all the answers

What is a significant adverse effect related to the use of Pentamidine?

Severe hypotension Signup and view all the answers

Which drug is considered first-line therapy for advanced West African Trypanosomiasis?

Eflornithin Signup and view all the answers

What is a common adverse effect of Sodium stibogluconate treatment?

Gastrointestinal symptoms Signup and view all the answers

Which agent is primarily used for American Trypanosomiasis (Chagas disease)?

Nifurtimox Signup and view all the answers

What is the mechanism of action for Albendazole?

Inhibition of microtubule synthesis Signup and view all the answers

What severe reaction can occur with the use of Melarsoprol?

Reactive encephalopathy Signup and view all the answers

Which of the following drugs is an effective treatment for visceral leishmaniasis?

Paromomycin Signup and view all the answers

What is an important monitoring requirement for long-term use of Albendazole?

Liver function studies Signup and view all the answers

Which of the following agents is contraindicated in patients with psoriasis?

Emetine Signup and view all the answers

Which of the following is a synthetic analog of emetine?

Dehydroemetine Signup and view all the answers

Study Notes

Antiprotozoal and Anthelminthic Drugs

Protozoal infections may include amoebiasis, trichomoniasis, giardiasis, leishmaniasis, trypanosomiasis, malaria, and toxoplasmosis.
Amebiasis is an infection of the intestinal tract caused by Entamoeba Histolytica.
This organism can cause asymptomatic infection, mild to moderate colitis, severe intestinal infections (dysentery), ameboma, liver abscess, and other extraintestinal infections.
Amebiasis can be acute or long-term, showing varying degrees of illness, from no symptoms to fulminating dysentery.
Therapy is aimed at both acutely ill patients and carriers.
Asymptomatic intestinal infection is treated with luminal amebicides.
Standard luminal amebicides include diloxanide furoate, iodoquinol, and paromomycin.
Each drug eradicates carriage in about 80-90% of patients with a single course of treatment.
Metronidazole plus a luminal amebicide is the treatment of choice for amebic colitis and dysentery.
Emetine and dehydroemetine are also used.
For extraintestinal infections, the treatment is metronidazole plus a luminal amebicide.
Chemotherapy of amebiasis includes metronidazole, emetine, dehydroemetine, chloroquine, iodoquinol, antibiotics and diloxanide furoate.
Mixed amebicides include metronidazole and tinidazole.
Luminal amebecides include diloxanide furoate, paromomycin, and iodoquinol.
Systemic amebicides include Chloroquine, emetine and dehydroemetine.
Metronidazole is selectively toxic to anaerobic organisms, including bacteria.
The nitro group of metronidazole serves as an electron acceptor, creating cytotoxic compounds that bind to proteins and DNA, resulting in cell death.
Metronidazole is used in the treatment of all tissue infections with E. Histolytica.
It is not effective against luminal parasites, so it must be used with a luminal amebicide to ensure eradication of the infection.
Metronidazole is the treatment of choice for giardiasis and trichomoniasis.
Adverse effects of metronidazole include nausea, headache, dry mouth or metallic taste in the mouth, pancreatitis, severe CNS toxicity, disulfiram-like effect, seizures, and peripheral neuropathy.
Metronidazole can potentiate the anticoagulant effect of coumarin-type anticoagulants.
Metronidazole may cause lithium toxicity.
Diloxanide furoate is useful in the treatment of asymptomatic passers of cysts.
90% of ingested Diloxanide furoate is absorbed from the intestinal mucosa.
Adverse effects of Diloxanide furoate include flatulence, dryness of mouth, pruritus, and urticaria.
Paromomycin is an aminoglycoside antibiotic that's not significantly absorbed from the GI tract.
Paromomycin is hydrolyzed in the intestinal mucosa; about 90% is absorbed.
Its amebicidal action is related to its effect on cell membranes, causing leakage.
Adverse effects of Paromomycin include abdominal distress and diarrhea.
Iodoquinol is a halogenated hydroxyquinoline; an effective luminal amebicide.
It is commonly used with metronidazole to treat amebic infections.
It is effective in the bowel lumen but not against trophozoites in the intestinal wall or extraintestinal tissues.
Infrequent adverse effects include GIS symptoms, headache, rash, and pruritus.
The drug should be discontinued if persistent diarrhea or signs of iodine toxicity (dermatitis, urticaria, pruritus, fever) occur.
Chloroquine is used in combination with metronidazole and diloxanide furoate to treat and prevent liver abscesses.
Chloroquine reaches high liver concentrations and may be used for amebic abscesses that fail initial therapy with metronidazole.
Rare reactions include hemolysis in glucose-6-phosphate dehydrogenase (G6PD)-deficient persons, impaired hearing, confusion, and psychosis.
Large i.m. injections or rapid i.v. infusions of chloroquine can result in severe hypotension, cardiac and respiratory arrest.
Chloroquine is contraindicated in patients with psoriasis or porphyria.
Emetine and Dehydroemetine are alkaloids derived from ipecac.
They are effective against tissue trophozoites of E. Histolytica.
Their use is limited due to significant toxicity concerns.
Serious toxicities include cardiac arrhythmias, heart failure, and hypotension.
Pentamidine has activity against trypanosomatid protozoans, but toxicity is significant.
It is only used parenterally.
Pentamidine is used for pneumocystosis, African trypanosomiasis, and leishmaniasis.
Adverse effects of pentamide include hypotension, tachycardia, dizziness, dyspnea, and pancreatic toxicity.
Sodium stibogluconate is a pentavalent antimonial.
It's used as a first-line agent for cutaneous and visceral leishmaniasis.
Toxicity of stibogluconate increases over the course of therapy.
Most common side effects are GIS symptoms. Hemolytic anemia, serious liver, renal and cardiac effects are rare.
Nitazoxamide is approved for Giardia Lamblia.
Its mechanism of action is unknown but it appears to have activity against metronidazole-resistant protozoal strains.
Suramin is the first-line therapy for early hemolymphatic East African trypanosomiasis.
Immediate reactions can include GIS symptoms, seizures, and death.
Later reactions include fever, rash, paresthesias, and agranulocytosis.
Melarsoprol is a trivalent arsenical.
It is first-line therapy for advanced CNS East African trypanosomiasis.
It is extremely toxic, with reactive encephalopathy as the most important toxicity.
It is probably due to disruption of trypanosomes in the CNS.
Eflornithine is an inhibitor of ornithine decarboxylase; used for advanced West African trypanosomiasis.
Adverse effects include GIS symptoms, anemia, thrombocytopenia, leukopenia, and seizures.
Nifurtimox is a nitrofuran; most commonly used drug for American trypanosomiasis (Chagas's disease).
Benznidazole is an orally administered nitroimidazole used in the treatment of Chagas' disease.
Amphotericin is an antifungal drug used as an alternative treatment for visceral leishmaniasis.
Miltefosine is the first effective oral drug for visceral leishmaniasis.
It has excellent efficacy.
Paromomycin sulfate is an aminoglycoside antibiotic used for visceral leishmaniasis which is approved.
Helminths (worms) are multicellular organisms infecting humans causing various diseases.
Albendazole is a broad-spectrum oral anthelminthic drug, a benzimidazole carbamate.
Benzimidazoles inhibit microtubule synthesis in nematodes.
Albendazole is administered on an empty stomach for intraluminal parasites but with a fatty meal for tissue parasites.
Clinical uses for albendazole include ascariasis, trichuriasis, hookworm and pinworm infections, hydatid disease, and neurocysticercosis.
Adverse effects of albendazole, when used 1–3 days, are mild and transient (GIS symptoms, dizziness, insomnia).
Long-term use may require monitoring of blood counts and liver function.
Bithionol is an alternative treatment for fascioliasis (sheep liver fluke).
Its adverse effects are generally mild and transient, including diarrhea, nausea, vomiting, dizziness, and headache.
Diethylcarbamazine citrate is a synthetic piperazine derivative used for treating Wuchereria bancrofti, Brugia malayi, Brugia timori, and Loa loa.
Adverse effects are mild and transient, including headache, malaise, anorexia, and dizziness.
Doxycycline is a tetracycline antibiotic that has significant macrofilaricidal activity against W. Bancrofti.
Ivermectin paralyzes nematodes and arthropods by intensifying GABA-mediated transmission in peripheral nerves.
Ivermectin is indicated for the treatment of onchocerciasis and strongyloidiasis.
Some patients may develop corneal opacities.
Mebendazole is a synthetic benzimidazole with wide-spectrum antihelminthic activity acting by inhibiting microtubule synthesis.
It's indicated for ascariasis, trichuriasis, hookworm, and pinworm infections.
Mild gastrointestinal (GI) symptoms may occur as adverse effects.
Metrifonate is a low-cost alternative drug for treating Schistosoma haematobium.
Its action relates to cholinesterase inhibition.
Adverse effects include mild and transient cholinergic symptoms (nausea, vomiting, diarrhea, bronchospasm, fatigue, vertigo).
Niclosamide is a second-line drug for most tapeworm infections, such as T. saginata and T. solium.
Oxamniquine replaces praziquantel for Schistosoma mansoni treatment.
Common adverse effects include CNS symptoms (dizziness, headache, drowsiness).
Piperazine is an alternative treatment for ascariasis, causing paralysis by blocking acetylcholine at the myoneural junction.
Occasional mild adverse effects include gastrointestinal symptoms.
Praziquantel is effective for treating schistosome infections of all species.
It increases the permeability of cell membranes to calcium, resulting in death.
It is also used for taeniasis, neurocysticercosis, and hydatid disease.
Pyrantel pamoate is a broad-spectrum antihelminthic drug used for pinworm and ascariasis infections.
It has neuromuscular blocking effects, causing worm paralysis.
Thiabendazole is an alternative to ivermectin or albendazole for treating strongyloidiasis and cutaneous larva migrans.

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Description

Test your knowledge on the treatment methods and drugs associated with amebic infections, including Entamoeba histolytica and Schistosoma haematobium. This quiz covers mechanisms of action, adverse effects, and the effectiveness of various medications used in these conditions.