Malaria and Quinine Quiz

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Questions and Answers

Which infectious disease has the highest case fatality rate?

Nipah virus

Rabies (correct)

Ebola haemorrhagic fever

H5N1 avian influenza

In 2023, what percentage of global malaria deaths occurred in the WHO African Region?

85%

91%

76%

95% (correct)

What is the primary method of transmission for malaria?

Contaminated water sources

Airborne pathogens

Direct contact with infected individuals

Bites from infected female Anopheles mosquitoes (correct)

What is the genus of the plant that produces the medicinally active bark containing quinine?

Cinchona Signup and view all the answers

Besides quinine, what other alkaloid is found in the bark of the Cinchona tree?

Quinidine Signup and view all the answers

Which of these diseases is responsible for the most deaths historically across the world?

Malaria Signup and view all the answers

According to the information, what was the significance of the countess of Chinchón?

She was the first European cured of malaria with Cinchona bark. Signup and view all the answers

What concept was conceived of by Dr. Samuel Hahnemann after experimenting with Cinchona bark?

Homeopathy Signup and view all the answers

What is the believed cause of Hahnemann's symptoms?

A hypersensitivity to Cinchona bark Signup and view all the answers

Who was awarded the Nobel Prize for discovering the motile parasite associated with malaria?

Alphonse Laveran Signup and view all the answers

Which of the following is NOT a known property of quinine?

Anti-bacterial Signup and view all the answers

Who first isolated quinine from the cinchona tree?

Pierre Joseph Pelletier and Joseph Caventou Signup and view all the answers

What did William Henry Perkin attempt to use to synthesize quinine?

N-allyl toluidine Signup and view all the answers

In 1918, what did Rabe and Kindler synthesize quinine from?

Quinidinone Signup and view all the answers

What is the primary method by which paracetamol reduces fever and pain?

By reducing the oxidized form of the COX enzyme in the brain. Signup and view all the answers

Which of the following is NOT a direct mechanism of paracetamol's action as described in the text?

Directly inhibits uptake of anandamide by neurons. Signup and view all the answers

What is the role of acetylcysteine in the treatment of paracetamol overdose?

To replenish the liver's supply of glutathione. Signup and view all the answers

Which of the following enzyme systems is primarily responsible for metabolizing paracetamol?

Hepatic cytochrome P450 enzyme system. Signup and view all the answers

What is the toxic metabolite produced during the metabolism of paracetamol, and how it is normally detoxified?

NAPQI, normally detoxified by combining with glutathione. Signup and view all the answers

Which of the following regarding paracetamol synthesis is NOT correct?

4-aminophenol is reacted with acetic acid. Signup and view all the answers

Which of the following is a minor metabolite of paracetamol?

NAPQI Signup and view all the answers

What is a potential symptom of an untreated paracetamol overdose?

Acute liver failure. Signup and view all the answers

Which research finding prompted further investigation into the synthesis of quinine?

Stork questioning the validity of a previously established synthesis of quinine. Signup and view all the answers

The synthesis of racemic vinylic gamma-lactones by Kondo and Mori in 1974 was significant because it:

Provided a key starting material for Stork’s synthesis of quinine. Signup and view all the answers

Which of these correctly states the conclusions of Seeman in the 36-page review?

The Woodward–Doering/Rabe–Kindler total synthesis of quinine was valid. Signup and view all the answers

Which compound was found to cause methaemoglobinemia as a serious side effect?

Acetanilide Signup and view all the answers

Which of the following is NOT a proprietary name for paracetamol?

Amodiaquine Signup and view all the answers

The different names for paracetamol such as 'N-acetyl-para-aminophenol', 'acetaminophen', and 'paracetamol' are primarily due to:

Different naming conventions used by various organizations Signup and view all the answers

What was the primary contribution made by Julius Axelrod and Bernard Brodie in 1948?

They demonstrated that acetanilide is metabolized to paracetamol. Signup and view all the answers

What was the importance of the work of Ishibashi & Taniguchy in 1988?

They resolved racemic lactones to enantiopure compounds via chiral resolution. Signup and view all the answers

Study Notes

Medicinal Chemistry Introduction

CH456 Medicinal Chemistry course, 2025, by James H. Gerlach

The Five Deadliest Infectious Diseases

Rabies: essentially 100% case fatality rate
Ebola hemorrhagic fever: 83% case fatality rate
Marburg hemorrhagic fever: 80% case fatality rate
H5N1 avian influenza: ~60% case fatality rate
Nipah virus: 40% to 70% case fatality rate

Measured in Disability-Adjusted Life Years (DALYs)
DALYs account for both years of life lost and years lived with disability
One DALY equals one lost year of healthy life
Cardiovascular diseases account for a significant portion of the total burden

Cardiovascular diseases, cancers, and musculoskeletal disorders are major contributors to the total burden of disease

Disease Burden from Communicable, Maternal, Neonatal and Nutritional Diseases, World

Estimated disease burden in Disability-Adjusted Life Years (DALYs) per year.
Data shows trends over time, with different diseases contributing more or less over the years

Disease Burden from Communicable, Maternal, Neonatal and Nutritional Diseases, Canada

Estimated disease burden in Disability-Adjusted Life Years (DALYs) per year.
Shows trends over time, with different diseases contributing differently over the years

Deaths from Infectious Diseases, 1980 to 2021, World

Estimated annual death toll from HIV/AIDS, diarrhea, malaria, respiratory, and other infectious diseases.
Overall trend is downward since 1980

Deaths from Infectious Diseases, 1980 to 2021, Canada

Estimated annual death toll from HIV/AIDS, diarrhea, malaria, respiratory, and other infectious diseases.
Overall trend is upward since 1980

Global Trends in Estimated Number of TB Deaths and Mortality Rate, 2000-2020

Data presented in a graphical format showing trends in TB deaths and mortality rates.
Includes total TB, HIV-negative, and HIV-positive breakdowns.

The Deadliest and Most Communicable Diseases

Chart visualising various diseases based on case fatality rate and basic reproduction number (Ro)
Infectious diseases are categorized based on primary transmission method and their mortality rate

Malaria is the Disease Responsible Historically for the Most Worldwide Deaths

Malaria is a life-threatening disease caused by parasites.
Transmission occurs through infected female Anopheles mosquitoes.
Preventable and curable, with estimated 263 million cases and 597,000 deaths in 2023.
WHO African Region carries a disproportionate share of the global malaria burden.
Children under 5 are significantly affected (76% of deaths in the Region in 2023).

Countries with Indigenous Cases of Malaria in 2000 and Their Status by 2023

Detailed map visualization of malaria cases in different countries

Quinine

Cinchona bark contains quinine (anti-malarial) and quinidine (anti-arrhythmic) alkaloids.
The first European cured of malaria fever, possibly, was the wife of the Spanish Viceroy of Peru.
In 1753, the Peruvian bark was named Cinchona after the countess.

Homeopathy and Cinchona

Homeopathy's origins are connected to Cinchona bark testing.
Samuel Hahnemann, founder of homeopathy, felt symptoms from an overdose of Peruvian bark.

Discovery of the Malaria Parasite

Alphonse Laveran, a French military doctor, discovered a motile parasite in infected patients' blood in Algeria in 1878.
He was awarded a Nobel Prize in 1907.

Quinine Properties

Natural white crystalline alkaloid
Antimalarial, analgesic, antipyretic and anti-inflammatory properties
Bitter taste, used in gin and tonic

Quinine Total Synthesis

Hundreds of years of efforts to synthesize quinine.
Various chemists and researchers discovered methods and processes to isolate and synthesize quinine over time

Woodward-Doering Quinine Synthesis

Detailed account of different chemist's approaches to achieve quinine total synthesis.
Discussion on experimental challenges

Stork Stereoselective Quinine Synthesis

Different steps involved in achieving synthesis

Chloroquine (1934) and Amodiaquine (1948) are related antimalarial drugs.
Chemical structures are presented and years of development are noted

Paracetamol (Acetaminophen)

IUPAC name: N-(4-hydroxyphenyl)-acetamide
Other chemical names: N-acetyl-para-aminophenol, APAP, para-acetamidophenol
International Nonproprietary Name (INN): Paracetamol

What's the origin of these names?

Different names for paracetamol are presented and details on their origins

Julius Axelrod and Bernard Brodie Demonstrated Acetanilide is Metabolized to Paracetamol in 1948

Acetanilide, initially used for pain and fever.
Methaemoglobinemia, formed by this drug was a serious side effect, leading to liver and kidney damage.
Later research demonstrated that the body metabolized acetanilide to paracetamol.

Paracetamol Total Synthesis

Detailed description of steps in synthesizing paracetamol
Starting materials and chemical reactions

Paracetamol Mechanism of Action

Paracetamol acts via cyclooxygenase (COX) pathways and inhibits COX-3 enzyme.
Metabolised to AM404 and this may impact pain receptors.

Paracetamol Metabolism

Metabolised primarily through the liver.
Major metabolites are inactive and excreted in the urine.
NAPQI is a toxic metabolite and can damage the liver if not quickly detoxified.

Reactions Involved in Paracetamol Metabolism

Paracetamol is metabolized through reactions like glucuronidation and sulfation reactions.

NAPQI Toxicity

The toxic metabolite causing liver injury in paracetamol overdose.
Involved in covalent binding with proteins and nucleic acids.
Causes cellular and organism responses, leading to necrosis and liver injury.

Treating Paracetamol Overdoses

Toxic doses range from 4–15g.
Treatment includes administering acetylcysteine within 8 hours to replenish liver glutathione.
Without treatment, liver failure can occur.

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Description

Test your knowledge on the critical aspects of malaria, its transmission, and the medicinal history of quinine. This quiz explores historical facts, significant figures, and the properties of quinine related to malaria treatment. Challenge yourself and learn more about infectious diseases and their impact.