Pharmacotherapeutics IV-Parasitic infections
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- Malaria is transmitted by what vector?
- Anopheles mosquito
- What is the hallmark of malaria?
- cyclic fevers (q48-72hours)
- The "hot" phase lasts several hours and coincides with what?
- rupture of schizonts
- Diagnosis of malaria
-
1. blood smears q12-24hours x3 days
2. DNA and RNA probes - Malaria prophylaxis
- Chloroquine
- Malaria prophylaxis if area of travel has endemic Plasmodium vivax or P. ovale
- Add primaquine for 14 days beginning last 2 weeks of chloroquine prophylaxis
- Malaria prophylaxis in areas with chloroquine resistant P. falciparum
- Mefloquine
- Malaria preferred therapy (except P. falciparum)
- Chloroquine
- Malaria preferred therapy if unable to take PO (except P. falciparum)
- Quinidine gluconate until able to take PO quinine
- Malaria therapy for P. falciparum
-
a. Mefloquine
b. Atovaquone - Clinical presentation of Amebiasis
-
-Bloody diarrhea w/ mucus
-abdominal pain
-liver abscess - Amebiasis diagnosis
-
1. Eosinophilia usually absent
2. E. histolytica or trophozites in fresh stool
3. ELISA (mabs) - Amebiasis treatment for minimal symptoms
-
1. Metronidazole
2. Iodoquinol
3. Paromomycin - Amebiasis treatment for moderate to severe symptoms
-
Metronidazole
FOLLOWED BY:
a. iodoquinol
b. paramomycin - Giardiasis clinical presentation acute and chronic
-
A: Diarrhea, cramp-like abd.pain
C: Large amounts of stool; foul-smelling, light-colored, and fatty; weight loss; Vitamin ADEK and B12 deficiency - Giardiasis diagnosis
-
1. fresh stool culture show trophozites
2. preserved stool show cysts
3. MAB
4. Nylon string test - Giardiasis treatment
-
>8years= metronidazole
<8years= metronidazole (albendazole 2nd line) - Leishmaniasis vector
- Sandfly
- Leishmaniasis clincial presentation
-
Visceral, Cutaneous, or mucocutaneous
V: papule which ulcerates -> dissemination -> abd distension, hepatosplenomegaly, fever, chills
C: raised ulcer persists for months to years
M: mutilating infections involve nose, soft palate, trachea - Leishmaniasis diagnosis
- Leishmaniasis in TISSUE or BONE
- Lesihmaniasis treatment
- Sodium stibogluconate
- American Trypanosomiasis (Chaga's disease) transmitted by what?
- Reduviid bug
- American Trypanosomiasis clinical presentation
-
-Unilateral orbital edema
-Granuloma or Chagoma at site of entry
Chronic:
-cardiomyopathy
-CHF
-CNS dx
-Uncoordinated peristalsis - American Trypanosomiasis diagnosis
-
1. finding trypanosoma cruzi
2. ELISA
3. Complement fixation - American Trypanosomiasis treatment
- Nifurtimox
- Helminthic diseases- HOOKWORM clinical presentation
-
-IRON DEFICIENCY ANEMIA 2ndary to blood loss and malabsorption of iron
-Abd pain
-diarrhea - HOOKWORM diagonsis
- direct fecal smear to examine for eggs
- HOOKWORM treatment
-
a. Albendazole
b. Mebendazole - Helminthic diseases- ASCARIASIS clincial presentation
-
-Pulmonary sxs
-GI obstruction
-Malabsorption - ASCARIASIS diagnosis
- direct fecal smear to examine for eggs
- ASCARIASIS treatment
-
a. Albendazole
b. Mebendazole - Helminthic infections- ENTEROBIASIS clinical presentatio\n
-
-PERIANAL IRRITATION/ITCHING
-2NDARY BACTERIAL INFECTION - ENTEROBIASIS diagnosis
- Perianal swab using scotch tape then examine for eggs
- ENTEROBIASIS treatment
-
a. Pyrantel pamoate
b. Mebendazole
c. Albendazole