Antimalarials

Chloroguanide: alternative to mefloquine (Lariam)in areas of the world without widespread chloroquine (Aralen) resistance
1. true
2. false
Treatment of Toxoplasmosis:
1. pyrimethamine (Daraprim) plus trisulfapyrimidines
2. pyrimethamine (Daraprim) plus sulfadiazine
3. both
4. neither
Rationale for the use of leucovorin calcium in combination with pyrimethamine (Daraprim) +trisulfapyrimidines in treating Toxoplasmosis:
1. increases pyrimethamine (Daraprim) efficacy
2. decreases pyrimethamine (Daraprim) cardiotoxicity
3. decreases pyrimethamine (Daraprim) hematological toxicities
4. A & C
5. A, B & C
Adverse/Side effects due to chloroguanide, unless leucovorin calcium is concurrently administered
1. megaloblastic anemia
2. atrophic glossitis
3. agranulocytosis
4. A & C
5. A, B & C
Contraindications/cautions for pyrimethamine (Daraprim):
1. cautious use in the presence of renal dysfunction
2. cautious use in the presence of hepatic dysfunction
3. both
4. neither
Only known definitive host for the sexual stages of T. gondii (Toxoplasmosis gondii)-main resource of infection
1. dogs
2. rodents
3. birds
4. cats
5. mosquitoes
Human infection by T. gondii can be acquired by:
1. ingestion of the oocyst from fecally-contaminated hands or food
2. transplacental transmission
3. blood transfusion
4. A & C
5. A, B & C
Concerning an acquired infection with Toxoplasma in an immunocompetent individual:
1. most patients will exhibit a flu-like illness
2. Clinical course is usually benign and self limited-symptoms resulting within the few months to a year
3. both
4. neither
Concerning T. gondii infection in a patient with AIDS:
1. may exhibit myocarditis or pneumonitis
2. toxoplasmic encephalitis is the most common cause of intracerebral.l mass lesions
3. both
4. neither
Concerning sulfonamides & sulfones and antimalarial activity: the
1. Blood schizonticidal activity against P falciparum (some species)
2. Significant effects against blood schizonts of P vivax
3. Active against immunocytes or liver stages of P falciparumor P vivax
4. rapid onset of action
5. minimal side effects
pyrimethamine-sulfadoxine (Fansidar)-antimalarial characteristics:
1. effective against falciparum malaria (some strains)
2. for serious cases quinine (Quinamm) is given concurrently since pyrimethamine-sulfadoxine (Fansidar) activity develops slowly
3. effective against P vivax malaria
4. A & B
Antimalarial characteristics of quinine (Quinamm):
1. rapid onset
2. highly effective schizonticide against P vivax, P ovale, P falciparum, P. malariae
3. gametocidal for P vivax & P ovale
4. no effect on sprorozoites earlier stages of any parasite
5. all the above
Clinical uses: quinine (Quinamm)-
1. parenteral treatment for severe falciparum malaria
2. oral treatment for chloroquine (Aralen) resistant falciparum malaria
3. management with other drugs for acute P falciparum-chloroquine (Aralen) resistant malarial attacks
4. A & C
5. A, B & C
Quinine (Quinamm) clinical uses
1. nighttime leg cramps
2. management of babesiosis
3. both
4. neither
Adverse effects-quinine (Quinamm):
1. cinchonism
2. gastrointestinal effects
3. both
4. neither