Question 1

Identify a true statement about antimalarial drugs.

Accepted Answer

Pyrimethamine and mefloquine have a special cautionary (black box) warning on the label. Pyrimethamine and mefloquine have been associated with Stevens-Johnson syndrome. This is a severe inflammatory reaction where lesions on the skin and mucous membranes cause the patient's eyes to be swollen and pruritic, and the patient may not be able to swallow.

Question 2

Which of the following is a true statement about malaria?

Accepted Answer

Normally, the malaria protozoal parasite inhabits the salivary glands of the Anopheles mosquito. When the mosquito bites an individual, the parasite is injected directly into the human bloodstream.

Question 3

Allen is taking Flagyl for the treatment of trichomoniasis.Which of the following cautions should Allen take?

Accepted Answer

The drug of choice used to eradicate Trichomonas vaginalis is metronidazole (Flagyl) or tinidazole (Tindamax). The usual side effects of these drugs include nausea, diarrhea, vaginal and urethral burning, and headache. These drugs produce a disulfiram reaction with alcohol, so that patients should be cautioned to avoid alcohol consumption during treatment (this includes OTC products with any alcohol content).

Question 4

A patient with a tapeworm infestation has been admitted to the hospital.The patient also has a low blood count.Which of the following is most likely to be suspected by the health-care professional?

Accepted Answer

Hookworms and tapeworms are especially dangerous because these parasites can perforate the intestinal membranes, resulting in loss of blood, anemia, and hemorrhage. When diagnosed early, most parasitic worm infestations are confined to the intestinal tract.

Question 5

Which of the following can be best defined as a thick-walled structure in which parasitic protozoal sex cells develop for transfer to new hosts?

Accepted Answer

An oocyst is a thick-walled structure in which parasitic protozoal sex cells develop for transfer to new hosts.

Question 6

Which of the following drugs may produce cinchonism in sensitive individuals?

Accepted Answer

Quinine may produce cinchonism in sensitive individuals. Cinchonism, a symptom complex characterized by central nervous system (CNS) stimulation, ringing in the ears, and headache, is derived from cinchona, the South American tree from which quinine is obtained.

Question 7

Which of the following drugs has been associated with the production of central nervous system (CNS)stimulation,amnesia,peripheral neuropathy,and optic atrophy,which can be permanent?

Accepted Answer

The quinoline derivatives, chloroquine and others, are probably the most toxic agents in this class. These drugs have been associated with the production of CNS stimulation, amnesia, peripheral neuropathy, and optic atrophy, which can be permanent.

Question 8

Tracy has been diagnosed with malaria and has been prescribed a quinoline for her treatment.Which of the following is true of her case?

Accepted Answer

Patients should be instructed to take these medications at the same time every day whenever possible. For drugs taken more than once daily, the dosing intervals should be evenly spaced. Explain that stopping this medication too early may allow the parasites to continue to grow, which may result in a relapse of the infection. Patients must be told to complete the full course of treatment even if symptoms disappear after a few doses. In order to ensure optimum compliance with the treatment schedule, patients can be instructed to take these drugs with meals. This will minimize any gastric irritation.

Question 9

Which of the following statements is true about Giardia lamblia?

Accepted Answer

Giardia lamblia is a flagellated protozoan that resides in the intestine of humans, cats, dogs, and rural wildlife. The waterborne organisms can exist even in chlorinated water that is not adequately filtered.

Question 10

Eva has been diagnosed with malaria.She has also been on rifampin treatment for tuberculosis.Her physician prescribes Qualaquin for treating malaria and asks her to interrupt the rifampin doses because it may:

Accepted Answer

Drugs that decrease the clearance of antiprotozoal drugs, such as cimetidine, increase the blood levels and predispose the patient to possible adverse effects. Cimetidine treatment may be interrupted until the protozoal infection is stabilized. Conversely, antibiotics such as rifampin may induce hepatic metabolism of the quinolines and quinine and therefore reduce their effectiveness.

Question 11

The adverse effects of anthelmintic drugs include _____.

Accepted Answer

Many anthelmintic drugs are derivatives of antimony, which is usually well tolerated by human hosts. The common adverse effects include nausea, fever, headache, cramps, and diarrhea. Tinnitus, hypotension, and paresthesia also have been reported.

Question 12

Identify an accurate statement about the pharmacokinetics of drugs effective in the treatment of dysentery.

Accepted Answer

Metronidazole is metabolized in the liver to active trichomonicidal conjugates. Therefore, the drug may accumulate in patients with severe liver disease. These patients must be monitored more closely; however, the drug can be given. The major route of metronidazole elimination is the urine.

Question 13

The adverse effects of the drugs available for the first-line treatment of Giardia lamblia include _____.

Accepted Answer

Three drugs are available for the first-line treatment of Giardia lamblia: metronidazole (Flagyl), nitazoxanide (Alinia), and tinidazole (Tindamax). Usually the medications are well tolerated, but adverse effects may include dizziness, headache, diarrhea, nausea, stomach pain, loss of appetite, constipation, changes in taste (dysgeusia), and dry mouth.

Question 14

Jacob has been prescribed mefloquine as a treatment for malaria.His physician should caution him about:

Accepted Answer

Patients should be instructed to use caution when driving, operating equipment, or performing tasks requiring coordination and dexterity because quinine and mefloquine may cause blurred vision, dizziness, and confusion.

Quiz 43: Antiprotozoal and Anthelmintic Drugs