Questions – Antiprotozoal and Anthelmintic Drugs

by Pravin Shukle, MD

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    00:00 Okay, let's take a look at a question here.

    00:04 The President returns from a first trip to Cuba.

    00:08 First time a president has visited Cuba in 50 years.

    00:12 He presents with fevers, dehydration and nausea.

    00:14 A blood smear shows plasmodium falciparum schizonts.

    00:18 The following drugs are schizonticides except: Choloroquine dihydroarteminisin Quinine Halofantrine Sulfonamides You chose halofantrine.

    00:40 Which drug would be effective in treating amebiasis in the liver? Diloxanide furoate Iodoquinol Paromomycin Metronidazole Good, you chose metronidazole.

    01:03 So remember metronidazole is particularly effective in systemic infection and it's effective in the liver.

    01:09 And we treat severe intestinal infections and liver abscess is the same with respect to amoeba type infections.

    01:20 The principle behind amebicidal therapy is understanding where each drug works.

    01:25 The first three drugs are luminal amebicides.

    01:29 They stay in the lumen of the gut and work very well there.

    01:32 If the infestation is at the luminal surface that is.

    01:35 Once the organism becomes systemic, metronidazole would be the logical choice.

    01:40 As it's activated by anaerobes and it's very, very effective in hepatic tissues.

    01:48 While on mission with Medecins sans Frontieres or Doctors without Borders, you see a young boy with a strange lump in his retina.

    01:56 It is a small cyst with a hard center.

    02:06 What would be the appropriate treatment for that finding? Niclosamide Praziquantel Mebendazole Albendazole.

    02:18 Good, you chose aldbendazole.

    02:19 So the image is a typical presentation of retinal cysticercosis.

    02:25 The larval stage of pork tapeworm.

    02:28 Niclosamide does not kill pork tapeworm in this stage.

    02:32 It only kills it in the cestode stage.

    02:35 Praziquantel should never be used in ocular cysticercosis because the destruction of the organism can actually cause permanent ocular lesions.

    02:46 Mebendazole is not systemically absorbed to any great a deal any great degree and it's therefore not a great choice.

    02:54 Albendazole is the drug of choice in ocular cysticercosis.

    03:00 That's it.

    03:02 You made it through this lecture.

    03:03 You did really well.

    03:05 I'm glad to say that nobody got sick looking at these wonderful pictures.

    03:09 And you made it through our pharmacology lecture.

    03:10 So kudos to you.

    03:12 Go write your exam.

    03:13 Show them what you know.

    About the Lecture

    The lecture Questions – Antiprotozoal and Anthelmintic Drugs by Pravin Shukle, MD is from the course Antimicrobial Pharmacology.

    Author of lecture Questions – Antiprotozoal and Anthelmintic Drugs

     Pravin Shukle, MD

    Pravin Shukle, MD

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