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A - Pre Reg COPY > Fungal Infections and malaria > Flashcards

Fungal Infections and malaria Flashcards

1
Q

Is Fluconazole or Itraconazole more readily absorbed?

A

Fluconazole

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2
Q

What is amphotericin B used for?

A

Aspergillosis, blastomycosis, candidiasis, cryptococcosis

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3
Q

Does amphotericin B need to be prescribed by brand?

A

Yes

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4
Q

Name 7 antifungal drugs?

A 
Fluconazole
Ketoconazole
Itraconazole
Amphotericin B
Nystatin 
Voriconazole
Miconazole
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5
Q

What is the mechanism of action of antifungal drugs?

A

Fungal cells contain ergosterol (not found in human/animal cells), antifungals bind to ergosterol creating pores as well as inhibiting ergosterol synthesis.

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6
Q

What are the main side effects of fluconazole? (3)

A

1) Prolonged QT interval
2) Hepatotoxicity
3) Renal impairment

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7
Q

What patient groups should avoid fluconazole? (2)

A

1) liver disease

2) pregnancy (teratogenic)

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8
Q

Which antifungal’s are CYP450 inhibitors?

A

Fluconazole
Ketoconazole
Itraconazole

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9
Q

What drugs do antifungals interact with?

A

1) CYP450 substrates

2) QT prolonging drugs e.g amiodarone, antipsychotics, quinolones etc

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10
Q

What are the main side effects of Voriconazole?

A

Hepatotoxicity

Photosensitivity (check for malignancy and seek medical attention if sunburnt)

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11
Q

What must you carry if you are taking voriconazole?

A

An alert card

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12
Q

What is nystatin normally used for? what are the typical dosage instructions?

A

Oral thrush-100,000 units QD for 7 days

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13
Q

What age group can fluconazole 150mg be sold to the public OTC?

A

16-60 for candidiasis

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14
Q

What must you monitor in patients taking LT treatment of fluconazole?

A

Liver enzymes before and during treatment

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15
Q

What must you monitor when taking LT treatment of voriconazole?

A

Renal and hepatic function before starting and then at least weekly for one month and then monthly.
Check for malignancy and avoid sunlight.

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16
Q

Hepatotoxicity is also associated with another antifungal, please name it?

A

Ketoconazole

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17
Q

What are the general monitoring requirements for antifungals?

A

1) ECG
2) Adrenal function (can cause adrenal insufficiency)
3) Hepatic function

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18
Q

What is the most common cause of fungal meningitis?

A

Cryptococcal meningitis

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19
Q

Can you use Itraconazole in heart failure or history of heart failure?

A

AVOID

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20
Q

How would you treat fungal meningitis?

A

IV amphotericin followed by oral fluconazole

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21
Q

What are the 1st and 2nd line treatments for aspergillosis?

A

1) Voriconazole

2) Liposomal amphotericin (alternatives are itraconazole or caspofungin)

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22
Q

What is tinea capitis?

A

Fungal infection of the scalp

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23
Q

What antifungal can you use to treat tinea capitis?

A

Griseofulvin

24
Q

What is tinea pedis?

A

athletes foot

25
Q

Is topical or systemic therapy more effective for fungal nail infections?

A

Systemic

26
Q

What is a helminth infection?

A

Parasitic infection

27
Q

What are the symptoms of thread worm?

A

itching around the anus and vagina, weight loss

28
Q

What are the symptoms of whip worm?

A

Gi disturbance, colitis, bloody diarrhoea

29
Q

What are the symptoms of hookworm?

A

Very few symptoms except weight loss and anemia (rare)

30
Q

What are the symptoms of round worm?

A

High temperature, dry cough, worms in the stools

31
Q

What is the main treatment for helminth infection? and what are the criteria for sale OTC?
What are the side effects?

A

Mebendazole, can be sold OTC to >2 years old if package is labelled 100mg as a single dose.
Side effects: GI effects, SJS (rare)

32
Q

What is the treatment duration for malarone in malaria prophylaxis?

A

Start 1-2 days before and 1 week after

33
Q

What is the treatment duration for doxycyline in malaria prophylaxis?

A

Start 1-2 days before and for 4 weeks after

34
Q

What is the treatment duration for mefloquine in malaria prophylaxis?

A

Start 2-3 weeks before and for 4 weeks after

35
Q

What is the treatment duration for chloroquine and quinine and proguanil in malaria prophylaxis?

A

Start 1 week before and for 4 weeks after

36
Q

Which antimalarials cannot be used in epilepsy? (2)

A

Chloroquine and mefloquine

37
Q

Which antimalarials cannot be used in renal impairment? (2)

A

Proguanil (AVOID)

Malarone (AVOID in eGFR <30)

38
Q

Which antimalarials should you avoid in pregnancy? (3)

A

Doxycycline
Malarone
Proguanil (must take folic acid until 1st trimester)

39
Q

Which antimalarial is associated with occular toxicity?

A

Chloroquine

40
Q

What is the safest antimalarial in pregnancy?

A

Quinine

41
Q

Which antimalarial is CI in patients with history of psychiatric disorders?

A

Mefloquine (Stop seek medical attention if experience insomnia, depression, anxiety etc)

42
Q

Name two antiviral drugs used for influenza?

A

Oseltamivir and zanamivir

43
Q

Which antiviral drug is licensed for use within 48 hours of influenza onset?

A

Oseltamivir

44
Q

Which antiviral drug is licensed for use within 36 hours of influenza onset?

A

Zanamivir

45
Q

What is tinea cruris?

A

Fungal groin infection, itchy inflammation with a visible patch of dry scaly skin

46
Q

What is impetigo?

A

Red sores that quickly burst leaving a thick golden crust typically around 2cm across

47
Q

What are the symptoms of measles/rubella?

A

rash for 3 days and cold-like symptoms with red blotchy rash and kopilks spots in the mouth

48
Q

What are the symptoms of molloscum contagiousum?

A

small, firm, raised flesh coloured spots on the skin; thick yellowy-white substance released if popped

49
Q

What are the symptoms of tinea corporis?

A

(ring worm)- affects the arms and legs, round silvery patch of skin that may be scaly inflamed and itchy.

50
Q

What are the symptoms of scarlet fever?

A

Sore throat, headache, swollen glands, red rash that feels like sandpaper, red cheeks, white or red tongue

51
Q

What are the symptoms of mumps?

A

Swollen, salivary glands, fever, headache and joint pain (in adults)

52
Q

What are the symptoms of scabies?

A

Intense itching, rashes with tiny red spots, burrow marks can be seen as silvery coloured lines on the skin

53
Q

What are the symptoms of hand, foot and mouth disease?

A

Mouth ulcers after one or two days, soon after a rash made up of small raised red spots on the skin appear, the spots may turn in to grey blisters

54
Q

What are the symptoms of slapped cheek syndrome?

A

Bright red rash on the cheeks, temperature, sore throat, runny nose and headache

55
Q

What is the treatment for ACUTE non-complicated falciparum malaria?

A

Artemether with lumefantime

A - Pre Reg COPY (35 decks)

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