Fungal infection + malaria

Question 1

Aspergillosis is treated with what antifungal?

Answer 1

Voriconazole or Amphotericin

Question 2

examples of the Triazoles

Answer 2

Fluconazole, Itraconazole, posaconazole and voriconazole

Question 3

Which triazole can be purchased OTC for candidia infection?

Answer 3

Fluconazole to those age 16 - 60 years max dose of 150mg

Question 4

What is a side effect of Fluconazole

Answer 4

QT prolongation

Question 5

Whihc triazole is more widely associated with liver damage?

Answer 5

Itraconazole - avoid in pt wiht liver disease

Question 6

High doses and long duration of treatment with itraconazole is associated with what?

Answer 6

Heart failure

Question 7

How should itraconazole capsules and solution be taken?

Answer 7

Solution - empty stomach

Capsules - with food

Question 8

Examples of imadzoles

Answer 8

Clotrimazole, miconazole, ketoconazole. econazole

Question 9

What are the imidazoles used for?

Answer 9

local treatment of vaginal candidiasis and dermatophyte infection
Miconazole is used in oral infection

Question 10

What drug does Miconazole interact with

Answer 10

Warfarin

Question 11

Examples of polyene antifungals

Answer 11

Amphotericin and nystatin

Question 12

Echinocandin antifungal examples

Answer 12

Caspafungin and Micafungin

Question 13

Drug of choice in nail infection/ringworm infection

Answer 13

Terbinafine

Question 14

What electrolytes can become derranged with Amphotericin B

Answer 14

HypoK + hypoMG

Question 15

What are 2 major side effects with Voriconazole

Answer 15

Hepatotoxcity and Photosensitivity

Question 16

What is given as an adjunct to co-trimox in HIV patients wiht PCP?

Answer 16

Pred for 5 days

Question 17

If a patient has threadworm what is the treatment?

Answer 17

All members of the family to be treated!

- Mebendazole ( a single dose given then can be repeated after 2 weeks)

Question 18

How are roundworm treated>

Answer 18

Mebendazole

Question 19

Niclosamide can be used to treat which Helminth infection

Answer 19

Tapeworm

Question 20

What drug is used to treat norwegian scabies?

Answer 20

Ivermectin 200mcg/kg

Question 21

Malaria bite prevention counselling points

Answer 21

• NET impregnated with permethrin
• DEET 20-50% (apply sunscreen first)
• Long sleeves/trousers

Question 22

If Doxycycline is being used for malaria propyhlaxis, how should it be taken?

Answer 22

1 - 2 days before entering and 4 weeeks after leaving

Question 23

What side effects make Mefloqunine undesirable to be used?

Answer 23

Psychosis, sucidal idealation

Question 24

Mefloquine has to be taken how long before travel?

Answer 24

2-3 weeks

Question 25

How long does malarone have to be taken after travel?

Answer 25

1 week

Question 26

What antimalarial can be offered to a pregnant lady?

Answer 26

Chloroquine + proguanil (give 5mg folic acid)

-Doxy CI

Question 27

How long are most antimalarials used for when leaving the area?

Answer 27

4 weeks

Question 28

Which antimalarials can not be used in epilepsy

Answer 28

Chloroquine and mefloquine

Question 29

What should patients on Warfarin be advised if starting antimalarials?

Answer 29

Start taking 2-3 weeks before departure and ensure INR stable before leaving. Check INR 7 days after starting and when completing course

Question 30

What is first line TREATMENT of falciparum malaria

Answer 30

Riamet (artemether + lumefantrine) given at 8,24,36,48 and 60 hours

Question 31

If a patient cannot tolerate treatment with Riamet, what alternative can be used?

Answer 31

Quinine 600mg TDS + Doxy 200mg OD (or clindamycin 450mg TDS if pregnant) for 7 days

Question 32

What is the treatment option for Non-falciparum malaria?

Answer 32

Chloroquine