Fungal & Protozoa Flashcards
(41 cards)
1
Q
- Histoplasmosis
- Coccidioidomycosis
- Cryptococcoisis
- Blastomycosis
- Paracoccidioidomycosis
- Sporotrichosis
A
Systemic mycoses caused by pathogenic fungi
2
Q
- Candida albicans
- Aspergillus species
- Trichosporon
- Candida glabrate
- Fusarium
- Alternaria
- Mucor.
A
Opportunistic fungi
3
Q
MOA:
- Selectively toxic to fungi
- Interacts w/ or inhibits the synthesis of ergosterol
- A sterol unique to fungal cell membranes
A
Antifungal agents
4
Q
What are the 2 targets for antifungal drugs?
A
- cell membrane
- cell wall
5
Q
Susceptibility Activity of which drugs?
- Candidemia
- Aspergillus
- Blastomyces
- Cryptococcus
- Coccidioides
- Histoplasma
- Mucormycosis
A
- Amphotericin B
- Azoles
- Ketoconazole
- Fluconazole* (prototype)
- Itraconazole
- Posaconazole
- Voriconazole
6
Q
Which drug?
- Binds to ergosterol in fungal cell membranes forming “leaky pores”
- Tx Candidemia
- Nephrotoxicity is dose-limitng, additive w/ other nephrotoxic drugs
- Infusion rxns (Chills, fever, muscle spasms, hypotension)
A
Amphotericin B
“Amphoterrible”
7
Q
Which drug?
- Interferes w/ DNA & RNA synthesis selectively in fungi
- Tx Cryptococcus and chromoblastomycosis infections
- Toxcities: renal excretions & myelosuppression
A
Flucytosine
8
Q
MOA of Azoles as antifungals
- Ketoconazole
- Fluconazole
- Itraconazole
- Posaconazole
- Voriconazole
A
Inhibit fungal P450 dependent enzymes blocking ergosterol synthesis
- Resistance can occur w/ long-term use
9
Q
What are the 3 clinical applications of Azoles
A
- Aspergillosis
- Blastomycosis
- Mucormycosis
10
Q
- Azoles have various topical & oral forms for ____.
- Oral & parenteral forms for _____
A
- dermatophytoses
- mycoses
11
Q
- Most azoles undergo ____ metabolism.
- ______ eliminated in urine unchanged.
A
- hepatic
- Fluconazole
12
Q
- ______ is rarely used in systemic fungal infections owing to its inhibition of hepatic and adrenal P450s
- Other azoles are less toxic, but may cause which 2 sxs?
- _____ causes visual disturbances & class D for pregnancy risk
A
- Ketoconazole
- GI upsets & rash
- Voriconazole
13
Q
Which drug?
- Inhibits epoxidation of squalene
- Tx for mucocutaneous fungal infections (accumulates in keratin)
- Oral: long duration of action (weeks)
- Toxicities: GI upsets / HA
A
Terbinafine
14
Q
- What is the 1st line tx for Aspergillus species?
-
What is the 1st line tx for:
- Balstomyces
- Candida
- Cryptococcus
- Coccidioides immitis
- Histoplasma
- Mucoraceae
- Sporothrix
A
- Voriconazole
- Amphotericin B (if this is not an option choose an Azole)
15
Q
Which 3 antifungals cause Nephrotoxicity?
A
- Amphotericin B
- IV Itraconazole
- IV Voriconazole
16
Q
Which 4 antifungals cause abdominal discomfort?
A
- Fluconazole
- Itraconazole
- Voriconazole
- Posaconazole
17
Q
Which antifungals cause increased hepatic transaminases?
A
All 6:
- Amphotericin B
- Fluconazole
- Itraconazole
- Voriconazole
- Posaconazole
- Echinoconazole
18
Q
Which antifungals cause Rash & photosensitivity?
A
- Fluconazole
- Itraconazole
- Voriconazole (Vori-Malignancy)
- Posaconazole
- Echinoconazole
(All except Amphotericin B)
19
Q
Which 2 antifungals cause Infusion related reactions/Histamine release?
A
- Amphotericin B
- Echinoconazole
20
Q
Which antifungal causes CNS & visual disturbances?
A
- Voriconazole
21
Q
Which antifungals cause Cardiomyopathy?
A
- Fluconazole
- Itraconazole
- Voriconazole
- Posaconazole
- Echinoconazole?
NOT ampho
22
Q
The treatment for ____ actually made the condition worsen. Go to CDC website to find out what to give patients for tx.
A
Malaria
23
Q
What tx?
- Used to tx infections caused by protozoa (single cell organisms that belong to type of parasites)
- Occur throughout the world
- Major cause of morbidity and mortality in some regions such as ____ & South-East Asia.
A
Antiprotazoal Treatments
24
Q
What are the 3 diseases caused by protazoa?
A
- Malaria
- Giardia
- Trichomoniasis
25
What is special about the treatment of malaria?
They are used to both TREAT and PREVENT malaria
26
What are the 4 antimalarial drugs?
* Mefloquine
* Chloroquine
* Atovaquone-proguanil (Malarone)
* Doxycycline
* Pimaquine
27
What is the MOA of antimalarial drugs?
Kill / inhibit growth of protozoa by affecting different stage of parasitic life cycle
28
**Prevention of Malaria**
* Choice of drugs is based on what?
Destinations visiting
29
**Which Tx of Malaria?**
* Treatment & chemoprophylaxis of infections w/ sensitive parasites
Chloroquine
30
**Which tx of Malaria?**
* Chemoprophlaxis & tx of infections w/ P falciparum
* Mefloquine
* Atovaquone-proguanil (Malarone)
31
**Which tx of Malaria?**
* Radical cure and terminal prophylaxis of infections w/ Plasmodium vivax and Plasmodium ovale; alternative for malaria chemoprophylaxis
Primaquine
32
**Which tx of malaria?**
* Treatment (with quinine) of infections w/ P falciparum; chemoprophylaxis
Doxycycline
33
* GI upset, so give w/ Cola
* Photosensitivity
* Can give to children if duration is \<21 days
Doxycycline
34
**Which Malaria drug?**
* Dyspepsia
* Insomnia
* Vivid dreams\*
* Use w/ caution in pts w/ epilepsy, szs, depression, or other mental health problems, severe heart or liver problems
Mefloquine
35
**Which Antimalarial tx?**
* Convulsions
* Visual disturbances
* Depigmentation or loss of hair
* Use w/ caution in pts w/ neurological disorders (myasthenia gravis), glucose-6-phosphate dehydrogenase deficiency (which helps RBCs function), liver & renal problems
Chloroquine
36
**Which antimalarial tx?**
* Insomnia & "abnormal" dreams
* Depression\*
* Should not be given to pregnant or breastfeeding women
* Not recommended for pts w/ severe kidney problems
Atovaquone-proguanil (Malarone)
37
**Which antimalarial tx?**
* N/V/D
* Causes yellow teeth and teeth disfigurement if taken during development
* Should not be given to pregnant/breastfeeding women & children under 8 yrs
* Avoid taking w/ antacids, milk , Ca, or Mg salts
* Photosensitivity may occur
* Avoid prolonged sunligh exposure and use appropriate sunscreen
Doxycylcine
38
What is the tx for Giardia lamblia?
* Metronidazole
39
Tx for Leishmaniasis
* Cutaneous is spread by what?
Sodium stibogluconate
* Sandflies
40
Protozoa tx for pregnancy
Spiramycin (daiy until delivery)
41
Protozoa tx for Trichomonas vaginalis
Metronidazole
