GI- Antibiotics And Anti-parastic Agents

Question 1

What are the three general things given to patients with an infection of cryptosporidium parvum

Answer 1

• Antidiarrheal agents
• Fluid management
• Antimicrobial agents

Question 2

What is the mechanism of action for ivermectin

Answer 2

Intensifies GABA transmission leading to inhibition of movement and paralysis

Question 3

What is the primary treatment for:

-A. Lumbricoides

Answer 3

Ivermectin

Question 4

What are the antimicrobial agent given for cryptosporidium parvum

Answer 4

Nitazoxanide or paromomycin

Question 5

What is the mechanism of action for praziquantel

Answer 5

Increases the permeability of nematode and cestode cell membranes to calcium, leading to paralysis, dislodgement, and death

Question 6

What is the alternate treatment for:

-S.Stercoalis

Answer 6

Albendazole

Question 7

What is the primary treatment for:

• N. americanus
• A. Duodenale

Answer 7

Albendazole

Question 8

What is the treatment for infection with the Schistosoma spp.

Answer 8

Praziquantel

Question 9

What is the alternate treatment for:

-T. Trichiura

Answer 9

Albendazole

Question 10

Of the three bendazoles, which is the worse

Answer 10

Thiabendazole has multiple and severe side effects

Question 11

What is the treatment of cryptosporidium parvum in an immunosuppressed patient

Answer 11

Reduce the dose of immunosuppressants and nitazoxanide

Question 12

What is the benefit of using fidaxomicin for recurrent C. difficile infections

Answer 12

Spares the anaerobic colonic flora

Question 13

What is the treatment of cryptosporidium in a patient with HIV

Answer 13

Antiretroviral therapy and nitazoxanide

Question 14

When is metronidazole used over vancomycin for a mild C. difficile infection

Answer 14

When the oral administration of Vancomycin wont work

Question 15

What is the pharmokinetics of iodoquinol

Answer 15

90% in the intestine and excreted in the feces

Question 16

What is the alternate treatment for:

-A. Lumbricoides

Answer 16

Ivermectin

Question 17

What is the treatment of choice for eradication of intestinal carriage of the organism (aka luminal amebicide)

Answer 17

Paromomycin or iodoquinol

Question 18

What is the mechanism of action for thiabendazole

Answer 18

Inhibits microtubule synthesis and causes paralysis

Question 19

Which drug has low efficacy for:

• N. americanus
• A. Duodenale

Answer 19

Ivermectin

Question 20

What is the primary treatment for:

-S.Stercoalis

Answer 20

Ivermectin

Question 21

What is the preferred antimicrobial agent given for cryptosporidium parvum

Answer 21

Nitazoxanide

Question 22

What is the mechanism of metronidazole

Answer 22

Messes with the ETC of the anaerobic bacteria

Question 23

What is the mechansim of action for albendazole

Answer 23

Inhibits microtuble synthesis and causes paralysis

Question 24

What are the side effects of nitazoxanide

Answer 24

Nausea, anorexia, enlarged salivary glands, yellow eyes, dysuria, bright yellow urine

Question 25

What is the antidiarrheal agents given for infection with cryptosporidium parvum

Answer 25

Loperamide

Question 26

What is the choice of treatment for elimination of invading entamoeba histolytica

Answer 26

Metronidazole and tinidazole | Must both be given to completely eradicate along with a luminal amebicide

Question 27

What are the pharmokenetics of praziquantel

Answer 27

Oral administration, excreted by the kidneys

Question 28

What are the treatments for H. Pylori

Answer 28

- omeprazole (PPI) - Metronidazole - Tetracycline - Bismuth subsalicyte (Peptol Bismol)

Question 29

What are the agents that can be given for infection with Giardia lamblia

Answer 29

- Tinidazole | - Nitazoxanide

Question 30

What are the alternate treatments for: - N. americanus - A. Duodenale

Answer 30

- Mebendazole | - pyrantel pamoate

Question 31

What is the treatment for cestode infection

Answer 31

Praziquantel Niclosamide Abendazole

Question 32

What is the mechanism of action for pyrantel pamoate

Answer 32

Neuromuscular blocker, causing the release of acetylcholine and inhibition of cholinesterase

Question 33

What is the treatment of choice for severe C. difficile infection

Answer 33

Vancomycin

Question 34

What is the mechanism of action for paromomycin

Answer 34

Aka aminoglycoside | -Prevents elongation of the 30S ribosome

Question 35

What are the pharmakinetics of nitazoxanide

Answer 35

Rapidly absorbed, excreted in the urine and feces

Question 36

What is the treatment of choice of recurrent C. Difficile infection

Answer 36

Fidaxomicin

Question 37

What is the primary treatment for: | -A. Lumbricoides

Answer 37

- Albendazole | - Mebendazole

Question 38

What is the mechanism of action for tetracycline

Answer 38

Binds to the 30S subunit and inhibits binding of the tRNA to complex

Question 39

What class of drug is omeprazole

Answer 39

PPI

Question 40

What is the treatment for the asymptomatic carriage 9 cysts or trophozoites without internalized RBCs

Answer 40

Luminal antibiotics aka paromomycin or iodoquinol

Question 41

What is the mechanism of tinidazole

Answer 41

Aka 5-nitoimidazole | -Messes with ETC and creating radical species

Question 42

What is the the mechansim of action for nitazoxanide

Answer 42

Inhibition of pyruvate ferredoxin oxidoreductase

Question 43

What is the mechanism of fidaxomicin

Answer 43

Aka macrolide | -Binds to P site of the 50S subunit

Question 44

What is the mechanism of action for mebendazole

Answer 44

Inhibits microtubule synthesis and causes paralysis

Question 45

What is the primary treatment for T.trichiura

Answer 45

Mebendazole

Question 46

What is the preferred treatment for a mild C. difficile infection

Answer 46

Metranidazole | Vancomycin

Question 47

What is the mechanism of action for niclosamide

Answer 47

Inhibition of the oxidative phosphorylation or stimulation of the ATPase activity

Question 48

What are the adverse effects of iodoquinol

Answer 48

Diarrhea, anorexia, nausea, vomiting , abdominal pain, headache, rash, itching

Question 49

What is the mechanism of action of vancomycin

Answer 49

Aka glycopeptide | -Prevent peptidoglycan synthesis by binding to the D ala D ala before they can be used to build

Question 50

What is the initial treatment of infection with Giardia lamblia

Answer 50

Correct the fluid and electrolyte abnormalities

Question 51

What is the effect of the luminal amebicides (paromomycin and iodoquinol) on extra-intestinal organisms

Answer 51

None

Question 52

Which parasite is niclosamide affective against, and which is it not

Answer 52

Effective against tapeworm infection, but not against hydatid cysts

Question 53

What is the diagnosis technique used for Trichuris trichiura

Answer 53

Football shaped eggs

Question 54

What is the mechanism of action for iodoquinol

Answer 54

Halogenated hydroxyquinoline

Question 55

What is the drug of choice for treatment of extraluminal amebiasis

Answer 55

Metronidazole

Question 56

What is the first line agent for infection with Giardia lamblia

Answer 56

-Tinidazole

Question 57

What are the pharmokenetics on pyrantel pamoate

Answer 57

Poorly absorbed, as half is lost in feces

Question 58

What is the primary treatment for: | -E. Vermicularis

Answer 58

- Albendazole - Mebendazole - pyrantel pamoate

Question 59

What are the side effects of praziquantel

Answer 59

- Immediate: headache, dizziness, drowsiness, lassitude | - Long term: low grade fever, skin rash and itching