Flashcards in myco/fungi/scabies/helmninth Deck (82):
1
prophylaxis for mycobacterium tuberculosis
isoniazid
2
treatment of mycobacterium tuberculosis
RIPE
rifampin
isoniazid
pyrazinamide
ethambutol
3
prophylaxis of mycobacterium avium-intracellulare
azithromycin
rifabutin
4
treatment for mycobacterium avium-intracellulare
azithromycin or clarithyromycin and ehtambutol
can add rifabutin or ciprofloxacin
5
azithromycin/clathrithromycin and ethambutol and can add rifabutin or ciprofloxacin for?
treatment for mycobacterium avium-intracellulare
6
treatment fo mycobacterium leprae - tuberculoid form
long term with dapson and rimapine
7
treatment of mycobacterium leprae - lepromatous form
dapsone, rifampin, clofazimine
8
treat ? with this: dapson, rifampine, clofazimine
mycobacterium leprae
9
what is the MOA of rifampin and rifabutin
inhibit DNA dependent RNA polymerase
10
what antimycobacterial drugs inhibit DNA dependent RNA polymerase
rifampin and rifabutin
11
what is the clinical use of rifampin and rifabutin?
m TB
delay resistance to dapson @ M leprae
meningococcal prolylaxis and chemoprophylaxis in contacts of children with HIB
12
toxo of rifampin and rifabutin
minor hepatotoxicity and increases P450
orang body fluids
13
which rifamycin is preferred in HIV patients and why
rifabutin bc stimulates cytochrome P450 less
14
what is the mechanism of resistance of rifampin and rifabutin
mutationed reduces drug binding to RNA polymerase
monotherapy - increased resistance
15
what are rifampins FOUR Rs?
RNA polymerase inhibitor
ramps up microsomal cytP450
red/orange body fluids
rapid resistance if used alone
16
what is the MOA of isoniazid
decreases synthesis of mycolic acids
bacterial catalase peroxidase encoded by KatG is needed to activate to its active metabolie
17
what is isoniazid used for
m TB
ONLY antimycobacterial that can be used on its own
18
what are the toxicities of isoniazid
neurotoxicity - can prevent with B6
hepatotoxicity
19
what is the mechanism of resistance of isoniazid
mutations that lead to underexpression of KatG
20
how can you decrease the neurotoxicity of isoniazid
give em B6
21
what is the MOA of pyrazinamde
unknown
22
what is the cxl use of pyrazinamide
M Tb
23
what are the a/se of pyrazinamde
hyperuricemia
hepatotoxcity
24
what is the MOA of ethambutol
decreases carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase
25
what is cilinical sue of ethambutol
m TB and with azithromycin/clarithromycin for MAC (Can add rifabutin or ciprofloxacin)
26
a/se of ethambutol please
optic neurpathy - red gree colour blindness
27
what is the MOA of amphotericin B
binds ergosterol to form membrane pores that allow electrolytes through
28
clinical use of amphotericin B
serious systemic mycoses
29
treat Cryptococcus meningitis!
amphotericin B and flucytosine
30
treat systemic blastomyces, cocciodies, histoplasma, candida please
amphotericin B
31
treat serious mucor!
amphotericin B
32
what do you need to supplement treatment of amphotericin B with
potassium and magnesium - altered renal tubule permeability
33
what are the toxicities fo amphotericn B
FEVER and CHILLES (shake and bake)
hypotension
nephrotoxicity
arrhythmias
anaemia
IV phlebitis
34
how to decrease nephrotoxicity in amphotericin B
hydrate
35
what form of amphotericin can decrease toxicities?
liposomal
toxos: nephrotoxicity, hypotension, arrhythmias, fever, chills, IV phlebitis
36
what is the MOA of nystatin
same as amphotericin B
binds to ergosterol and makes pores in membrane so electrolytes leak
37
what is the clinical use of nystatin
topical only bc too toxic for systemic use
swish and swallow for oral candidiates
topical at diaper rash and vaginal candidaisis
38
treat diaper rash @ the munchkins!
nystatin
39
treat vaginal candidiasis @ the ladies!
nystatin
40
treat oral candidiasis @ the immunocompromised
nystatin
41
what is the MOA of flucytosine
DNA and RNA biosynthesis inhibition
converted to 5-FU by cytosine deaminase
42
what is the use of flucoytosine
cryptococcal systemic/meningitis with amphotericin B
43
what is the toxo of flucytosine
bone marrow suppression
44
list the azoles
clotrimazole
fluconazole
itraconazole
ketoconazole
miconazole
voriconazole
45
what is the moa of the azoles
inhibit funcal sterol/ergosterol synthesis by inhibiting the cytochrome _450 enzyme that converts lansterol to ergosterol
46
what are azoles used for
less serious systemic and local mycoses
47
treat: chronic suppression of cyroptococcal meningitis in AIDS patients
fluconazole
48
treat: candida infection of all types
fluconazole
49
treat: blacstomyces, cocciodiosis, histoplasmosis non serious systemic
itraconazole
50
treat topical funcal infections
clotrimazole
miconazole
51
what is fluconazole used for
chronic suppression fo cryptococcal meningitis in ADIs patients
candida infetino of all types
52
what is itraconazole used for
balstomyces, cocciodiosos, histplamsoms - not so serious infections
53
what are clotrimazole and miconazole used for
treatment of topical fungal infections
54
what is the moa of terbinafine
inhibits the funcal enzyme squalene epoxidase
55
used of terbinafine
dermatophytoses - especially onychomycosis
56
whats the toxo of terbinafine
gi upset
headaches
hepatotoxicity
taste disturbance
57
what are the toxo fo azoles
testosterone synthesis inhibition - gynecomastia especially @ ketoconazole
liver dysfunction - inhibits cytochrome P450
58
list the echinocandins
anidulaFUNGIN
caspoFUNGIN
micaGUNFIN
59
what is the MOA of anidulafungin, caspofungin, micafungin
echinocandins: inhibit cell wall synthesis by inhibiting synthesis of beta glucan
60
what is the clinical use fo echinocandins
invasive aspergillosis candida
61
treat invasive aspergillus!
echinocandin!!
anidulaFUNGIN
caspoFUNGIN
micaFUNGIN
62
what are the a/se of anidulafungin, caspofungin, micafungin
gi upset
flushing
HISTAMINE RELEASE
@ echinocandins
63
what is the MOA of griseofulvin
interferes with microtubule founction - fustuprs mitosis
deposts in keratine containing tissues
64
what are your options of dematophyte infections
terbinafine and girseofulvin
65
cxl use of griseofulvin please
oral reatment of superficial infections
inhibits growth of fermatophyts - tinea and ringworm
66
what is the toxicity of griseofulvin
teratogenic
carcinogenic
confusion
heaaches
increases cytP450 and warfarin metabolism
67
toxoplasmosis thearphy please
pyrimethamine
68
treatment of trypansoma brucei pelase
seramin and melarsoprol
69
treatment of T cruzi
nifurtimox
70
treatment of leishmaniasis
sodium stibogluconate
71
list the drugs used for mite/louse treatment
permethrin
malathion
lindane
72
what is the use and moa of permethrin
scabies and lice
blocks Na channels - neurotoxicity
73
what is the use and moa of malathion
scabies and lice
inhibit acetylcholinesterase
74
what is the use and moa of lindane
blocks GABA channels - neurotoxicity
scabies and lice
75
permethrin
malathion
lindane
?
scabies and lice
76
function of chloroquine
inhibits the conversion of heme into hemozoin - heme accumulates and is toxic to the plasmodia
77
what is chloroquine used for
plasmodia EXCEPT falciparum
78
how is falciparum resistant to chloroquine?
membrane pump that decreases intracellular drug concentration
79
how do you treat plasmodium falciparum
artemether/lumefantrine
OR
atovaqone/proguanil
80
what ot use for life threatening malaria?
quinidine or artesunate
81
what toxos to worry about with chloroquine
retinopathy
prurutis esp at dark skinned individuals
82