myco/fungi/scabies/helmninth Flashcards Preview

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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

list the antihelmninthic therapies

mebendazole
pyrantel pamoate
ivermectin
diethylcarbamazine
praziqantel