Pharm for Parasites/protozoa/C. diff Flashcards Preview

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Flashcards in Pharm for Parasites/protozoa/C. diff Deck (44):
1

Drugs used for Nematodes

-Albendazole
-Mebendazole
-Pyrantel pamoate
-Diethylcarbamazine
-Ivermectin

2

Drugs used for Cestodes

-Albendazole
-Mebendazole
-Praziquantel
-Nicolsamide

3

Drug used for Trematodes

Praziquantel

4

What are the Soil-transmitted helminths

-Acaris
-hookworm
-Trichuris

5

In endemic areas, these drugs are used for treatment of children with helminth infections

-single doses of Albendazole or the older mebendazole
-These are Benzimidazoles

6

What is the Benzimidazoles that are only used for cutaneous infections

-Thiabendazole

7

MOA of benzimidazoles

bind to parasite b-tubulin, disrupt microtubule polymerization and microtubule dependent processes like attachment and glucose transport

8

Which benzimidazole has Poor absorption so low systemic exposure?

Mebendazole

9

Which benzimidazole has modest absorption and has metabolites that can affect tissue dwelling helminths, cysts, and is cleared renally

Albendazone-->Albendazole sulfoxide (active metabolite) --> Albendazole sulfone (inactive and cleared renally)

10

Benzimidazole used for larval migrans ONLY

Thiabendazole (has systemic toxicity)

11

Enterobius vermicularis (pinworm . . itchy butt children)

Mebendazole

12

Necator americanus and Ancylostoma duodenale (Hookworms)

Albendazole

13

Ascaris Lumbricoides

Albendazole OR Mebendazole

14

Trichuris trichuria (Whipworm)

Mebendazole or Albendazole (need 3 day course rather than single dose)

15

Toxacara (Larval migrans)

Albendazole

16

Benzimidazoles and pregnancy

teratogenic

17

Alternative/Adjunct Nematode therapy that is effective against hook, pin, and round worms but NOT Trichuris trichiura
-MOA: binds to N-AChR causing spastic paralysis and depolarization

Pyrantel pamoate

18

What is the indication for Pyrantel pamoate therapy

HEAVY Ascaris infection

19

Pregnancy and Pyrantel Pamoate

Can use but be cautious

20

Indications for Ivermectin

-Intestinal Strongloidyiasis (thread worm)
-Onchocerciasis (River Blindness)
-Also Lymphatic Filariasis (Wuchereria bancrofti and Brugia malayi)

21

MOA of Ivermectin

-inactivates Glutamate-gated chloride channels causing hyperpolarization and paralysis

22

When is Ivermectin contraindicated

-when BBB is disrupated like meningitis and trypanosomiasis

23

What are the intestinal Cestodes (Tapeworms)

-Cysticercosis
-Echinococcosis
-Taeniasis (pork and beef)
-Diphyllobrothriasis (fish)

24

What is the drug of choice for all ADULT form (Taenias and diphyllobothrium) tapeworm infections in US?

Elsewhere?

Praziquantel

Niclosamide

25

Drug of choice for LARVAL forms (Cysticercosis and Echinococcus granulosus/cystic hydatid disease) of tapeworm infections?
What is an adjunct therapy you can add on?

Albendazole

Praziquantel

26

What is a contraindication for Praziquantel therapy

treatment of ocular cysticercosis . . . destruction of organism in the eye may damage the eye

27

What are the intestinal trematodes/flukes

Schistosomiasis

28

What would you look for in a stool sample that has schistosomisasis

A spear head coming of the trematode

29

drug of choice for schistosomiasis

praziquantel

30

MOA of praziquantel

-interferes with calcium homeostasis and causes flaccid paralysis in adult flukes
-causes antigen within parasite to be exposed to action of host antibodies

31

Drug list for anti protozoal/antiamebic agents

-Metronidazole
-Tinidazole
-Nitazoxanide

LUMINAL AMEBICIDES
-Iodoquinol
-Diloxanide
-Paromomycin

32

Metronidazole extensively used to treat what?

What is unique about these organisms is used to target them?

-Entamoeba histolytica
-Giardia Lamblia

Lack mitochondria and do not rely on pyruvate dehydrogenase

33

Explain the metabolism of E. histolytic and G. lamblia

Pyruvate -->pyruvate-ferredoxin oxidoreductase (PFOR)-->this activates metronidazole and damages DNA

34

Drug of choice for E. histolytica?

G. Lamblia?

Metronidazole

Tinidazole

35

Adverse effects of Metronidazole/Tinidazole?

-Metallic taste
-Disulfiram-liek reaction - with intake of acohol -->abdominal distress, vomiting, flushing, headache, alcohol-withdrawal symptoms

36

-one celled parasite
-can invade liver and form abscess

E. histolytica

37

Symptomatic or invasive colitis is treated with what?

metronidazole followed by luminal amebicide (such as paromomycin, diiodohydroxyquin, or diloxanide furoate) to elminate intraluminal cysts

38

-aminoglycoside (not orally absorbed)
-Bind to 30S ribosome to disrupt protein synthesis
-drug of choice for colonization of intesting with E. histolytica
-Alternative to metronidazole for E. histolytica infection during PREGNANCY

Paromomicin

39

Flagellated protozoan parasite

Giardia Lamblia

40

Rice paddy fields?

Treatment?

schistosomiasis

Praziquantel

41

Low CD4 count . . less than 100?

Treatment?

cryptococcosis

Tenovovir-Emtricitabine-Efavirenz

42

Patient with C. diff . . doesn't respond to metronidazole. give this next ORALLY to treat the diarrhea

Vancomycin

43

Recurrent hospital acquired infectious colitis (C. diff) . . . ICU acquired also

Fidaxomicin

44

1st choice for C. Diff?

Recurrence?

ICU?

-metronidazole

-Vancomycin

Fidaxomicin