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26 Cards in this Set
- Front
- Back
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Amphotericin B : class MOA -6 uses -how do you give it for meningitis |
-polyene binds ergosterol and forms membrane pores that allow leakage of electrolytes -serious systemic mycoses -crypto, blasto, coccidioides, histo, candida, mucor -intrathecally for fungal meningitis
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Amphotericin what do you supplement and why? -toxicity (6) -what should you do to decrease certain tox -what decreases overal toxicity -what causes all these side effects? |
-supplement K and Mg bc of altered renal tubule permeability -fever/chills (shake and bake), hypotension, nephrotoxicity, arrhythmias, anemia, IV phlebitis -hydration decreases nephrotoxicity -liposomal amphotericin decreases toxicity -its binding cell membrane cholesterol |
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Nystatin -only used how? -uses (3) |
topically (oral too toxic) -"swish and swallow for thrush (oral candida), diaper rash, vaginal candida |
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azoles MOA uses: -fluconazole -itraconazole -clotrimazole, miconazole |
inhibit ergosterol synthesis by inhibiting 14,a-demethylase (cytochrome P450 enzyme that converts lanosterol to ergosterol) USE: -fuconazole for chronic suppression of crypto in AIDS and candida of all types -Itraconazole for blasto. coccidioides, histo -clotrimazole and miconazole for topical fungal infecitons |
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azoles toxicity |
tstosterone synthesis inhibition (gynecomastia eps with ketoconazole), liver dysfunction (inhibits p450) |
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Flucytosine MOA use tox
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inhibits DNA and RNA biosynthesis by conversion to 5-fluorouracil by cytosine deaminase -use: systemic fungal infections (esp crypto meningitis) in combo with amphotericin B -tox: bone marrow suppression |
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Echinocandins -ending -MOA -2 uses -2 tox |
fungins: caspofungin, micafungin, anidulafungin -inhibit cell wall synthesis by inhibiting synthesis of B glucan uses: invasive aspergillosis, candida -tox: GI upset, flushing (histamine release) |
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Terbinafine MOA USE (especially) -4 tox |
MOA: inhibits the fungal enzye squalene epoxidase -use: dermatophytoses (esp onchomycosis aka finger/toe nails) -GI upset, headache, hepatotoxicity, taste disturbance |
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Griseofulvin MOA deposits in use tox |
MOA: interferes with microtubule function; disrupts mitosis -deposits in keratin containing tissues (nails) -oral treatment of superficial infections; inhibits growth of dermatophytes (tinea/ringworm) -tox: teratogen, carcinogenic, confusion, headaches, induces P450 and warfarin metabolism |
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how do you treat toxo |
sulfadiazine and pyrimethamine |
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how do you treat trypanosoma brucei |
suramin for blood born disease and melarsoprol for CNS penetration |
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how do you treat E histolytica? what about for asymptomatic cyst passers? |
metronidazole, -iodoquinol for asymptomatic cyst passers |
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how do you treat cryptosporidium in immunocompetent |
nitazoxanide |
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What has been effective for a few people with Naegleria fowleri? |
amphotericin |
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plasmodium treatment begin with -if resistant? if life threatening which ones do you have to test for G6PD |
begin with chloroquine, if resistant use mefloquine or atovaquone/proquanil -if life threatening: IV quinidine (test for G6PD def) -primaquine for hyponozoites of vivax/ovale -test for G6PD def |
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babseia treatment (2) |
atovaquone and azithromycin |
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trypanosoma cruzi treatment 2 options |
benznidazole or nifurtimox |
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Leishmania donovani treatment 2 |
amphotericin B, sodium stibogluconate |
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trichomonas |
metronidazole (and treat partner) |
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enterbious vermicularis (pinworm) treament -2 options |
bendazoles or pyrantel pamoate |
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ascaris lumbricoides (giant roundworm) treatment (2 options) |
bendazoles or pyrantel pamoate |
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strongyloides treatment (2 options) |
ivermectin or albendazole |
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onchocerca volvulus treatment |
ivermectin |
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loa loa treatment |
diethylcarbamazine |
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wuchereria bancrofti treatment |
diethylcarbamazine |
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toxocara canis (2 options) |
albendazole or mebendazole |
