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19 Cards in this Set

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mebendazole
antihelminthic

MOA: inhibits glucose uptake

use: broad action, except strongyloides and echinococcus (hydatid disease)

(category: energy metabolism)
albendazole
antihelminthic

MOA: causes degeneration of intestine and tegument of helminths

use: hydatid disease (echinococcus - a cestode)
thiabendazole
antihelminthic

Z: strong thiaghs ->strongyloides

MOA: inhibits fumarate reductase

USE: broad spectrum, drug of choice for strongyloides
*also for saprophytic pathogenic fungi

antipyretic, antiinflammatory, and analgesic. this prevents some of the tissue damage from adaptive immunity
ivermectin
antihelminthic

Z: alan iverson became paralyzed, GABA

USE: heartworm and sleeping sickness, also strongyloides

MOA: potentiates GABA action - paralysis
niclosamide
antihelminthic

Z: cestodes and NICKELS are flat

USE: cestodes

MOA: inhibits glucose and oxygen uptake
praziquantel
antihelminthic

Z: prazi is the wonderful drug b/c of its synergism and lack of side effects.

USE: all trematodes (incl. schistosomiasis), some cestodes

MOA: increases membrane permeability to Ca - tetany/death

* syngergism b/t immune system and drug

No side effects, great drug!
metrifonate
antihelminthic

Z: fo - phosphate, organophosphate

USE: schistosomiasis

MOA: organophosphate, irreveresible AchE inhibitor. In schistosomes, Ach is the anti-movement NT, so metrifonate causes paralysis. active only against h. haematobium in vivo b/c it lets go and winds up in lungs instead of liver. in lungs it can be killed. h. mansoni and h. japonicum let go and wind up in liver, where they can recover
niridazole
antihelminthic

MOA: glycogen phosphorylase can't be inactivated, all glycogen is used up and organism dies

use: schistosomiasis, cheap drug, used in Africa
oxamiquine
antihelminthic

Z: "The Ox!" - nucleic acids

MOA: may inhibit nucleic acid utilization

USE: S. mansoni, American strains, some African
amphoterecin B
polyene antifungal

binds to ergosterol and acts as a pore. osmotic death (cidal)

low TI - nephrotoxicity!

broad spectrum, but nephrotoxicity limits its use
decreases renal blood flow ->tubule ischemia and death

don't give with other nephrotoxic drugs or in person with renal condiction

also - infusion related toxicity - the shake and bake - rigors and chills, fever

concentration dependent killing (makes sense)

lipid preparartions (liposomal, phospholipid, cholesterol disc)
decrease nephrotoxicity and infusion related shake and bake
also penetrate the CNS so it can be used for cryptococcal meningitis
ketoconazole
azole antifungal (inhibit 14alpha demethylase - ergosterol synthesis)
itroconazole
azole antifungal (inhibit 14alpha demethylase - ergosterol synthesis)

Itro is good against Endemic Fungi (Coccidioides, Histoplasma, Blastomyces, Sporothrix).

Z: CAHABA is an INTRO to whitewater. must take food down the intro cahaba.
posaconazole
azole antifungal (inhibit 14alpha demethylase - ergosterol synthesis)

posa is only effective treatment for Zygomyces
must eat a fatty meal for absorption

Z: RAMZ is a POS (Piece of Shit)
fluconazole
azole antifungal (inhibit 14alpha demethylase - ergosterol synthesis)

Z: flu is important!

Fluconazole is the most important treatment for:
1. systemic and mucosal CANDIDA infections
2. Cryptococcal meningitis. use Amb + Fluconazole. can also use 5FC instead of fluconazole.
voriconazole
azole antifungal (inhibit 14alpha demethylase - ergosterol synthesis)
Vori S/E: photopsia - tripping on acid! - strange colors/lights

Vori + echinocandin is first line for aspergillus
Z: (voracious asparagus)
anidulafungin
Echinocandin anitfungal

Echinocandins inhibit glucan (CW) synthesis and are fungicidal (osmotic death)

used almost exclusively for
1. candida
2. aspergillus (with voriconazole)

IV only (too large and charged)

AUC/MIC must be > 10
Conc dep killing
AUC24/MIC > 10 or peak/MIC
AmB
Echinocandins
flu & posa

hepatic metabolism (watch out for liver failure)
caspofungin
Echinocandin anitfungal

Echinocandins inhibit glucan (CW) synthesis and are fungicidal (osmotic death)

used almost exclusively for
1. candida
2. aspergillus (with voriconazole)

IV only (too large and charged)

AUC/MIC must be > 10

hepatic metabolism (watch out for liver failure)

Conc dep killing
AUC24/MIC > 10 or peak/MIC
AmB
Echinocandins
flu & posa
micafungin
Echinocandin anitfungal

Echinocandins inhibit glucan (CW) synthesis and are fungicidal (osmotic death)

used almost exclusively for
1. candida
2. aspergillus (with voriconazole)

IV only (too large and charged)

AUC/MIC must be > 10

hepatic metabolism (watch out for liver failure)

Conc dep killing
AUC24/MIC > 10 or peak/MIC
AmB
Echinocandins
flu & posa
flucytosine
antifungal - blocks DNA synthesis (pyrimidine synth) and RNA synth (protein synth)

used with AmB for cryptococcal meningitis b/c it penetrates the CNS and eye very well

s/e: bone marrow suppression, GI probs (just like a chemo drug)

Time > MIC
flucytosine
vori & itra