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36 Cards in this Set
- Front
- Back
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Imidazoles
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All are hepatotoxic but fungicidal
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Fluconazole
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DOC: most fungal infections, thrush, non-disseminated coccidioidomycosis, and cryptococcal infections (not meningitis)
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Miconazole
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DOC: vaginal candidiasis.
used topically. Alternate: HIV+ - nystatin HIV neg - fluconazole |
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Clotrimazole
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topical agent
oropharyngeal candidiasis |
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Itraconazole
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broad spectrum, very potent - more hepatotoxic
use limited to resistant or severe systemic fungal infections. DOC: blastomycosis, histoplasmosis, and sporotrichosis |
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Posaconazole
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Alternate DOC: mucormycosis (mold, Rhizopus, related fungi)
actual DOC is Amphotericin B |
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Voriconazole
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very potent
DOC: aspergillosis (alt is amp B), rare but aggressive fungal species like Scedosporium apiospermum. May cause skin reactions, photosensitivity, hepatotox, visual change. LFT and creatinine tests |
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Ketoconazole
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severe infections, but rarely used due to toxicity
toxicity due to suppression of testosterone and cortisol production. DOC: tinea versicolor |
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Amphotericin B
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Binds to ergosterol and inhibits it. Forms a pore through which electrolytes cross at will - kills cell.
severe nephrotox alternate DOC: aspergillus and mold infections known as mucormycoses (Rhizopus or related molds), and fusarioses (fusarium spp.) one of 2 drugs used for cryptococcal meningitis (with flucytosine). lipid-based amp b and liposomal amp b preferred due to lower SE. |
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Nystatin
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similar actions to amp b, but used topically because high systemic tox.
used for thrush (DOC: fluconazole). Alternative treatment for vaginal candidiasis in HIV+ pts (DOC: miconazole) |
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Flucytosine
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nucleoside analog - inhibits DNA synthesis.
1st line drug for treatment of cryptococcal meningitis (with amp b) bone marrow suppression |
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Terbinafine
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DOC: onychomycosis (fungal nail infections) and tinea capitis (ringworm of scalp).
Works to inhibit ergosterol by inhibiting squalene epoxidase. severe hepatitis |
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Butenafine
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same MOA as terbinafine.
Topical agent. DOC for all types of tinea (ringworm; dermatophytosis) except tinea capitis |
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Griseofulvin
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disrupts mitotic spindles (inhibiting mitosis).
Drug accumulates in keratin (skin and nails). Treats dermatophytic infections (tinea), but only used as an alternative to the DOC (terbinafine for tinea capitis) and (butenafine for tinea corporis, cruris, and pedis) |
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What is the DOC for the prophylaxis of malaria in chloroquine-sensitive areas?
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Chloroquine or atovaquone-proguanil
Chloroquine in pregnant females too |
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What is the DOC for the prophylaxis of malaria in areas of known chloroquine-resistance?
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atovaquone-proguanil
2nd line - mefloquine or doxycycline mefloquine if pregnant |
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Doxycycline
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protein synthesis inhibitor
discolors developing teeth |
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Mefloquine
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MOA similar to chloroquine
effective even against chloroquine resistant Falciparum. has serious ADRs (MI, psychosis, seizures) exacerbates G6PD |
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Atovaquone
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ubiquinone analog - inhibiting the protozoans ETC
limits ATP synthesis teratogenic |
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Chloroquine
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poisons the malarial organism, physical destruction, starves them, and inhibits DNA synthesis.
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DOC for chloroquine resistant Plasmodium falciparum
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quinine plus one of doxycycline, tetracycline, clindamycin
also can use atovaquone-proguanil or mefloquine If pregnant - quinine plus clindamycin (only choice) |
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What is chloroquines MOA
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Transforms heme into a toxin - poisons Plasmodia
Forms complexes that lyse the Plasmodia and the RBCs that contain Plasmodia Alkalizes the Plasmodia food vaculoe (needs to be acidic) - starves organism Inhibits Plasmodia DNA synthesis |
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DOC for malaria caused by chloroquine-resistant P. Vivax?
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quinine plus either doxycycline or tetracycline PLUS primaquine.
alternative mefloquine PLUS primaquine |
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Quinine
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causes cinchonism
Inhibits Plasmodial DNA synthesis |
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Primaquine
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kills any malarial organism in liver.
Prevents gametocyte formation Prevents malaria spread to other people |
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Artemether
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combined with Lumefantrine - used for chloroquine-resistant plasmodium falciparum.
Resolves parasitemia and fever and has gametocidal effect. |
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Metronidazole
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DOC: trichomoniasis and amoebiasis.
alternate for Giardia lamblia Binds to proteins and DNA causes organism death. |
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Tinidazole
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similar to metronidazole
alternate DOC for amoebiasis better side effects, less powerful |
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Stibogluconate
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inhibits glycolysis
DOC for cutaneous leishmaniasis. |
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What is the treatment for early stage East African sleeping sickness? West?
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Suramin
Pentamidine |
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What is the treatment for both East/West African sleeping sickness in late stage?
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Melarsoprol
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Treatment for Chagas Dx?
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Nifurtimox - only if localized
creates radical O2 species that destroys enzymes, killing the organism |
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Trimethoprim-sulfamethoxazole
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DOC: pneumocystis jiroveci (P. carinii)
DOC: toxoplasma encephalitis inhibits folate manufacture and use (inhibits DNA synthesis) |
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What is the DOC for flatworms?
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Praziquantel - except echinococcus granulosus
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DOC for most roundworms?
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albendazole or mebendazole
bind to tubulin and prevent microtuble formation. inhibits glucose uptake Trichinosis is only Abendazole Ivermectin is used for Strongyloides stercoralis |
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What is the DOC for head and pubic lice? Body lice?
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Permetherin - cream/lotion - rapid and permanent paralysis
Malathion or permethrin - treat the bedding and clothing, not the patient |
